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Sclerosing adenosis of the breast
Last reviewed: 05.07.2025
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There are several forms of breast adenosis, which are usually localized in the glandular components of the mammary gland. In sclerosing adenosis, lobule growth is observed, while the layers of internal and external tissue are preserved.
The first stage of dyshormonal diseases of the mammary gland develops mainly at the age of 30-40 years, but the pathology is possible at a younger age and after 50 years.
Adenosis is one of the simplest forms of dyshormonal pathologies. In the sclerosing form, changes in glandular tissues practically do not occur, basal membranes are preserved, structures are limited.
Sclerosing adenosis consists of small seals that are associated with an increase in lobules. Usually, the seals are very sensitive, in some cases they are painful. Due to the distorted forms on mammography, adenosis can be mistaken for a cancerous tumor, but it is worth noting that the pathology is a benign condition.
The disease can be detected against the background of pathological proliferation of breast tissue, which leads to a change in shape, carcinoma (ductal or lobular).
ICD-10 code
In ICD-10, sclerosing adenosis of the mammary gland belongs to the class of diseases of the mammary gland (N60-64).
Causes of sclerosing adenosis of the mammary gland
The main cause of the pathology is hormonal imbalances that occur in a woman’s body (frequent causes of this are constant stress and a weak immune system).
An imbalance of sex hormones in women can be associated with puberty, pregnancy, in which case the level of estrogen and prolactin in the blood increases, progesterone decreases. Such hormonal changes cause the development of various forms of mastopathy, but sclerosing adenosis is usually caused by prolonged hormonal disorders.
To determine the cause of the disease, a blood test for hormonal balance is often prescribed.
In some cases, sclerosing adenosis of the mammary gland is associated with hyperplastic processes in the pelvis (excessive proliferation of the endometrium, ovarian dysfunction, ovarian cysts, thyroid pathologies, excess weight associated with thyroid pathologies or consumption of foods high in fat and easily digestible carbohydrates).
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Pathogenesis
Adenosis increases the risk of developing breast cancer several times, compared to other types of mastopathy. Sclerosing adenosis of the mammary gland is diagnosed in women aged 20-40 years (approx. 5% of all cases of mastopathy).
The disease is characterized by the proliferation of connective cells in the epithelial tissue and their fibrous degeneration. In the process of tissue replacement, calcifications are formed, which are often confused with invasive breast cancer on mammography.
Sclerosing adenosis comes in two forms: limited (single nodules) and diffuse (multiple foci).
Symptoms
A common symptom of the pathology is frequent nagging pain that intensifies before menstruation. A palpable lump of regular shape appears in the breast (in the entire gland or in a separate area), which can spread to surrounding tissues.
Sclerosing adenosis of the mammary gland can also affect the milk ducts, which causes the formation of papillomas (a benign tumor in the form of a nipple-shaped growth).
Diffuse sclerosing adenosis of the mammary gland
The diffuse form of sclerosing adenosis is caused by a disorder of neurohumoral regulation, which leads to increased production of estrogen or a lack of progesterone in the body. The disease can also be provoked by bad habits (alcohol, smoking), ecology (especially in large cities), harmful production (ionizing radiation), passion for tanning (solariums, beaches, etc.). Childbirth (from 20 to 25 years), breastfeeding, oral contraception (within reasonable limits) will help reduce the risk of pathology, all these factors represent a kind of protection against diseases caused by dyshormonal pathologies.
Diffuse sclerosing adenosis of the mammary gland is associated with the phase of the menstrual cycle and provokes severe pain in the second half or middle of the cycle.
Pain in the mammary gland varies in nature in each individual case and can be aching, bursting, stabbing, radiating to the neck, shoulder, back.
Swelling or thickening of the breast tissue, the appearance of palpable small granular structures, transparent discharge from the nipples (or in the form of colostrum) are possible, and the intensity of such discharge increases before menstruation.
Treatment of the diffuse form of sclerosing adenosis is mainly conservative, and the specialist must monitor the woman’s condition dynamically.
In case of diffuse adenosis, it is recommended to change the diet and increase the amount of dairy and fermented milk products, plant fiber, and limit animal fats.
If you have digestive problems that interfere with the absorption of nutrients, a consultation with a gastroenterologist is recommended.
In some cases, vitamin and mineral supplements are prescribed.
Recently, experts have recommended using homeopathic remedies (Mastodion), herbal preparations (phytolone), sedatives, diuretics and enzymatic preparations for adenosis.
For diffuse adenosis, therapeutic exercise is recommended.
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Proliferation without atypia
Benign breast lesions are divided into three categories based on cell type: non-proliferation (no tissue growth is observed), proliferation without atypia, and atypical growths of the glandular component of the breast.
Pathologies without proliferation usually do not degenerate into cancerous tumors.
Sclerosing adenosis of the mammary gland is characterized by the growth (proliferation) of glandular tissue in the center of the mammary gland lobule, while the cells can retain their structure, i.e. the disease develops without atypia.
With atypical hyperplasia, the risk of transformation into a cancerous tumor increases by 4-5 times.
First signs
Sclerosing adenosis of the mammary gland may not manifest itself for a long time, the main symptom may be pain in the mammary glands before menstruation, which usually does not cause concern in many women. The pain in most cases is nagging and intensifies in the corpus luteum phase.
The development of adenosis may be indicated by the appearance of a mobile lump in the mammary gland that can be felt.
Consequences
When sclerosing adenosis is detected, specialists, in most cases, are in no hurry to prescribe treatment, especially hormonal drugs.
Hormones can harm women's health, especially at a young age, since hormonal surges occur most often during this period and the pathology can pass without special intervention.
If necessary, a specialist can prescribe minimal hormonal therapy; operations for this form of mastopathy are performed very rarely.
Despite the fact that doctors are in no hurry to treat sclerosing adenosis of the mammary gland, the risk of degeneration into a cancerous tumor is quite high and constant monitoring of the woman’s condition is required.
Complications
Sclerosing adenosis of the mammary gland usually requires minimal treatment, which includes dietary changes and treatment of diseases that provoked hormonal imbalances.
Usually, this form of mastopathy does not cause an atypical process, but the woman is recommended to undergo regular examination by a mammologist.
Diagnosis of sclerosing adenosis of the mammary gland
If dyshormonal diseases of the mammary gland are suspected, after a preliminary examination by a specialist, a mammogram and ultrasound examination are prescribed.
The examination helps to identify the pathological focus and determine the shape and boundaries of the tumor.
With the growth of adenosis and damage to the milk ducts, the probability of developing a malignant process increases significantly. For the timely detection of pathology, cytological, histological and immunological studies are prescribed.
Tests
Sclerosing adenosis of the mammary gland is considered a hormone-dependent disease, and to identify the causes, a hormone test is prescribed.
Analysis of the levels of progesterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estrogen, testosterone, etc. allows us to determine whether there are hormonal imbalances in a woman’s body.
Estrogen is produced by the ovaries (and a small part by the adrenal glands), these hormones are responsible for the development of secondary sexual characteristics, and are also involved in the reproductive system.
Estradiol has a special biological activity, which is responsible for cyclic changes in the body, helps reduce the risk of developing heart and vascular diseases, and prevents the development of osteoporosis.
Progesterone is produced mainly by the ovaries (a small part by the adrenal glands). This hormone is also called the pregnancy hormone, since in the "interesting" position the level of the hormone increases, it helps prepare the inner layer of the uterus for the implantation of the embryo, prevents the rejection of the embryo, reduces the contraction of the uterus.
FSH and LH are classified as gonadotropic hormones, the production of which is the responsibility of the pituitary gland. They are responsible for the maturation of follicles, the formation of the corpus luteum, and the production of progesterone and estrogen.
In addition to determining hormone levels, the ratio of hormones in the body is important.
Instrumental diagnostics
Instrumental diagnostic methods are necessary to make an accurate diagnosis.
This type of diagnostics can be invasive (with damage to the integrity of the skin) and non-invasive. Sclerosing adenosis of the mammary gland
Invasive procedures include biopsy, which allows tissue samples to be examined under a microscope.
Fine needle aspiration biopsy is used for palpable breast lesions. The procedure is performed without anesthesia, using a syringe and a thin, long needle.
A needle is inserted into the mammary gland and glandular tissue is drawn into a syringe, which is sent for laboratory testing.
A core biopsy allows you to obtain more breast tissue for testing. The analysis requires a thick needle with a cutting device.
The advantage of this method is that due to the larger area of tissue, after histology the doctor will be able to make a more accurate diagnosis.
Non-invasive, i.e. not violating the integrity of the skin, instrumental diagnostic methods include mammography, ultrasound, and computed tomography.
Mammography is recommended to be done annually for women after 35 years. The purpose of this study is the early detection of pathological changes in the mammary gland. On a mammogram, each disease of the mammary gland has its own characteristic picture.
Ultrasound examination allows to clarify the nature of changes in the mammary glands. The method is simple and safe, the advantage is the detection of differences between hollow (cyst) and solid formations (tumors).
Differential diagnostics
Differential diagnostics is considered the most important in making a diagnosis. This diagnostic method allows us to distinguish diseases from each other, since the same symptoms can be associated with different diseases.
During the examination, the specialist gradually excludes diseases that do not fit certain symptoms, which ultimately allows for a final, only probable diagnosis.
Sclerosing adenosis of the mammary gland is usually detected by a doctor during an examination; dense nodes of a regular shape are found during palpation. The patient's complaints about pain (its nature, what period of the cycle it appears in, etc.) are also taken into account. To confirm the diagnosis, an ultrasound is usually prescribed, since there is a high risk of an incorrect result with mammography (adenosis can be mistaken for breast cancer).
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Treatment of sclerosing adenosis of the mammary gland
Treatment options depend on the stage, age, and general health of the patient. In most cases, sclerosing adenosis of the mammary gland is not treated, and the woman should undergo an ultrasound and visit a doctor every year.
In some cases, multivitamin preparations, sedatives, combined oral contraceptives or hormones, drugs to improve immune function, and diuretics may be prescribed.
In case of dyshormonal pathologies, oral combined contraceptives (Lindinet 30) may be prescribed. Such drugs contain a certain level of hormones that balance the hormonal background and prevent monthly hormonal fluctuations in the body.
Lindinet 30 contains a synthetic analogue of estradiol, which regulates the menstrual cycle, as well as gestodene (analogue of progesterone). The drug helps prevent a number of gynecological diseases, including tumor growth. Take 1 tablet daily (preferably at the same time) for 21 days, then repeat the course after a week's break.
Gestagens (Duphaston, Norcolut) are steroid hormones that suppress the production of luteinizing hormone and have antiestrogenic, gestagen, androgenic and antiandrogenic effects.
After taking the drug, you may experience swelling, nausea, and high blood pressure. In case of liver dysfunction and a tendency to thrombosis, such drugs are contraindicated.
Duphaston contains dydrogesterone, which is similar in properties to natural progesterone; the drug does not have the side effects typical of most synthetic analogues of progesterone.
You need to take Duphaston 10 mg 2-3 times a day for 20 days (from the 5th to the 25th day of the cycle) or constantly.
Norcolut blocks the production of gonadotropin and prevents the maturation of follicles.
Prescribe 1-2 tablets on certain days of the cycle.
In some cases, the doctor decides to perform surgical treatment of adenosis (usually if a malignant process is suspected).
Drug treatment
When choosing hormonal therapy, specialists prefer Lindinet 30, which helps reduce the clinical manifestations of sclerosing adenosis.
After 2 months of taking the drug, the symptoms of the disease disappear and menstruation returns to normal.
During the intake, some side effects of the body may occur: increased blood pressure, thromboembolism (including myocardial infarction, stroke), and hearing loss is also possible.
Lindinet 30 is taken according to the scheme - 1 tablet every day for 21 days, then a 7-day break is taken and the course is repeated. The duration of treatment is on average 6 months, the decision to continue treatment is made by the attending physician.
In addition to Lindinet 30, other oral contraceptives containing dienogest (2 mg) may be prescribed: Genegest, Janine Silhouette.
Gestagens are used for more pronounced symptoms of adenosis, which are especially intensified before menstruation.
Among such drugs are Norcolut, Pregnin, Duphaston, Progesterone (oil solution), which are prescribed from the 16th to the 25th day of the cycle. The effect of the treatment appears after 2 months - discharge from the nipples, engorgement and pain in the mammary glands decreases (sometimes completely stops). The course of treatment is from 3 to 6 months.
Pregnin belongs to the group of progestogens and is an analogue of the hormones of the corpus luteum. Prescribed 1-2 tablets 2-3 times a day, with an increase in dosage, an increase in pressure, swelling, a short-term increase in uterine bleeding is possible.
Progesterone (oil solution) - the hormone of the corpus luteum has a gestagenic effect. Usually prescribed at 5 mg daily, can cause drowsiness, apathy, headaches, visual impairment, shortening of the menstrual cycle, swelling, increased pressure, weight gain, allergies.
Sclerosing adenosis of the mammary gland is treated with gestagen drugs for 3-6 months; at the discretion of the doctor, the use of drugs can be extended.
Folk remedies
Sclerosing adenosis of the mammary gland can be treated with folk remedies, but it is worth remembering that any recipes, even harmless at first glance, should be carried out after consulting a doctor.
For adenosis, you can use compresses:
- apply pumpkin pulp to the affected breast for 3-5 days
- apply a cabbage leaf, greased with butter and sprinkled with salt, to the chest at night for a week (usually the pain decreases in the morning).
- grated fresh beetroot with 2 tbsp. vinegar in warm form is applied to the chest for 8-10 days.
These methods help reduce the unpleasant symptoms of the disease.
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Herbal treatment
Today, treatment of various forms of mastopathy, including sclerosing adenosis of the mammary gland, can be carried out using medicinal herbs, but in this case, a comprehensive approach is mandatory.
Phytotherapy can use plants from several groups – gonadotropic (selectively affect female sex hormones), antitumor herbs, immunomodulators.
Gonadotropic plants can be poisonous (they have a rapid therapeutic effect and a large number of side effects) and ordinary (they act more slowly, have mild properties and a minimum of side effects).
Poisonous plants of this group include: black cohosh, rhododendron occidentalis, meadow pasqueflower, twisted Dutchman's pipe; common plants include oregano, lemon balm, orthilia secunda, sweet woodruff, lavender, radiola, lycopus, horehound, and angelica.
Herbs with antitumor effect: plantain, St. John's wort, elecampane, calendula, lemon balm, hawthorn, nettle, wormwood, horsetail, mint, aloe, immortelle, calamus rhizomes, etc.
To boost immunity, use calamus, Manchurian aralia, aloe, echinacea, chamomile, hawthorn, and ginseng.
The following recipe helps relieve the symptoms of adenosis: valerian root, succession, celandine, St. John's wort, nettle, rose hips, mint, hawthorn flowers, 1 tbsp each. Mix all the ingredients, take 1 tbsp and pour 1 liter of boiling water, leave for 15-20 minutes, take 2 times a day (between meals).
Homeopathy
Sclerosing adenosis of the mammary gland can be treated with homeopathy, this method is recommended by a number of specialists, recognizing it as effective in the case of this pathology.
For this type of adenosis, the homeopathic medicine Mastodinon is usually prescribed.
The product is available in the form of tablets or drops. The therapeutic effect is achieved due to natural components - iris versicolor, alpine violet, bitter chestnut, chaste tree, hanging cohosh, tiger lily (it is worth noting that the composition also contains alcohol). The drug reduces the production of prolactin and has a positive effect on the tissues of the mammary gland, preventing pathological processes.
After about six months, the therapeutic effect can be observed, and Mastodinon can be used both as part of complex therapy and independently.
Side effects during the intake occur extremely rarely, most often expressed in allergic reactions. Sometimes nausea, stomach pain, weight gain, headaches, acne may bother.
The drug should not be taken by girls under 12 years of age, during breastfeeding, pregnant women, or in case of individual intolerance to some components.
It is worth noting that drinking alcohol and smoking negatively affect any treatment, and homeopathy is no exception, despite the fact that all homeopathic preparations have natural ingredients.
Mastodinone should usually be taken 2 times a day, 1 tablet or 30 drops.
The drops should be shaken well before use and diluted with water.
Homeopaths recommend taking this medicine 20 minutes before meals or 40 minutes after.
Mastodinone must be taken for at least 3 months, but noticeable improvements in the condition are observed after six months of continuous treatment.
Surgical treatment
Sclerosing adenosis of the mammary gland is treated surgically extremely rarely. When choosing this method of treatment, sectoral resection is usually prescribed.
The operation can be performed under local or general anesthesia (depending on the number and size of nodes, age, and concomitant diseases).
During the operation, the surgeon always cuts the edge of the areola, the removed node is subsequently sent for histology to clarify the nature of the neoplasm or determine further treatment tactics.
Usually the patient is discharged from the clinic the next day after the operation, the doctor may prescribe painkillers.
If a woman has one node or multiple nodes that are not prone to growth, the disease is not treated, and the woman is prescribed regular examinations (ultrasound and examination by a mammologist once every 6 months).
Prevention
Hormonal changes in the female body occur regularly, but such dyshormonal diseases as sclerosing adenosis of the mammary gland can be prevented both in a teenage girl and after 40 years of age.
Preventive measures are quite simple, it is necessary to promptly identify and treat gynecological and other diseases. It is also necessary to remember the following measures that help reduce the risk of developing dyshormonal diseases: first pregnancy (necessarily full-term), no abortions, regular examination by a gynecologist, reduction of stressful situations.
Physical exercise is important, swimming has a good effect on a woman's overall health. Don't forget about proper nutrition.
Forecast
Sclerosing adenosis of the mammary gland does not pose a danger to a woman’s life, but still, the pathological process can degenerate into a malignant tumor, therefore, in this case, timely diagnosis and regular monitoring by a mammologist are extremely important.
Sclerosing adenosis of the mammary gland is a benign process in which the glandular structure grows. The disease is associated with hormonal changes in the woman's body, especially long-term hormonal imbalance leads to the development of adenosis. Pathology in most cases does not require treatment, sometimes sedatives can be prescribed (if hormonal disorders are associated with stress), hormones, treatment of existing concomitant diseases is also indicated, in rare cases, surgical treatment is prescribed.