Fibrosis of the breast

Fibrosis of the mammary gland is a pathology of its tissues, in which the proliferation and compaction of fibroblast-synthesized proteins of collagen and elastin and glycoprotein cells forming the matrix of connective tissues. These changes lead to the appearance of scar neoplasias and the inevitable disruption of the functioning of the breast. This process is able to develop in the connective tissues of any internal human body. This article examines breast fibrosis in women, because this pathology over the past half century has become a serious problem of women's health.

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Causes of the fibrosis of the breast

Before enumerating the causes of fibrosis of the breast, it is necessary to note the terminological "diversity" of modern mammology, which has become a monopoly in the field of all mammal diseases in women.

In fact, fibrosis (from Latin fibra - fiber) is a process of formation of fibrous, that is, connective tissue, and fibrous formation in the breast (as a result of fibrosis) should be called otherwise - as an option, fibroma, that is, a tumor of connective tissue. However, doctors call fibrosis and pathological process of excessive formation of connective tissue, and education itself. In clinical practice, breast fibrosis and pathological changes associated with this process can be referred to as mastopathy (which includes all benign tumors and cysts in the chest), dyshormonal dysplasia, fibrocystic mastopathy, fibromatosis, fibroma, etc.

To date, the main causes of the disease are disorders in the level and ratio of sex hormones (primarily estrogen and progesterone) that affect the stability of the hormonal system of a woman during menstruation, during pregnancy and lactation, after repeated abortion , with menopause.

Experts say that the disease can also start because of persistent stress, fatigue, thyroid problems (hypothyroidism due to iodine deficiency) and pancreas (diabetes mellitus), exposure to some toxic substances, inflammation of the uterus or ovaries. It is not excluded the genetic predisposition to this disease.

In addition, the causes of the disease can be associated with radiation (for example, when passing a course of radiotherapy), and then the diagnosis of radiation fibrosis of the breast. By the way, radiation therapy can cause fibrosis of the tissues of any organs.

But in domestic mammology, the biochemical mechanism of the fibrosis process, which is associated with the activation of the so-called transforming growth factor beta (TGF-β), is still neglected. TGF-β is an endogenous complex of antigen-specific peptide molecules (cytokines) that transmit signals between tissue cells. The beta factor is able to synthesize lymphocytes, macrophages, fibroblasts, endothelial cells, etc. TGF-β is involved in the optimization of cellular metabolism and regulates the growth and apoptosis (natural death) of cells, as well as stimulates all intracellular processes in adverse circumstances (inflammation and other pathological effects ). Activation of the growth factor beta, according to researchers, is at the heart of the violation of the intercellular "message", which leads to the activation of fibroblasts and the proliferation of cells of connective tissue.

These processes are also the cause of a number of other diseases, for example, cirrhosis of the liver is associated with the formation of scar tissue and nodules that replace liver tissue and disrupt its work. Endomiocardial fibrosis is the result of myocardial infarction. And still there is a fibrosis of lungs, a mediastinum, soft fabrics of a retroperitoneal space.

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Symptoms of the fibrosis of the breast

Key symptoms of breast fibrosis: presence in the breast tissues of individual painless seals (with sizes from 0.2-03 cm and more) or compacted sites of different localization; change in skin color over the affected area of the gland; a feeling of discomfort in the glands; liquid discharge from the nipple (transparent or slightly dyed).

Often there is a heaviness and "bursting of the chest from the inside," minor pulling or aching pain, which before the onset of menstruation becomes stronger and can be given to the shoulder and the armpit region.

In the clinical picture of the cystic form of the disease, there is a greater soreness of the nodes during palpation, as well as a slight increase in the formations, as well as axillary lymph nodes before the onset of menstruation.

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Forms

Fibrosis of the breast has a variety - depending on the scale of the proliferation of cells of connective tissue and its specific location relative to the anatomical structures of the gland.

When pathological changes in the fibrous tissue of the breast are concentrated at a limited point, doctors detect focal or local fibrosis of the breast. Either - in yet another terminological interpretation - localized. In focal, most often in the upper quadrant of the gland, a dense fibrous knot 2-3 cm oval or round in shape - one or several. This type of disease is usually considered only the initial stage of a more extensive process of abnormal reproduction of fibroblasts, which can develop, as they say, in breadth and in depth - especially in the absence of therapy. If the process affected a significant part of the gland or even the entire breast (that is, the fibrous tissue replaced the glandular and fatty tissue), then this is diffuse fibrosis of the mammary gland.

Nodular fibrosis of the breast from a local or focal breast, in principle, does not differ in anything, as it develops as a separate node. A cystic is associated with the formation of cysts - having a wall of capsules with contents. Cysts in the chest, as a rule, are retentive, that is, due to narrowing or complete blockage of the milk ducts.

Periductal fibrosis of the mammary gland (or plasmacytic) means the formation of collagen fibers around the milk ducts. This variety is typical for patients of menopausal age.

Ductal fibrosis of the breast is a protocol fibrosis, affecting solely the ducts and not breaking the tissues of other areas of the breast. And when a peri-dular perivascular type of pathology is diagnosed, it means that the excess formation of connective tissue occurs not only around the ducts, but also around the lymphatic and blood vessels.

Fibrosis of the breast stroma is a pathological proliferation of the fibrotic tissue itself - the stroma, which supports and binds the parenchyma and adipose tissue. In addition, through the fat tissue pass "partitions" of fibrous tissue, which connect the skin with a glandular capsule.

Linear, which also bears the name of interlobular or lean fibrosis of the breast, is the result of the proliferation of interlobular connective tissue and intraprotective tissue, often with the formation of cysts. Discovering this type of pathology, mammologists feel dense strands in the patients' chest, and they clearly see them on the mammogram. And in this case, the verdict of the doctor: a tight interlobular linear fibrosis.

In cases of replacement of adipose tissue cells with the connective tissue, involute fibrosis of the mammary glands, more characteristic of older women, is determined.

In terms of severity of symptoms, the disease is divided into moderate and severe severity of the disease.

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Diagnostics of the fibrosis of the breast

In modern mammology, the following diagnostic methods are used:

• palpation of the breast and regional lymph nodes;
• mammography (chest radiography);
• general blood analysis;
• blood test for hormones;
• ultrasound (ultrasound);
• computed tomography (CT);
• Doppler sonography (examination of blood vessels and blood flow in the chest);
• chromoductography (X-ray of ducts with contrast substance);
• biopsy with histological examination of the obtained tissue sample.

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Treatment of the fibrosis of the breast

Treatment of the disease is carried out, based on a specific type of fibrosis and its etiology. An important role in the choice of treatment methods is played by the age and individual characteristics of the woman's organism, in particular, the presence of inflammatory processes in the uterus and ovaries and endocrine disorders. Preference is given to conservative therapy, although the possibility of surgical intervention is not ruled out.

Treatment of focal, as well as treatment of local fibrosis of the breast - as well as practical all other varieties of the disease - is carried out with the help of hormonal drugs.

For example, containing a synthetic analogue of the female sex hormone progesterone Dufaston (Dydrogesterone) is used in the deficiency of this hormone. This hormonal agent neutralizes the activity of estrogen, which plays a leading role in the cyclic changes in breast tissue. The standard dose is 10 mg (one tablet) per day, which is taken for 14 days of each menstrual cycle.

The anti-estrogen drug also includes Tamoxifen (Zitazonium, Jenoxifene, Nolvadex, Cytophen), which blocks the receptors of endogenous estrogens. This drug is prescribed for women during the menopause in cancerous breast tumors, endometrium and women of reproductive age - with infertility due to the unmasking of eggs.

In the treatment of various pathological neoplasias in the breast, an external agent is used. Progestogen is a gestagenic preparation containing the hormone of the ovary's yellow body (progesterone) and reduces edema of the fibrous tissues of the breast. The gel is recommended to be applied to the skin of the breast (with rubbing until completely absorbed) - every day twice.

As for the drug Bromocriptine (Abergin, Ronalin, Parlodel), which reduces the synthesis of prolactin and somatropin, it is contraindicated to prescribe in premenstrual syndrome and benign breast pathologies.

To treat diffuse mammary fibrosis, Mastodinone is often prescribed - a liquid homeopathic preparation - an alcoholic tincture of iris, a cyclamen, a tiger lily and a strychnine containing emetic nuts (chilibuks). Doctors prescribe to take 30 drops twice a day, the course of treatment - three months.

With iodine deficiency and hypothyroidism, potassium iodide (Yodex, Iodobalance, Iodomarine, etc.) is prescribed - one tablet once a day. With the goal of normalizing liver function, hepatoprotective drugs (Karsil, Gepabene, Essentiale, Architol, etc.) are used. Vitamins A, C, E and B vitamins are also prescribed.

In the case of edema of the breast, diuretics of plant origin are recommended. And to relieve nervous tension the doctor should prescribe a mild sedative.

Surgical intervention - excision of nodes and cystic lesions by sectoral resection - is performed quite rarely and only with their considerable dimensions. There is a method of excretion of pathological formation (nucleation).

In a successful fight against pathology, it is very important to monitor the normal functioning of the intestine in order to prevent the reverse absorption of estrogens, which are metabolized by the liver. Therefore, it is best to exclude from the diet fats of animal origin and to consume more plant fiber (that is, vegetables and fruits).

But the treatment of fibrosis of the mammary gland offered by some healers with alternative means, for example, with the help of cabbage leaves or ointment with celandine juice, has no therapeutic effect, since this pathology is multifactorial, and alkaloids, flavonoids and phytoncides known to phyto-therapeutists of medicinal plants can not cope with them.

Prevention

Today, it is not possible to prevent the onset of the disease. Although in time to identify this pathology, each owner of the breast can itself - if it conducts a regular breast self-examination (in the first two weeks of the menstrual cycle).

If you want to reduce the risk of developing fibrosis of the breast, do not delay the birth of children after "30", do not abuse interruptions of unwanted pregnancies, and hormonal contraceptives. And after the birth of a child, breastfeed for at least 12 months.

Refuse bad habits and watch your health.

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Forecast

The prognosis of the disease is favorable, so this pathology, according to doctors, does not degenerate into oncology. Although, for the sake of justice, it should be noted that in the presence of any breast disease a woman runs the risk of encountering an intimidating diagnosis. And this probability is almost five times higher than in women with healthy breasts.

It should also be borne in mind: almost every third case of treatment of women about mastopathy is diagnosed as fibrosis of the breast.

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