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Diffuse fibroadenomatosis of the mammary glands
Last reviewed: 04.07.2025
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Diffuse fibroadenomatosis of the mammary glands has several names: dysplasia of the mammary gland, mastodynia, fibrocystic mastopathy, fibrocystic disease. But the essence of the pathology is one, and it lies in the fact that proliferative changes occur in the tissues of the mammary gland with the formation of cystic and fibrous seals.
Unlike the nodular type, in which fibroepithelial neoplasia in the breast has clear boundaries and localization, diffuse fibroadenomatosis of the mammary glands is manifested by glandular, cystic or fibrous seals scattered throughout all breast tissue.
Causes diffuse breast fibroadenomatosis.
The causes of diffuse fibroadenomatosis of the mammary glands are directly related to hormonal disorders in women of any age. Moreover, this concerns not only purely female sex hormones (estrogens, progesterone, gonadotropins, etc.).
But there are many more reasons why hormonal imbalances occur in the female body. Doctors include congenital and genetically determined factors, pathological deviations of the menstrual cycle, some infectious diseases, weakening of the immune system, abortions, refusal to breastfeed a child.
Among the causes of hormonal imbalance and, as a consequence, diffuse fibroadenomatosis of the mammary glands, experts name inflammatory diseases of the ovaries (for example, adnexitis); irregular sexual life; thyroid pathologies (hypothyroidism); dysfunction of the adrenal cortex (with increased or insufficient secretion of cortisol); disruption of the pancreas (with type II diabetes and obesity).
A special group of causes of female sex hormone imbalance includes pathologies accompanied by a disruption of hormone metabolism, which are excreted from the body only after being converted into a water-soluble form. In the liver, female steroid hormones that have converted into methoxyestrogens bind to glucuronic acid and are then excreted from the body with bile. When this process is disrupted, estrogens can return back (through the intestinal walls), and their content in the body increases. This leads to diseases of the female reproductive system, including pathological fibrocystic neoplasms in the mammary glands.
Obesity plays a major role in the development of diffuse fibroadenomatosis of the mammary glands, and here's why. The fact is that excess fat in a woman's body provokes the accumulation of estrogens due to the conversion (under the influence of the enzyme arotamase) of testosterone formed in the adrenal glands into female sex hormones, causing hyperestrogenism.
Symptoms diffuse breast fibroadenomatosis.
The main symptoms of diffuse fibroadenomatosis of the mammary glands are a feeling of "bursting" and uncomfortable heaviness in the chest, as well as its soreness, especially before menstruation. These symptoms can be permanent in the case of fairly large formations. In this case, pain can be felt in nearby parts of the chest.
As mammologists note, if the glandular tissue of the mammary gland (parenchyma) is involved in the pathological process, then the palpable seals most often have clear boundaries. When the disease affects the connective tissues (dividing the mammary gland into lobes), solid seals are detected by palpation and diffuse fibrous fibroadenomatosis of the mammary glands is diagnosed.
In case of presence of cysts in tissues, a significant number of formations with clear contours of elastic in consistency nodes of round or oval shape up to 2 cm or more in size are found in the mammary gland. These neoplasias do not have connections with the skin of the mammary gland. And the diagnosis is formulated as diffuse cystic fibroadenomatosis of the mammary glands.
Also, a characteristic symptom of diffuse fibroadenomatosis of the mammary glands at the initial stage of the disease is a slight change in the size of neoplasms depending on the monthly cycle in women who have not reached menopause.
Where does it hurt?
Diagnostics diffuse breast fibroadenomatosis.
Diagnosis of diffuse fibroadenomatosis of the mammary glands is based on:
- patient complaints and examination of the mammary glands by palpation;
- X-ray examination of the breast (mammography);
- ultrasound examination (ultrasound);
- results of analysis of the content of female sex hormones in the blood serum;
- studies of blood vessels and blood flow in the mammary gland (Doppler sonography);
- magnetic resonance imaging (MRI, including with the introduction of a contrast agent);
- biopsy and histological examination of biopsy samples of the neoplasm (only a biopsy provides an unambiguous answer to the question of the benign or malignant nature of the neoplasia).
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What do need to examine?
Who to contact?
Treatment diffuse breast fibroadenomatosis.
Treatment of diffuse fibroadenomatosis of the mammary glands involves drug therapy using a number of modern pharmacological agents. In most diagnosed cases of this disease, hormonal drugs with an anti-estrogenic effect are prescribed.
Thus, the antiestrogenic drug Toremifene (analogues - Fareston, Tamoxifen, Clomiphene citrate, Droloxifene) - in the form of tablets of 20 and 60 mg - is a non-steroidal derivative of triphenylethylene. Doctors recommend taking it at 20 mg per day. But this drug is contraindicated in hyperplasia of the uterine mucosa (endometrium) and liver dysfunction. The use of Toremifene can cause undesirable effects in the form of hot flashes, dizziness, increased sweating, vaginal bleeding, nausea, rash, itching in the genital area, edema and depression.
Raloxifene (Evista) is a benzothiophene derivative that is similar in action to Toremifene. It is prescribed only to postmenopausal women, 60 mg per day.
The drug Duphaston (Dydrogesterone) has the active substance dydrogesterone, which is a synthetic analogue of the hormone progesterone. It is prescribed only in case of deficiency of this hormone; the standard dosage is 10 mg (one tablet) per day, taken for two weeks during each monthly cycle.
The medicinal effect of Faslodex is based on the ability of its active component fulvestrant to block the trophic effect of estrogens by inhibiting the activity of estrogen receptors. The drug is available in the form of a solution for intramuscular injections (250 mg, 5 ml syringe). The dosage is determined by the attending physician individually, the standard dose is 250 mg per day - once a month. The drug is not used in the presence of severe forms of liver failure, as well as in pregnant and lactating women. The most common side effects of Faslodex are nausea, vomiting, diarrhea, anorexia, vaginal bleeding, edema, urticaria, and venous thromboembolism.
The drug Parlodel (Bromocriptine), being a derivative of the alkaloid ergot, reduces the synthesis of hormones such as prolactin and somatropin. Women of childbearing age are prescribed from 1.25 to 2.5 mg of the drug per day. It should be taken after the end of menstruation, the course of treatment is up to 4 months. Side effects of Parlodel include headache, dizziness, weakness, nausea and vomiting. This drug is contraindicated in hypertension, cardiac arrhythmia and gastrointestinal pathologies.
In the treatment of diffuse fibroadenomatosis of the mammary glands, the drug Provera (Farlutal, Klinovir, Vadezin, Tsikrin and other synonyms) is also used, which blocks the production of pituitary gonadotropins. The average dose of this drug is from one to three tablets per day, after meals. Side effects include headaches, allergic reactions, sleep disorders, depressive states, heart rhythm disturbances, etc.
In diffuse fibroadenomatosis of the mammary glands after menopause, mammologists recommend the drug Femara (Letrozole), which inhibits the synthesis of estrogens in fatty tissues. The drug is usually taken one tablet per day. Some patients may experience side effects such as headache, joint pain, weakness, nausea and hot flashes.
Surgical intervention for diffuse fibroadenomatosis of the mammary glands is performed only if breast cancer is suspected. However, sectoral resection of the gland, in which part of the affected tissue is excised (with urgent histological examination of the tissues) does not completely eliminate the disease. Some time after the operation, diffuse fibroadenomatosis of the mammary glands may make itself known again, and new formations in the breast appear in 15% of operated patients.
Prevention
In the prevention of all breast dysplasias, it is very important to detect pathologies in time. Therefore, women should regularly examine their mammary glands themselves. And after forty years, the prevention of diffuse fibroadenomatosis of the mammary glands consists of periodic visits to a mammologist, especially if close relatives have had a similar disease.
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Forecast
The prognosis for diffuse fibroadenomatosis of the mammary glands – with adequate treatment – is positive in most cases, since these neoplasms are benign. However, the risk that diffuse fibroadenomatosis of the mammary glands will develop into oncology is quite high, and with intensive cell proliferation it can reach 25-30%.