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Fibromatosis of the breast
Last reviewed: 04.07.2025
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When a pathological process of proliferation of glandular or connective tissue occurs in a woman’s breast, caused by an increase in the proliferative activity of their cells, and various seals and nodes appear, this is called fibromatosis of the mammary gland.
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Causes breast fibromatosis
The disruption of tissue development, which doctors also call dysplasia, can occur at almost any point in the human body. Intensively multiplying "extra" cells of some tissues are capable of penetrating the structure of surrounding tissues, forming neoplasms in the form of tumor-like conglomerates, dense nodes or cysts. The result of this process in the mammary glands is mastopathy - that is, breast pathology. Its main clinical and morphological manifestations are defined by many specialists as fibromatosis of the mammary gland, but more often - as various forms of nodular mastopathy.
Fibromatosis of the mammary gland is a pathological change in its parenchyma and stroma, which leads to clearly defined nodular mastopathy or to diffuse mastopathy, that is, diffuse fibromatosis, in which abnormal cell division affects the entire gland.
In clinical mammology, diffuse fibromatosis of the mammary glands or diffuse mastopathy is divided into glandular, cystic or fibrous - according to the predominant type of affected tissue. There is a mixed type of mastopathy, in which signs of both nodular and diffuse mastopathy are detected. Fibrocystic mastopathy is also diagnosed.
In addition, this disease manifests itself in such types of nodular mastopathy as fibroadenoma (or adenofibroma), phyllodes (leaf-shaped) fibroadenoma, cyst or intraductal papilloma.
The causes of fibromatosis of the mammary gland are that all these pathological transformations occur as a result of hormonal imbalance in the woman's body. The level of estradiol, estrogen, testosterone, progesterone, prolactin changes cyclically due to sexual development, menstruation, pregnancy, menopause. And not only the ovaries, which produce estrogens, work in this system, but also the pituitary gland, which synthesizes luteotropic hormone and prolactin. The thyroid gland, responsible for the production of thyroxine and triiodothyronine, which regulate the state of metabolism, also participates in it. So a decrease in thyroid function (hypothyroidism) can significantly increase the likelihood of developing fibromatosis of the mammary gland.
The occurrence of this pathology can also be "facilitated" by problems in the pancreas, which produces insulin. Therefore, various breast formations are often diagnosed in women with type II diabetes and obesity. And in women suffering from type I diabetes, a special one often occurs - autoimmune diabetic mastopathy.
Why do women's hormonal systems malfunction? In addition to the above-mentioned physiological factors of a cyclic nature, normal hormonal levels are destabilized by genetic predisposition and many hereditary diseases, uterine diseases (fibroids, endometriosis), ovarian inflammation, etc. Destructive factors also include: multiple artificial terminations of pregnancy, surgeries for gynecological diseases, the use of certain medications (primarily hormonal contraceptives), bad habits, stress, sudden weight loss or weight gain. All this leads to excess levels of some hormones (estrogens) and an obvious deficiency of others (progesterone). And this is precisely what causes fibromatosis of the mammary gland.
Symptoms breast fibromatosis
With all the variety of forms of fibromatosis of the mammary gland, its main clinical manifestations come down to the fact that in the soft tissues of the breast a nodule (or nodules) is palpated - in the form of a round "pea" or oval "bean" several millimeters or centimeters in size. If the nodule is dense, with clear contours, quite mobile, but even when palpating it there is no pain, then this is most likely a pericanalicular fibroadenoma. If the formation is softer and does not have precise contours, then this is an intracanalicular fibroadenoma. Their difference is only in structure, but in both cases during menstruation a woman may feel discomfort in the mammary gland.
The signs by which doctors recognize nodular mastopathy include dense strands and elastic rounded formations of a tumor-like structure that are not connected to the skin of the mammary gland; aching pain in the chest; a feeling of engorgement, distension or heaviness in the glands. These symptoms become more distinct before menstruation.
Similar symptoms are seen in diffuse fibromatosis of the mammary glands (more precisely, diffuse fibroadenomatosis), only there are several nodules in the breast. In some cases, minor pain is noted, which before the onset of menstruation can become more intense and even radiate to the shoulder, armpit or shoulder blade. But with a fairly rare phylloid fibroadenoma, the neoplasia grows to gigantic sizes and causes severe pain in the mammary gland.
The presence of a small cyst in the mammary gland (which is most often found in women over 35 who have not given birth) - as in most cases with fibroadenoma - does not manifest itself in any way and is also detected by chance. With a larger size of the cystic formation, painful sensations are possible before the onset of menstruation. And constant pain (regardless of the cycle) is caused by large cysts. In addition, they can not only deform the natural shape of the breast, but also cause inflammation with reddening of the skin on the chest and an increase in temperature.
Symptoms of fibromatosis of the mammary gland, which is diagnosed by mammologists as intraductal (intraductal) papilloma, are manifested by transparent or bloody discharge from the nipple. And when examining patients, a round papillary node of intraductal tissue proliferation is found inside the milk duct - not very dense, moderately painful. This node can injure the duct and cause local inflammation.
Where does it hurt?
Diagnostics breast fibromatosis
The following methods are used in the diagnosis of fibromatosis of the mammary gland:
- collection of anamnesis, physical examination (palpation of the mammary glands and regional lymph nodes);
- X-ray mammography (allows detection of formations as small as 1 mm);
- blood test for hormone levels;
- ultrasound examination (US) of the mammary gland;
- X-ray computed tomography (XCT);
- Doppler sonography (allows you to assess the state of blood flow in the mammary gland);
- MRI (if necessary - MRI with dynamic contrast);
- ductography (radiography with the introduction of a contrast agent into the milk ducts)
- to identify their pathology);
- pneumocystography (to determine the contents of fibrocystic dysplasia);
- puncture biopsy of the glands followed by histological examination of a sample of tumor tissue.
What do need to examine?
Who to contact?
Treatment breast fibromatosis
When prescribing treatment for fibromatosis of the mammary gland, the doctor takes into account the patient's age, characteristics of the menstrual cycle and prospects for reproductive function; the presence of gynecological, endocrine and other diseases.
Drug therapy for almost all of the above types of fibromatosis of the mammary gland is not symptomatic, but etiological. Therefore, hormonal drugs, as well as vitamins and enzymes, are widely used here.
Drug treatment of fibromatosis of the mammary gland
Among the hormonal drugs used in the treatment of fibromatosis of the mammary gland, doctors often prescribe the following drugs: Duphaston, Bromocriptine, Provera, Goselerin, Letrozole, Progestogel, Mastodinone.
Duphaston (Dydrogesterone, Duphaston) belongs to the pharmacological group of gestagens (drugs based on female sex hormones produced by the corpus luteum of the ovary and the adrenal cortex) and is used only in case of laboratory-confirmed deficiency of endogenous progesterone. The active substance of Duphaston is a synthetic analogue of progesterone dydrogesterone. Taking the drug compensates for the deficiency of progesterone and neutralizes the proliferative effect of estrogens. For long-term treatment, one tablet (10 mg) is prescribed for 14 days of each menstrual cycle. This drug is contraindicated in liver diseases.
The drug Bromocriptine (Parlodel) is a derivative of the ergot alkaloid ergocryptine. It stimulates dopamine receptors in the hypothalamus and thereby reduces the production of prolactin and somatropin. Women of childbearing age are recommended to take this drug at 1.25-2.5 mg in the second phase of the cycle - for 3-4 months. Side effects of Bromocriptine include headache and dizziness, weakness, nausea and vomiting. This drug should not be taken with high blood pressure and cardiovascular and gastrointestinal diseases.
For fibromatosis of the mammary gland, the drug Provera (Klinovir, Vadezin, Tsikrin, Ora-gest, Farlutal, Methylgesten, Sedometril, etc.) is used. The drug contains medroxyprogesterone acetate, which inhibits the synthesis of gonadotropins in the pituitary gland and thereby stops the growth of hormone-dependent tumors of the uterus and mammary glands. The dosage is determined by the doctor depending on the diagnosis and is on average 1-3 tablets of 500 mg per day (orally, after meals). The drug has many side effects, ranging from allergies, headaches and depression to alopecia, thromboembolism and cerebrovascular disorders.
To reduce the effect of estrogen on pathological proliferation of breast tissue, the drug Goselerin (Zoladex) can be prescribed, which is a synthetic analogue of the natural releasing factor luteinizing hormone. After the introduction of this drug, the production of this hormone in the pituitary gland decreases, and the level of estradiol in the blood decreases. Method of its use: a capsule of the drug (3.6 mg) is injected subcutaneously into the anterior abdominal wall using the attached syringe applicator every 28 days. The maximum duration of treatment is 6 months.
Side effects of this drug may include skin rash, decreased blood pressure, hot flashes, and increased sweating.
The drug Letrozole (Femara) belongs to the pharmacological group of aromatase inhibitors and is used to treat fibromatosis of the mammary gland in postmenopausal women. At this age, estrogens are formed mainly with the participation of the aromatase enzyme. This drug is aimed at inhibiting the activity of this enzyme, resulting in the suppression of estrogen biosynthesis in tissues. The standard dosage is one tablet (containing 2.5 mg of the active substance) once a day (daily). Side effects are possible, but they are quite rare and manifest themselves as headaches and joint pain, weakness, nausea, swelling and hot flashes.
In the treatment of various forms of breast fibromatosis, in particular fibrocystic neoplasia, a preparation based on plant progesterone Progestogel is used - 1% gel for external use. It is recommended to apply it to each mammary gland - 2.5 g of the preparation, for at least 4 months in a row. Then you need to take a break for two months. The instructions for the preparation indicate that a positive result can be achieved after one or two courses of therapy. Progestogel has no side effects.
The homeopathic drug Mastodinon, often recommended by doctors, is one of the remedies for treating diffuse fibromatosis of the mammary glands and nodular mastopathies. This is an alcohol extract of medicinal plants (cyclamen, chilibukha, iris and tiger lily), which should be taken twice a day, 30 drops (for three months).
In the treatment of fibromatosis of the mammary gland, vitamins (A, C, B6, E, P) are prescribed, which have a positive effect on the tissues of the mammary gland and activate microcirculation in them. Wobenzym, an enzyme preparation based on proteolytic enzymes of plant and animal origin, is successfully used in the treatment of this pathology. This drug has an immunomodulatory, anti-inflammatory and fibrinolytic effect.
Wobenzym accelerates the removal of toxins from the body and the resorption of hematomas and edema, improves the supply of tissues with oxygen and nutrients. The standard dosage of Wobenzym is 3-5 pills 3 times a day (without chewing and always with 200 ml of water), half an hour before meals. This drug has no side effects, and among the contraindications are hemophilia, thrombocytopenia and other blood clotting pathologies.
Surgical treatment of fibromatosis of the mammary gland
The surgical way of solving the problems of fibromatosis of the mammary gland is chosen in two cases. The first is when the size of hyperplasia is quite significant already at the stage of their detection. The second is when the undertaken conservative treatment did not give positive results. However, it should be borne in mind that with the diagnosis of phylloid fibroadenoma and intraductal papilloma, only surgical intervention is indicated.
All forms of fibromatosis of the mammary gland can be removed in two ways. The first is sectoral resection (lumpectomy), in which the affected area of the breast is excised in the form of a sector, with some healthy tissue. The second method is nucleation (or enucleation), which consists of enucleating only the pathological formation, without affecting the normal tissues of the gland.
There is another method of surgical treatment of fibromatosis of the mammary gland – laser (laser-induced thermotherapy).
More information of the treatment
Forecast
Considering that the proliferative activity of breast tissue cells in 85% of cases is benign, the prognosis for breast fibromatosis can be considered positive. But everything depends on the specific type of dysplasia.
If the degeneration into cancer (malignancy) of fibroadenoma is observed in only 3% of cases, then such a type of fibromatosis of the mammary gland as phyllodes fibroadenoma is considered by most mammologists to be a precancerous tumor: it degenerates into connective tissue sarcoma in almost 10% of cases.
The probability of malignancy of fibrocystic mastopathy with significant tissue proliferation, according to research data, is 31%.
In addition, the role of hormones in the functioning of the mammary glands is so great that under the negative impact of their imbalance, even operated fibromatosis of the mammary gland reoccurs in 15% of cases. But it is comforting that at least 10% of benign formations that appear in the breast during menopause (that is, with a change in hormonal levels) resolve on their own.