Mammary dysplasia

Medical statistics are disappointing and voice quite frightening figures of diseases affecting the mammary gland of women. And every year these figures are increasing. One of such pathologies is dysplasia of the mammary gland, the varieties of which affect from 30 to 63 percent of the fair sex.

But if a woman’s medical history includes gynecological pathologies, then this figure is alarmingly close to 95%.

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Causes breast dysplasia

So why does this disease appear and how does it manifest itself symptomatically? To avoid such a lesion or take adequate therapeutic measures, it is necessary to know the causes of breast dysplasia and pay special attention to your health. This disease behaves quite easily.

And it's not that ignoring its symptoms allows it to transform into a malignant neoplasm. Even in its benign form, breast dysplasia (also called fibrocystic mastopathy) causes significant discomfort to a woman.

• One of the main causes of breast dysplasia is a hormonal imbalance. If the quantitative component of progesterone and/or estrogen changes upward or downward, the likelihood of developing this disease increases sharply. In addition, the following can be attributed primarily to such an imbalance:
  • Decreased production of thyroid enzymes (hypofunction).
  • Hyperandrogenism is an increase in the level of male sex hormones (androgens) in women.
  • Hyperprolactinemia is a condition of the body in which the pituitary gland produces an excess amount of the hormone prolactin.
• The impetus for the development of the disease can be apoptosis (a type of cell death in which the cell itself actively participates in the process of its self-destruction). This disease is accompanied by an inflammatory process that worsens the structural and physiological position of the glandular tissues and the capillary system of the mammary glands. The consequences of such a metamorphosis can be very deplorable.
• Long-term emotional stress:
  • Conflict situation of a domestic nature.
  • Difficult psychological atmosphere in the work team.
  • Sexual dissatisfaction. Other factors of a sexual nature.
• In many ways, the development of breast dysplasia depends on the condition of the female reproductive organs. And this concerns not only the breast, but also the pelvic organs.
• The time when a woman's first menstrual cycle began, its subsequent natural course and the presence or absence of failures also play a significant role. Women who experience menarche (the first menstrual bleeding) quite early are at a higher risk of having a history of breast dysplasia.
• The timing of menopause is also important. If menopause occurs after fifty, such a woman has a higher chance of acquiring the disease in question.
• The probability of defeat also increases with the growth of the number of abortions, both spontaneous and artificially induced.
  • Inflammation occurring in the pelvic organs:
  • Uterine fibroids.
  • Endometrial hyperplasia.
  • And others.
• The source of breast dysplasia can be hepatopathy (liver pathology), as well as problems with metabolic processes in the woman’s body.
• If a woman has a history of the disease in her family, her chances of getting the disease increase tenfold.

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Symptoms breast dysplasia

The clinical picture of the disease shows the following symptoms of mammary gland dysplasia:

• The woman is bothered by painful symptoms in the chest area, which increase in intensity during the premenstrual period.
• Pain symptoms are observed to vary in intensity and nature of manifestation.
• In most cases, it subsides once the bleeding stops.
• If the problem is not nipped in the bud, the pain intensity increases and begins to affect larger areas. The axillary, shoulder and scapular areas fall into the pain zone.
• Sleep problems may be observed.
• Cancerophobia gradually develops – the fear of further transformation of a benign tumor into a malignant neoplasm.
• Depressive moods appear.

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Forms

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Benign mammary dysplasia

If proliferative changes in connective, epithelial tissues (abnormal ratio) begin to occur in the chest area, which are regressive in nature, and fibromatous-cystic formations are formed, doctors diagnose benign dysplasia of the mammary gland (BMD). Diseases of this group dominate among all pathological changes occurring in the mammary gland.

This category includes mastopathy and fibrocystic lesions of the mammary glands. According to unverified data, this type of disease occurs in 60 to 90 percent of women. These figures were obtained based on histological studies of the mammary glands of women who died from various causes.

Benign breast dysplasia is divided into two categories:

• The proliferative variety of benign dysplasia is a predominant division of the myoepithelia and epithelium of the ducts or lobes. Less often, but it occurs when connective tissues are also involved in this process. In the case of proliferative processes in the mammary gland, the probability of degeneration into cancer cells increases by two to five times, and in especially difficult cases, by 14 times.
• In the case of a non-proliferative variety of benign dysplasia, the growth mainly affects fibrous cells, and the enlargement of the ducts occurs according to the cystic variant. In this case, the formation of one node or a conglomerate of nodes is observed, mainly this process occurs in one gland. Less common are cases when the neoplasm has developed from hyalinized (thickened fibers) cicatricial connective tissue, which is localized around atrophic lobes. In this case, the risk of developing cancerous neoplasms is quite small.

A benign compaction consisting of spread connective and glandular matter (fibroadenoma) is represented by a capsule of fibrous texture and is considered as a proliferation of the epithelial layer of the alveoli, connective cells and ducts of the intralobular zone. According to statistics, fibroadenoma degenerates into cancer in 20 to 50% of cases, according to various sources. Although there are also experimenters who categorically deny any risk of malignancy of this category of neoplasm.

Another benign neoplasm is intraductal papilloma. It is diagnosed as peri-papillary formations formed from ductal epithelium. Less common are cases when cystic enlargement of the ducts themselves is added to this symptomatology. If there is only one papilloma, it is not subject to malignancy, but in the case of multiple neoplasms, the possibility of degeneration into cancer increases four to six times.

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Dyshormonal dysplasia of the mammary glands

Breast mastopathy includes a wide range of heterogeneous diseases that differ from each other in both etiological and morphological characteristics, are represented by different clinical pictures, but all of them are associated with disturbances occurring in the structural structure of various cells of the mammary glands.

Dyshormonal dysplasia of the mammary glands (or as it is called, mastopathy) is a fibrocystic disease defined as a failure in the proportionality of the division of connective and epithelial cells, aggravated by all sorts of proliferative processes of a regressive nature, radically changing the tissue component of the mammary gland.

Medical professionals distinguish between several types of dyshormonal dysplasia.

1. First of all, it is necessary to dwell on nodular mastopathy, the parameters of which are single or multiple neoplasms of the nodular type. They, in case of diagnosis, are defined as local fibrosis, fibromatosis, adenosis, fibroadenomas, cysts and adenofibromas.

This type of pathology is quite difficult to diagnose, since very often the clinical picture of the disease is similar to both benign and cancerous pathologies. Sometimes even cytology, X-ray examination, and sonography do not help to make a clear diagnosis. Having received ambiguous examination results, the doctor has clear indicators that determine his further actions. The doctor, operating with relative and absolute indicators, accepts or rejects a decision on surgical intervention, forms a treatment protocol.

2. The second type of pathology can be called diffuse mastopathy, which has its own subtypes.

• Adenosis is a diffuse mastopathy with a predominantly glandular component. This disease is more common in women of childbearing age, but who have not yet become mothers (i.e., have not given birth). Symptoms of the pathology are pain in the mammary glands that occurs when pressing on the chest. After the end of menstruation, the pain symptoms subside somewhat or completely cease to bother. X-ray shows high contrast of formations, heterogeneity of the structure of glandular tissues. Small seals with blurred edges with a diameter not exceeding one and a half centimeters are observed.
• Fibroadenomatosis is a diffuse mastopathy with a predominantly fibrous component. Pain symptoms are quite moderate. When palpating breast tissue, fibrous compactions are differentiated, highlighted on the radiograph as uniform darkened areas.
• Diffuse mastopathy with a predominantly cystic component. The clinical picture of the disease is represented by bursting pains in the mammary glands. When pressing, numerous lumps of elastic texture with clearly defined boundaries are palpated. Large cysts are quite visible on an X-ray - oval or round areas of uniform texture, multiple small ones - polycystic - are practically indistinguishable on mammograms. An ultrasound examination of the mammary glands (ultrasound of the mammary glands) will help confirm or refute the diagnosis of this type of pathology. It is this examination that allows the doctor to specify the problem.
• Fibrocystic mastopathy is a mixed form of this pathology, most often diagnosed by mammologists, with a particularly high percentage of lesions in women aged 35 to 40 years. The disease can affect one or both breasts. On an X-ray, it is represented by a pattern in the form of a mixture of large loops with compacted spots with a blurred outline. In addition to pain symptoms, minor discharge may be observed coming from some ducts, and regressive changes are visible in the structure of the gland. The doctor prescribes a ductogram, which shows what changes the milk ducts have undergone and the size of the cysts that have formed. Quite often, an inflammatory process can be observed in the subareolar milk ducts, which leads to expansion of the ducts.

3. Other benign neoplasms:

• Papilloma within the ductal zone.
• Cyst.
• There are also special types of benign tumors – phylloid or leaf-shaped neoplasms.

The main reason for the transformations occurring in the gland is the reaction of epithelial cells and stroma that occurs in the woman’s body against the background of hormonal imbalance.

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Severe mammary dysplasia

A precancerous condition is a congenital or acquired through life experiences deformation of tissue layers, which subsequently becomes the basis for transformation into cancerous neoplasms.

Severe dysplasia of the mammary gland is dysplasia of stage III, when atypism of the epithelial layer affects 2/3 or more epithelial cells. In their multilayered structure, foci of proliferation with a non-uniform structure arise. Proliferation affects the entire cell: hyperchromatosis of cell nuclei and growth of its size pass, polymorphism and basal cell hyperplasia are observed.

In the layers of glandular epithelium, the severity of dysplasia is determined by the disorganization of the structural features of these neoplasms. The glands are located chaotically or take on a branched character, while they are distinguished by atypical characteristics. A failure in the work of secretions is observed. Both an increase and a weakening of this function can be diagnosed.

In most cases, severe breast dysplasia malignizes into malignant tumors. However, the causes that become the catalyst for transformation are still not completely clear.

Mild and moderate stages of dysplasia are partially or completely reversible in their morphology, while in severe cases tissue regeneration is no longer possible and the only treatment method is complex therapy, which combines surgical intervention with drug support. Initially, pathological changes begin to capture the cambial areas, subsequently spreading along the maturation line of the same tissues.

Some researchers perceive the severe stage of dysplasia as "imperfect cancer". In the chain of progressive development of the disease, malignancy is the final stage in cancerous degeneration. There is a term such as carcinoma in situ, which defines the state of cancerous tumors that are devoid of infiltrates, epithelial cells are replaced by atypical ones, but at the same time the basement membrane is still differentiating and malignant cells have not penetrated into the underlying tissue layers.

Based on the above, severe breast dysplasia is a rather dangerous pathology that can transform into cancer, while the causes of degeneration and the catalyst of the process are unknown. Therefore, it is very important to contact a specialist in a timely manner and establish a diagnosis at an early stage.

Fibrous dysplasia of the mammary gland

Fibrosis is a proliferation of connective tissue, accompanied by the development of scar fibers due to chronic inflammation. Any disease of this localization is very dangerous, since for unknown reasons it can degenerate into a cancerous tumor. Fibrous dysplasia of the mammary gland mainly develops against the background of hormonal imbalance: there is a deficiency of progesterone and excessive production of estrogens. This condition of the body occurs in almost half of women.

At an early stage of the pathology, it is impossible to recognize the disease, as it is practically asymptomatic. It can only be diagnosed accidentally during a preventive examination. Over time, the symptoms begin to manifest themselves more clearly.

• During menstruation, the breasts become swollen and painful to the touch.
• The woman feels discomfort in her chest, it is simply “bursting” from the inside.
• The symptoms of premenstrual syndrome become more pronounced.
• As the pathology worsens, the manifestations of fibrous dysplasia of the mammary gland become more pronounced.
• The pain loses its connection with the menstrual cycle and becomes more intense and constant.
• When palpating, painful seals are already clearly defined. The pain symptoms intensify when pressing on the mammary gland.
• There is serous discharge from the nipple.

If a woman observes such symptoms, she should not postpone a visit to a doctor - a mammologist or gynecologist - this is fraught with a worsening of the situation and an increased likelihood of degeneration into cancer.

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Diagnostics breast dysplasia

Not all clinics today are equipped with modern diagnostic equipment capable of recognizing pathological changes occurring in the human body at early stages. This is especially true for this disease. It is necessary that the diagnosis of breast dysplasia be carried out using the latest modern equipment and innovative examination methods. After all, the prescribed therapy depends on the reliability of the diagnosis. If a specialist has even the slightest doubt about the correctness of the result, a duplicate study is prescribed, but the patient undergoes it in another medical institution. This allows the doctor to get a more objective and reliable picture of the disease, which allows prescribing the most effective treatment.

The complex of diagnostic measures includes:

• Screening of patient complaints.
• Analysis of the patient's medical history.
• Clinical examination of a woman's mammary glands.
• Physical examination by palpation of the breast. The examination is carried out both in the lying and standing positions. Palpation is carried out carefully, without missing a single millimeter of the breast.
• The mammologist must examine and palpate the lymph nodes in the supraclavicular, subclavian and axillary areas.

The patient is examined at a strictly defined time of the menstrual cycle. For menstruating women, this is the period from the seventh to the tenth day of the cycle. In addition to visual examination, X-ray scanning is used for diagnostics. In this situation, it is the most informative. It is also known as bilateral mammography. Thanks to this method, it is possible to recognize the disease in 95% of a hundred cases, determine its localization and extent of damage, and examine the other gland. This approach to research allows you to choose the most effective therapeutic tactics.

Here are just some of the benefits of mammography screening:

• Possibility of obtaining a multidimensional image of the mammary glands.
• The estimated information content reaches 95%. This is especially relevant in the case of non-palpable neoplasms.
• This study is widely used both for diagnostics and in the treatment of certain diseases.
• Possibility of dynamic examination of the organ.

Dopplerographic scanning is also used, which is performed using ultrasound and allows the organ being examined to be observed in color. This study is also performed during the period from the seventh to the tenth day of the natural menstrual cycle and is an additional diagnostic method. Having a high resolution, it allows for some details to be clarified, complementing the clinical picture of the disease, and makes it possible to assess the quality of silicone implants. This diagnostic method is considered one of the safest in light of the dose load.

In case of suspected focal nodular dysplasia of the mammary gland, the specialist, after analyzing the results of the mammography, performs a biopsy, which is performed by taking a puncture with a very thin needle. The doctor may also prescribe magnetic resonance imaging (MRI), which allows obtaining high resolution and contrast images.

Each of the listed examination methods has its own advantages and disadvantages, but together they are ready to provide a comprehensive clinical picture of the disease, which is very important for further treatment.

It may also be useful to consult with specialists in other fields, for example, an endocrinologist and/or gynecologist.

Treatment breast dysplasia

The main goal of any therapy is to remove the primary source causing the pathology and eliminate the factors supporting its progression. Treatment of breast dysplasia includes correction of the hormonal balance in the woman's body. For this purpose, such drugs as danol (danazol), a synthetic derivative of ethisterone, are successfully used, which work to suppress the function of the pituitary gland, which produces gonadotropic hormones that have luteinizing and follicle-stimulating characteristics.

Danazol is available in capsules, which are taken in a dosage of 0.2 to 0.8 g, divided into two to four doses. The duration of therapy and the dosage of the drug are prescribed strictly individually for each clinical picture of the disease.

The drug should not be prescribed to pregnant women and those who are breastfeeding. The drug is also contraindicated in case of porphyria. Particular caution should be exercised in case of dysfunctional abnormalities in the kidneys and heart, and in diabetes mellitus.

If the analysis showed a lack of progesterone or estrogen, the doctor may prescribe selective estrogen receptor modulators to restore their normal levels: estroprogestin, lynestrenol, progestin, tamoxifen or progestogens (Duphaston, Progestogel, Utrozhestan).

Lynestrenol is taken orally. The dose of the drug is prescribed individually within the range of 5 to 15 mg per day. The duration of therapy is not less than six months.

Lynestrenol is contraindicated for use if the patient has a history of individual intolerance to the components of the drug, severe liver dysfunction, thrombophilitis, arterial hypertension, insulin-dependent diabetes mellitus, uterine bleeding of unknown origin, in the presence of a congenital form of bilirubin metabolism, during pregnancy.

The medicine Wobenzym is taken no later than half an hour before meals or two hours after meals. The starting dosage of the drug is three tablets three times a day. The duration of treatment is prescribed from two to five weeks.

In case of moderate disease, it is allowed to take five tablets three times a day. If the pathology is diagnosed as severe, the dose of Wobenzym increases to seven tablets administered into the body three times a day, and when the therapeutic effect is achieved, the amount of the drug taken is reduced to three tablets.

If surgery is planned, to avoid complications or reduce their intensity, five days before the expected operation the patient begins to take three tablets three times a day.

Contraindications to the drug include individual intolerance to individual components of the drug, in the case of thrombocytopenia or hemophilia, during hemodialysis.

The attending physician also prescribes antiprolactin medications. For example, bromocriptine, nor-prolac, parlodel. Vitamins will not be superfluous either.

Bromocriptine tablets are administered to the woman's body with food. The starting dose of the prescribed drug is 1.25 mg. The best time to administer it is in the evening before bedtime. After two to three days, the dosage of the drug is increased to 2.5 mg. The next step, again after two to three days, is to increase the amount of the drug by 1.25 mg and so on until the daily amount of bromocriptine is 2.5 mg, taken twice a day.

The drug is not recommended for use by people suffering from hypersensitivity to bromocriptine, components of the drug or ergocriptine derivatives, in cases of arterial hypertension, coronary heart disease, other cardiovascular pathology and severe psychological disorders.

In case of severe pain symptoms, the patient is prescribed the homeopathic drug Mastodinon, which is well tolerated and has virtually no contraindications, except for increased individual intolerance to the components of the drug.

The drug is taken two tablets twice a day. The course of treatment is from two weeks to three months.

Antihistamines and painkillers are often included in the treatment protocol.

Diazolin in a dosage of 0.05 - 0.2 g is used one to three times a day immediately after meals. The maximum daily dosage of the drug should not exceed 0.6 g. It should be taken with great caution in case of pathological changes observed in the digestive tract and in case of increased sensitivity to the components of the drug.

Codeine or tramadol (narcotic analgesic) or antispasmodics and anti-inflammatory drugs: phenazole, ibuprofen, ketoprofen, indomethacin, piroxicam.

The nonsteroidal anti-inflammatory and antirheumatic drug ibuprofen is prescribed in strictly individual dosages, which are determined depending on the intensity of pain symptoms. The drug is administered one to two tablets, which correspond to a dosage of 0.2 - 0.4 g, used three to four times during the day after meals. In case of medical necessity, the amount of the drug can be increased and amount to 3 tablets (0.6 g) three to four times during the day. The maximum daily dosage should not exceed 2.4 g.

It is strictly forbidden to take the drug in case of increased individual intolerance to the components of the drug, in case of erosive and ulcerative lesions of the digestive tract, dysfunction of the kidneys, heart and liver, arterial hypertension, pathology of the optic nerve.

To boost a person's immune system, immunostimulants containing a complex of vitamins and microelements are introduced into the treatment protocol. If a woman has obvious signs of emotional arousal, it would be a good idea to take tonic and sedative medications or herbal decoctions (hops, valerian or motherwort).

Surgical treatment for breast dysplasia is prescribed quite rarely. One of the surgical methods of therapy is biopsy, which is effectively used for large cysts with liquid contents inside. The contents are sucked out with a thin needle, and a special sclerosing substance is introduced in its place, which “glues” the cystic walls, preventing repeated accumulation of fluid. This procedure is performed in an outpatient clinic. If the cyst contents are highly viscous with blood streaks, regardless of the cytology results, a sectoral resection of the affected mammary gland is prescribed. Relapses, in this case, are not observed.

If fibroadenomatosis of the mammary gland is diagnosed, in particularly severe cases the patient is hospitalized and undergoes sectoral resection or enucleation of the mammary gland tumor. Most often, it is not removed, but its dynamics are monitored for a long time. In the case of puncture, resection or enucleation, the obtained material is necessarily sent for cytological examination.

Traditional medicine advice also plays an important role in treating breast dysplasia. But first of all, it is worth mentioning that it can only be used with the permission of a doctor and only after a routine examination. Without a clear diagnosis and treatment prescribed by a specialist, you can lose precious time, worsening an already difficult situation with your health.

So, here are some recipes that can help in the treatment of breast dysplasia.

• Cabbage and burdock leaves, which are applied fresh to the mammary glands (burdock is applied with the darker, shiny side), have an effective resorptive effect.
• Tea prepared from the herb whitehead has also proven itself to be effective in treating dysplasia. Take until the symptoms go away.
• You can make a mixture of equal parts of chamomile flowers, dill seeds, valerian root and peppermint leaves. Steep a tablespoon of the mixture in a glass of boiling water. Drink half a glass three times a day.
• You can smear the glands with burdock oil. The ready-made composition is sold in any pharmacy, but it is possible to prepare it yourself. To do this, you need to grind the burdock root and take olive oil in proportions of one to three. (1 - burdock, 3 - oil). Let it brew for ten days in a warm place. After that, strain and you can use it. It must be stored in the refrigerator.

Therapeutic therapy also involves diet. If breast dysplasia is diagnosed, it is worth adjusting the diet, eliminating fatty and spicy foods, increasing the consumption of vegetables and fruits, legumes, and soy. It is necessary to limit the intake of chocolate, carbonated products, coffee, and coffee drinks.

Prevention

Any prevention is the best way to avoid the disease or recognize it at the early stages of manifestation. Prevention of breast dysplasia is, first of all, a healthy lifestyle, as well as:

• A fulfilling sex life.
• Maintaining psychological comfort.
• It is important to take a responsible approach to the consequences that may arise after an artificial termination of pregnancy.
• Timely detection and comprehensive treatment of diseases of the female reproductive system.
• Remove all bad habits from your life.
• Be careful when taking medications and any other factors that may provoke a hormonal imbalance.
• Complete, healthy and balanced nutrition.
• Maintaining your immune status at a high level.
• Do not ignore preventive examinations and check-ups with specialists.
• Conduct regular self-examination of the mammary glands, evaluate the symmetry of both breasts and their shape, the condition of the lymph nodes in the armpit area, the shade of the skin, the presence of seals and discharge from the nipples.
• At the slightest suspicion, without delay, seek advice and examination from a qualified specialist: a gynecologist or mammologist. Timely therapy allows you to reduce the risk of progression of breast dysplasia by half.
• Monitor your body weight. Excess weight, and especially obesity, is a hormonal imbalance and a stimulus for the development of pathology.
• Prevention of early obesity (concerning children and adolescents) can protect against early menarche (the beginning of the first menstrual cycle), which, in turn, makes it possible to reduce the likelihood of premenstrual dysplasia of the mammary gland.
• An active lifestyle and moderate exercise.

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Forecast

Provided that the diagnosis is made early and adequate therapeutic treatment is completed in a timely manner, the prognosis for breast dysplasia is quite favorable. However, relapses of the disease cannot be completely ruled out, and this also applies to surgical excision of the cystic formation, since the mechanism of the influence of hormonal levels and their instability on this pathology, as well as on many others, has not yet been thoroughly studied. If mastopathy is diagnosed in a woman’s medical history, it is necessary to regularly visit a doctor – a mammologist. This approach to your health will make it possible to avoid multiple problems and the recurrence of the pathology.

Breast dysplasia does not have a significant impact on a woman's quality of life, but if left untreated, there is a real risk of benign neoplasms transforming into malignant tumors. This should be the driving force for early diagnosis and timely and comprehensive treatment. It should not be forgotten that the earlier any disease is diagnosed, the easier it is to stop and the less severe the further consequences.

Beautiful breasts are a woman's pride as a representative of the fair sex, an organ for feeding the next generation. Therefore, the mammary gland requires special treatment. Constant self-examination, preventive observation by a gynecologist or mammologist, adherence to a healthy lifestyle and recommendations of specialists will allow you to protect yourself as much as possible from such an unpleasant disease as dysplasia of the mammary gland.

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