Localized breast fibrosis

The functions and health of the female breast are directly related to the state of the hormonal balance in the body. For example, changes in the amount of hormones that occur during puberty, the period of gestation and breastfeeding, during menopause, can provoke all sorts of processes in the structure of the mammary glands. Local fibrosis of the mammary glands is one of such probable processes. It is the development of cystic or fibrous formations, which is considered a very frequent and widespread phenomenon among middle-aged women.

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Causes localized breast fibrosis

The main factor in the formation of fibrosis is considered to be an increased level of sex hormones in the woman's body. The following reasons play a huge role in the appearance of the disease:

• numerous stressful situations;
• negative emotions;
• exposure to radiation and toxic substances;
• prolonged fatigue and exhaustion;
• thyroid disease;
• periodic inflammation of the reproductive system.

The risk of developing fibrosis appears in women whose medical history includes the following factors:

• long-term use of hormonal contraceptives;
• precocious puberty;
• late onset of menopause (after age 50);
• the onset of the first pregnancy after 35 years of age, or premature birth;
• frequent abortions (more than 2 cases);
• absence of a lactation period, insufficient period of breastfeeding, or, conversely, excessively long breastfeeding;
• metabolic disorders in the body, presence of serious chronic pathologies, excess weight;
• long-term treatment with hormonal drugs.

Pathogenesis

The main role in the appearance of fibrosis is given to the restructuring of hormones in the female body. It has been proven that the formation of the breast, periodic cyclic transformations in it, structural changes during pregnancy and breastfeeding occur under the influence of a number of hormones - these are gonadotropins, prolactin, hypothalamic hormones, hCG, TSH, androgens, corticosteroids, insulin, progesterone and estradiol. Any disorder of the hormonal balance occurs with some changes in the breast tissue.

In the mechanism of fibrosis development, relative or absolute hyperestrogenism (increased number of estrogens) and progesterone deficiency are of great importance. Estrogens provoke the growth of alveolar epithelial tissue and stroma, and the effect of progesterone is manifested in counteracting these processes, in decreasing the activity of estrogen receptors and decreasing the number of active estrogens. Hormonal imbalance in breast tissue (lack of progesterone) occurs with the appearance of edema and an increase in the volume of ductal epithelial tissue, which can result in the formation of cystic formations.

The development of fibrosis can be accompanied by increased levels of prolactin in the bloodstream, which is manifested by enlargement, fullness of the breasts, swelling, which is most noticeable in the second half of the menstrual cycle.

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Symptoms localized breast fibrosis

Local fibrosis of the mammary glands is most often determined in women aged 30 to 50 years. Single or multiple nodular formations appear in the tissues of one or both breasts. These nodes have clear boundaries, they do not fuse with nearby tissues, are clearly visible when the woman is standing, and disappear from view when the woman is lying down. The following clinical signs may be observed:

• the first signs are enlargement and swelling of the mammary gland;
• the appearance of discharge from the nipple;
• the appearance of small individual or multiple formations that can be felt independently.

Most often, fibrous tissue nodules are found in women who have reached pre-menopausal age. The appearance of pain with fibrous lesions is not typical.

On the radiograph, such a formation looks like a node with irregular contours, with a non-uniform structure, with low density. The growth of the local fibrous node is quite slow.

Forms

ICD 10 code

• diseases of the mammary gland N 60-N 64 (except those associated with childbirth)
• benign course of breast dysplasia N 60 (including fibrocystic mastopathy)
• diffuse cystic mastopathy N 60.1
• fibroadenosis of the breast N 60.2 (except fibroadenoma)
• fibrosclerosis of the breast N 60.3
• other benign dysplasias of the mammary gland, also unspecified N60.8

Complications and consequences

An advanced form of fibrosis can later result in the development of dangerous pathologies in the female body, and, in particular, the occurrence of infertility.

Complications are also associated with an increased risk of developing a malignant disease – breast cancer, since most specialists consider fibrosis to be one of the probable precancerous conditions. Of course, such consequences and transformations of the disease into breast cancer do not occur in all patients, but the risk of their occurrence increases approximately 4-5 times.

Single nodes that are compacted and slightly mobile when palpated pose a particular danger – fusion with nearby tissues may indicate malignant degeneration of initially benign formations.

In addition, hormonal imbalance in fibrous breast disease creates favorable conditions for the development of a cancerous tumor in the cervix and appendages, so if symptoms of the disease appear, you should immediately consult a doctor and undergo all necessary diagnostic procedures.

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Diagnostics localized breast fibrosis

An important stage of diagnostics is self-examination of the mammary glands, which has its own rules and sequence of actions:

• the examination is carried out regularly on the same day of the cycle (preferably in phase I);
• The chest should be examined standing directly in front of the mirror with your arms down;
• then examine the chest with your hands behind your head, or in a lying position;
• palpate the area of the nipples, the glands themselves, right up to the armpit area;
• check to see if there is any discharge from the nipples.

If during self-examination a woman discovers compacted areas, pigmentation, redness, painful areas or the presence of discharge, then it is necessary to immediately consult a gynecologist or mammologist.

Instrumental diagnostics of local fibrosis of the mammary gland is improving every year. Such examinations are becoming more informative and accurate, and the corresponding medical equipment is becoming more qualitative. Currently, the diagnosis of local fibrous lesion can be established and confirmed within a few hours.

• The mammography method is an X-ray diagnostic method that provides the most extensive information, helping to identify and detect even very small, non-palpable nodules. However, this method is not without its drawbacks: due to the radiation effect on the body, mammography is not used during pregnancy, as well as for patients under 35 years of age. Today, digital mammograms are especially popular, when the resulting image is first transferred to film and then to a monitor, which makes the image easier to recognize and process.
• Ultrasound examination is an equally popular diagnostic procedure that is constantly being improved. Using ultrasound in combination with Doppler sonography helps to detect not only compactions in the gland structure, but also to examine the vascular network, determine the thickness of the cystic walls, and analyze the condition of the lymph nodes. This method of examination is considered the safest. It is approved for repeated use at all periods of a woman's life, both during pregnancy and lactation, and at a young age.
• CT and MRI of the mammary gland are used very rarely for local fibrosis, and only in cases where a small amount of information is obtained using the above methods.

In addition to instrumental methods, the following analyses are also carried out:

• biochemical blood test;
• calculation of prothrombin index;
• blood test for hormone levels;
• blood test for tumor markers;
• fibrosis marker analysis.

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Differential diagnosis

Differential diagnostics can be carried out if a malignant formation is suspected - in this case, a biopsy of the lump is performed with subsequent histological examination of the material.

Treatment localized breast fibrosis

Treatment consists of correcting problems of the sexual sphere, hormonal imbalance and other associated pathologies.

Nutrition for local fibrosis.

Of no small importance in the treatment of fibrous lesions of the mammary gland are the principles of a woman's nutrition. The fact is that food has a significant impact on hormonal metabolism. Dietary nutrition for fibrosis has the following goal - to limit the consumption of animal fats and meat products, since such food causes an increase in the amount of estrogens in the body.

It has been noted that drinking coffee in large quantities, as well as cocoa, strong black tea, promotes the growth of connective tissue in the glands, as well as filling the cystic elements with liquid content. It is also recommended to give up alcoholic beverages, hot spices, fried foods and carbonated water. The menu includes a large number of plant products and ensures sufficient drinking regime.

Drug therapy.

In the early stages of the disease, in addition to changes in nutrition, non-hormonal drugs are prescribed. Homeopathy and traditional herbal preparations are used. As a rule, such drugs give a quick and positive result: the patient's condition is relieved, the gland becomes softer, the seals are absorbed. The drugs can be prescribed separately or in combination with each other (this is decided by the doctor):

• Mastodinone is a popular homeopathic medicine;
• Mastofit is a natural complex from Evalar;
• Mastopol is a safe homeopathic remedy;
• Mamoclam is a herbal preparation based on kelp;
• Cyclodinone is a drug that normalizes the ratio of gonadotropic hormones;
• Klamin is a dietary supplement based on brown algae that replenishes iodine deficiency in the body;
• Fitolon is a bio-product made from seaweed, used for the prevention of malignant pathologies.

Often, a doctor may recommend multivitamin supplements containing vitamin A, E, iodine, zinc and selenium.

Symptomatic treatment is also prescribed - most often sedatives based on motherwort, valerian, etc.

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Hormonal therapy.

In most cases, it is possible to stabilize the breast condition with the help of progestogen contraceptives - they are taken in tablets throughout the monthly cycle. However, there are other medications that can induce artificial menopause (Diferilin, Zoladex) and normalize the "jumps" in the amount of estrogens at different phases of the cycle.

If prolactin deficiency is diagnosed, a course of treatment with medications such as Dostinex or Parlodel is prescribed.

In addition to the listed medications, a positive result in treatment is expected from the use of gestagenic drugs. The most famous of them are Duphaston and Utrozhestan - representatives of progesterone, which are prescribed in a course of 3 to 6 months.

Another type of hormonal therapy includes the administration of testosterone or oral steroid drugs - they suppress the production of estrogens by the body, but are not recommended for use before the age of 40.

Surgical treatment.

Surgical intervention is indicated when large areas of compaction appear, or when there is a risk of malignancy (malignancy) of the fibrous process. The following surgical treatment options are usually used:

• sectoral resection (surgery to remove a suspicious formation with elements of healthy breast tissue);
• enucleation (an operation to remove the tumor and separate it from other nearby tissues).

The duration of the operation is usually from 40 minutes to 1 hour, under general or local anesthesia (depending on the situation).

All removed biological material is sent for histology for diagnosis.

Local treatment.

To increase the effectiveness of the main treatment, external agents can also be used. Such agents include ointment-like and cream-like medications, such as Mastofit, Progestogel, Mastorel, resin preparations, etc. However, such treatment can only play the role of an additional agent for the disease and can be combined with any therapeutic regimen.

Folk remedies

Herbal treatment should not be used instead of standard drug therapy, but only in its background, after consultation with the attending physician. The most common is the prescription of herbal mixtures, which contain St. John's wort, burdock, valerian rhizome, calendula, nettle, etc.

During the treatment period, it is not recommended to use a sauna or other hot procedures, or sunbathe.

• The use of such a well-known "female" plant as Red Brush allows to stabilize the balance of hormones, however, medicinal products based on this plant should not be used together with medicinal hormonal treatment. For use, a tincture is prepared, which includes 50 g of plant material and 500 ml of high-quality vodka. The medicine is infused for one month in a dark place, filtered and taken 1 teaspoon in the morning, afternoon and evening half an hour before meals. The course of administration is one monthly cycle, after which a break is taken and the intake is resumed through the cycle.
• A cabbage leaf is a simple and effective remedy that is almost always at hand. Cabbage successfully eliminates discomfort, dissolves seals, and prevents the development of an inflammatory reaction. As a remedy, a fresh leaf lightly beaten with a hammer is placed on the affected gland under underwear. The procedure is recommended to be carried out at night for 2 weeks. Cabbage can also be used in crushed form under a compress, which is held on the gland area for about 2 hours. The duration of treatment is 7-10 procedures.
• Hemlock is used in the form of a tincture, which is prepared as follows: 1/3 of a glass jar is filled with plant material, the rest of the space is filled with vodka. It is recommended to add hemlock seeds to the same jar, 1/5 of the jar's capacity. The medicine is infused for 14 days in the dark. Dosage: 15 drops per day for six months, monitoring your condition. This plant is considered poisonous, so it should be taken with caution, in no case exceeding the dosage.
• Herbal teas based on medicinal mixtures can be drunk throughout the day in three doses. The mixture can be prepared from such plants as nettle, sage, plantain, wormwood, knotweed. To prepare the infusion, take 1 tablespoon of the herbal mixture and pour 250 ml of boiling water, leave for an hour.
• In case of fibrous growth, it is useful to take propolis preparations. The easiest way is to buy a special propolis tincture at a pharmacy and drink 1 teaspoon 2 times a day before meals. At the same time, it is recommended to lubricate the skin of the chest with any cream that contains propolis.

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Prevention

Disease prevention is the best way to keep your breasts healthy and attractive. Specialists have developed a special set of measures aimed at reducing the existing risk of developing serious pathologies of the mammary glands.

Let us list the main preventive measures.

• Try to avoid tense and stressful situations. If you think that this is impossible, then ask your doctor to prescribe you sedatives to stabilize your psycho-emotional state, normalize cardiac activity and blood pressure. To prevent breakdowns, it is recommended to take medications based on valerian root, drink sedative infusions, avoid overexertion, listen to your favorite light music, etc.
• As trivial as it may sound, you should lead a healthy lifestyle, giving up habits that are harmful to your health – nicotine addiction, alcohol consumption, etc. Determine a rational daily routine for yourself, in which you need to designate time for work, sleep, useful pastime, rest and food intake. A chaotic daily routine can lead to hormonal disorders and weakening of the body's defenses, which aggravates the negative impact of external factors.
• Monitor your body's metabolic processes - treat diseases in a timely manner (especially in the genital area), do not allow extra pounds to appear (obesity and excessive growth of adipose tissue contribute to the development of local fibrosis). Experts have noted that eating meat and fatty foods provokes a decrease in androgen levels and an increase in estrogen levels in the body. And that's not all - everyone knows that fatty and fried foods are potential carcinogens that can push benign processes to malignancy. For this reason, maximum attention should be paid to nutrition, namely: eat a sufficient amount of plant foods, reduce the consumption of animal fats, avoid pickles, smoked foods, preservatives, fried foods and foods containing artificial additives.
• Regularly conduct a general examination of your breasts in front of a mirror. If such self-examination is done correctly and constantly, then you can notice the appearance of dangerous diseases at the earliest stage of their development, which will allow you to promptly consult a doctor and begin treatment.

Among the rules and conditions of secondary prevention, the following can be distinguished:

• exclusion of abortions;
• presence of healthy pregnancies;
• full lactation period;
• regular sexual life;
• active lifestyle;
• prevention of chest injuries.

The listed preventive rules are within the power of every woman, so doctors strongly recommend listening to them and gradually introducing them into your life.

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Forecast

An advanced form of fibrous lesion can subsequently cause dangerous diseases. It is important to know that it is not possible to completely cure fibrosis, but with a competent approach and qualified treatment, a woman will be able to forget about the disease and lead an absolutely full life. A full course of treatment will help correct the hormonal balance and strengthen the immune system. In the future, the doctor will advise avoiding injuries, stressful situations and paying close attention to nutrition and lifestyle.

Since local fibrosis of the mammary glands is considered a chronic pathology, the patient will be advised to regularly visit a medical specialist, carefully follow his instructions, take tests and not resort to self-medication.

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