Pregnancy with fibrocystic mastopathy: doctor's advice. Fibrocystic mastopathy and pregnancy: symptoms of breast disease Why can a fibrous tumor develop in the breast

Many women are familiar with such a disease - mastopathy. Some even know that it is a consequence of a violation of the hormonal status of the body. And of course, both those and others are interested in whether it is possible to get pregnant with mastopathy. Will doctors allow pregnancy, and is it possible at all with the “wrong” amount of female sex hormones? Well, let's try to answer.

The essence of the disease

Mastopathy is not cancer, and not even always a precancerous condition. Nevertheless, in terms of discomfort, it can be compared with. It is usually diagnosed quite early because of pain, which is not easy to endure even for the most patient woman.

There are two main forms - diffuse and nodular. The second is manifested by the presence of one or several seals (nodes) of a relatively large size in the thickness of the mammary gland, while the first nodes are small, but located everywhere in the organ. Many believe that the nodular form often degenerates into cancer, but in fact any of the forms becomes malignant. The main risk factor is the growth of the glandular tissue (proliferation), which can occur regardless of the type of disease.

The main cause of mastopathy is an imbalance of estrogen and progesterone in the body. Not only their concentration is taken into account, but also their biological activity. A drop in progesterone function and an increase in estrogen "activity" is a sure way to the development of mastopathy. Especially often this imbalance develops in women who have terminated their first pregnancy, in those who have menstruation very early, heredity is burdened, etc. There are also mechanisms of influence on the mammary gland from growth hormones, hypothalamic factors and some other substances. All this together gives ground for the development of mastopathy.

Is it possible to get pregnant with mastopathy

Of course, having heard the terrible word "hormones", many believe that a violation of their background will not allow you to get pregnant with mastopathy. No wonder, because for a proper pregnancy it is necessary that everything in the body be in order - the genitals, sex hormones, the absence chronic diseases etc. But few people remember that if only exceptionally healthy women could get pregnant, humanity would have died out long ago!

In fact, mastopathy does not interfere with pregnancy. Ovarian work, "quality" menstrual cycle depend on estrogens, which are in the body of a woman suffering from mastopathy. quite enough. Of course, a qualified specialist can finally help such a lady with the issue of pregnancy, because there may be too much estrogen. However, mastopathy is not a synonym for the word "infertility"! It’s just that pregnancy in this case should be approached consciously, planning it in advance, being examined in advance and going through necessary treatment also in advance, as many women in Western countries do. A perfectly acceptable "sacrifice" for the joy of motherhood, isn't it?

Tell me, is mastopathy dangerous during pregnancy? Valeria, 36 years old

Hello Valeria. No, mastopathy during pregnancy is no more dangerous than outside it. There may be some difficulties with its treatment, since some drugs are prohibited for women in the "position", but in general there is no danger.

Mastopathy and pregnancy after 35 years

The first pregnancy after 35 years is a risk factor for her pathology. Such a woman is considered “problematic”, but not at all because she is only a problem. It may just be more difficult for her to get pregnant, and the pregnancy itself will have to be monitored with the greatest attention, not missing a single screening, not a single analysis. If the doctor recommends to lie down "for preservation", you should not refuse him - this is in your interests.

Considering that mastopathy develops in many women after the age of 35, and taking into account the fact that many women give birth at this age, we can say that there is nothing wrong with this situation. Just prepare in advance, undergo a course of treatment that suppresses the growth of mastopathy before conception and carefully observe the doctor during pregnancy - and everything will be in order.

This question is best asked by your doctor. We do not know what your hormonal background is, so we cannot answer for sure. By itself, mastopathy is not an obstacle to pregnancy.

How to treat mastopathy during pregnancy

A rather serious question is placed in the title of this block of information. Indeed, although pregnancy is not a disease, it imposes quite serious restrictions on the choice of drugs for the treatment of any disease. Mastopathy is no exception, some drugs used to combat it are contraindicated during pregnancy. Below will be brief information about the most commonly used drugs:

Progestogel is a progesterone drug. It is applied to the skin of the mammary gland and absorbed directly into its tissue. It does not have an effect on the entire body, which means it can be used during pregnancy, if you do not violate the dosages, the frequency of administration.
Bromocriptine is a drug that acts on the synthesis of hormones in the hypothalamus. Quite effective in mastopathy, but categorically contraindicated in pregnancy. You should stop taking it in advance when planning a pregnancy, and if it comes unexpectedly, stop taking it immediately!
Tamoxifen is a drug that suppresses the activity of estrogens. By itself, it can reduce a woman's ability to conceive, but if it happens, tamoxifen is immediately stopped. Can cause developmental abnormalities, so all warnings related to bromocriptine apply to it.
Diuretics - used for severe swelling of the mammary gland. They do not eliminate the disease itself, but reduce the brightness of its symptoms. Contraindicated in pregnant women, as they penetrate the blood of the fetus and can provoke violations of its development.
Sedative drugs. From this group, all synthetic drugs are unambiguously contraindicated (the same “chemistry” that most mothers are afraid of). It is possible to take naturopathic remedies (of plant origin), which, although they do not have a powerful effect, are quite safe when taken according to the recommendations established by the doctor. It should be remembered that natural preparations do not act immediately, you need to wait for their accumulation in the body for a full effect.
Vitamins. Definitely indicated for mastopathy in therapeutic doses. However, care should be taken when taking them, as rare cases their uncontrolled use is possible overdose - an undesirable phenomenon, and especially during pregnancy.
Homeopathic remedies. Despite the fact that this group of drugs is sometimes prescribed by doctors and even got into the registry of essential medicines, most scientists and medical practitioners do not believe in their effectiveness. Without going into the details of the eternal "war" between homeopaths and naturopaths, let's say that in some situations this group of drugs can help and is by no means dangerous. So it is possible to accept, whether it will help is unknown.

Remember only that taking any drug during pregnancy can only be done in consultation with the observing gynecologist.

Is it possible to give birth with mastopathy

With pregnancy, everything became clear, but what about childbirth? Here, as in any case of childbirth, everything depends not on the presence or absence of mastopathy, but on the very course of pregnancy, additional health problems such as the anatomical features of the pelvic region and genital organs, the presence of heart disease, kidney disease, endocrine system etc. Of course, if mastopathy has developed, then not everything is fine in the body and problems may arise in childbirth (for example, weakness of the birth forces). Nevertheless, doctors do not always recommend a caesarean section with this diagnosis.

In any case, follow the doctor's recommendations, because he sees the situation as a whole, not limited only to the process in the mammary gland. If he says “caesarean”, then it’s better to go through it and be sure of a successful outcome of the birth than to refuse, get a protracted birth and fetal hypoxia, coupled with a birth injury.

Does mastopathy go away after childbirth

This is perhaps the most discussed issue in the medical (and not only) community. Some believe that a woman's body during pregnancy and childbirth goes through a kind of "reboot" - the bad state of hormones is, as it were, "erased" and new, correct information is written to the "computer". Others tend to believe that the hormonal shocks of pregnancy, childbirth and the postpartum period, coupled with lactation, either do not affect the course of mastopathy in any way, or even worsen its course. Both the first and the second operate with some arguments, but the truth is unknown to anyone. There is no hard evidence that anyone is right.

It should simply be remembered that even after childbirth, a woman should be periodically examined, check the condition of the mammary glands with a mammologist, especially after 35 years and especially if mastopathy was already detected in her before pregnancy.

Is it possible to do IVF with breast mastopathy

In vitro fertilization may be the only way to conceive a child for more than 10% of couples. Here, however, the question arises about the causes of infertility. The woman is not always “guilty” - a man can also be infertile. There may well be viable spermatozoa in his sperm, they just aren’t enough for conception natural way. Perhaps infertility and purely mechanical, for example, with obstruction of the fallopian tubes. In these cases, IVF helps undeniably.

I want to ask if IVF is done for mastopathy? Wanda, 30 years old

Wanda, many factors are taken into account when deciding on the possibility of IVF. As part of a short answer, we will not be able to give you comprehensive information. In principle, in vitro fertilization with mastopathy is possible, but it all depends on the specific case.

However, there are situations when infertility is associated with a certain imbalance of hormones, which can also affect the possibility of conception. This happens quite often, but the reason is usually a decrease in estrogen activity. Mastopathy, we recall, occurs when their function is excessive. In these cases, the woman is offered one or more courses of hormone therapy, after which conception usually becomes possible.

There is, however, one pitfall in this whole situation and it is called "ovarian hyperstimulation syndrome". It occurs during IVF, carried out at high initial estrogen numbers and is a potentially life-threatening condition. It is precisely with mastopathy that the risk of its development is higher due to the fact that mastopathy develops against the background of an increase in the level of estrogen hormones. You can reduce the likelihood of its development by a thorough examination of the hormonal background and even more careful selection of the dose of drugs.

In short, IVF with mastopathy can be done, but it is necessary to inform the attending physician about the presence of this pathology and carefully monitor yourself throughout the pregnancy. In any case, the final verdict is made by a specialist.

Remember, mastopathy is not a sentence. You can live a full life, taking the necessary drugs, you can get pregnant and give birth. But it is necessary to monitor your health and it is better to do this under the supervision of a good doctor.

Is it possible to get pregnant with fibrocystic mastopathy. Irina, 26 years old

It is theoretically possible to become pregnant, but many factors can affect conception. Plan a pregnancy together with a gynecologist, get examined, sanitize foci of infection, and the likelihood of conception will increase significantly.

You can ask your question to our author:

Fibrocystic mastopathy (FCM) is a pathological condition of the mammary glands, accompanied by the appearance of seals and cysts of various sizes and shapes. This is a fairly common disease among women of reproductive age, it affects at least half of the female population. The disease responds well to treatment early stages: it is better to go through all therapeutic procedures in advance, without waiting for the development of adverse effects.

ICD-10 code

N60.1 Diffuse cystic mastopathy

Causes of fibrocystic mastopathy

The main reason for the development of fibrocystic mastopathy is hormonal destabilization in the body: the hormones progesterone and estradiol play a dominant role in the process. Factors that determine the imbalance of hormones can be the following:

early puberty. The rapid renewal of the hormonal background does not allow the body to quickly adapt to changes, which is reflected in the tissue structure of the mammary glands;
late menopause. The decisive role is played by the long-term effect of hormones on the tissues of the gland;
no history of pregnancies;
frequent forced termination of pregnancies (more than twice) provokes a sharp rise and fall in hormonal activity;
absence or extremely short lactation period;
constant or frequently recurring stress;
age period from 40 years;
metabolic disorders - obesity, diabetes, endemic goiter;
violations of the liver;
disorders of the endocrine system: hypo- or hyperthyroidism, thyrotoxicosis;
diseases of the genitourinary sphere, reproductive dysfunction;
uncontrolled intake of hormonal drugs, including contraceptives.

Symptoms of fibrocystic mastopathy

Initially, the fibrocystic form of mastopathy was not defined as a condition predisposing to breast cancer. However, recent scientific studies have shown that mastopathy should be considered precisely as a precancerous condition, which under certain circumstances can transform into a malignant tumor.

The probability of developing breast cancer, as a result of FCM, depends on many factors, for example, on the total duration of the disease, its stage, intensity and brightness of manifestations. A history of multiple and large cysts, fibroadenoma, adenosis, hyperplasia and proliferative mastopathy increases the risk of developing cancer by 2-4 times.

Although fibrocystic breast disease is considered a benign disease, in some cases it is an intermediate process in the formation of a malignant formation. That is why the clinical examination of patients with treated FCM and long-term monitoring of their condition is an important link in the prevention of breast cancer.

The clinical symptoms of fibrocystic mastopathy are determined by painful sensations, breast seals and the appearance of secretions from the milk canals. By palpation, you can feel fine and coarse-grained formations, dense areas of breast tissue. Soreness in this disease can appear spontaneously, or occur only when trying to touch: a feeling of slight discomfort can be replaced by sharp severe pain even from a slight touch.

Pain in the mammary gland may be accompanied by a feeling of weight, puffiness, squeezing, sometimes it radiates to the shoulder joint or to the axillary area.

Often, patients note the appearance of secretion from the milky channels: the secreted liquid resembles colostrum, or it may be slightly yellow or greenish.

The initial symptoms of fibrocystic mastopathy may be more pronounced with the onset of menstruation or PMS. With the progression of the disease, the symptoms become brighter, the pain is more noticeable, and tissue compaction can be determined already, regardless of the frequency of the cycle.

Pain in fibrocystic mastopathy

The presence of pain in fibrocystic mastopathy is a fairly common, but very individual symptom. Dull, aching, shooting, twitching, it can have a different intensity and be accompanied by a feeling of pressure in the mammary glands.

Soreness often increases before the onset of menstruation (at the same time the level of hormones increases), may be limited to a local manifestation or radiate to the shoulder joint, subscapularis and axillary region.

Not all women feel pain during mastopathy: about 10% of patients usually do not observe signs of pain discomfort, and some feel pain only during critical days. In this case, the general symptoms of the disease in them can absolutely coincide. The reason for this phenomenon may be the difference in pressure on the nerve endings and differences in the individual pain threshold.

Also, pain can be observed not only in the mammary glands, but also in nearby lymph nodes, which can be slightly enlarged and strained.

Allocations with fibrocystic mastopathy

Allocations in fibrocystic mastopathy may not be observed in all cases of the disease. This phenomenon is individual: there may be no liquid discharge at all, sometimes it can be very abundant (often this symptom allows you to independently detect the disease), or it can occur only with slight compression of the peripapillary region. The secretions usually do not have a specific smell, their color varies from transparent, light, whitish to yellowish and greenish. Sometimes their appearance resembles colostrum (the secret of the mammary glands, separated in the last days of pregnancy and in the first days after childbirth).

In some cases, the discharge may acquire a brownish or bloody hue: this is a rather formidable symptom that requires a mandatory medical examination. Bloody issues from the milk canals can be a sign of a malignant process in the mammary glands, destruction of the capillary blood supply system and damage to the walls of the ducts.

In principle, any detected discharge from the nipples requires the consultation of a specialist, and this especially applies to discharges with an admixture of blood.

Pregnancy and fibrocystic mastopathy

Pregnancy with fibrocystic mastopathy is not only possible, but also desirable. Everyone knows that during the period of bearing a child, a significant restructuring of the hormonal status in a woman's body occurs. This can serve as an impetus to further stabilize the level of hormones and stop the development of the disease. For this reason, many gynecologists strongly recommend that women become pregnant, boldly bear and breastfeed their child in the future.

By the way, the natural lactation period often becomes the main medicine fight the disease. You should not interrupt breastfeeding in advance: the period of breastfeeding often brings women relief and even complete recovery with the resorption of cystic formations and nodes.

If the woman was treated for FCM hormonal drugs and became pregnant in the same cycle, the treatment of the disease should be stopped immediately, since the use of hormones during pregnancy requires great care. In this situation, consult your doctor, perhaps he will prescribe you other, non-hormonal drugs that are approved for use during pregnancy.

Lactation

The issue of breastfeeding a child with fibrocystic mastopathy should be decided by a mammologist, since the degree of progression and severity of the disease in all women is individual.

The bottom line is that breastfeeding promotes certain physiological processes in a woman's body: in particular, the growth and reproduction of breast epithelial cells are activated, which tend to synthesize their own antibodies that can affect various neoplasms, including cysts and fibromatous nodes.

Long-term breastfeeding should be carried out with constant monitoring of the state of the mammary glands, with periodic examination by a doctor and measures to prevent lactostasis. Reception medications during the lactation period must be agreed with the doctor.

Fibrocystic mastopathy and cancer

According to recent scientific research, fibrocystic mastopathy should be considered as a possible precancerous condition. This concept is morphological in nature, it can include intraductal atypical growth of the epithelium and manifestations of carcinoma.

When found in the breast the following signs and symptoms, you should immediately seek the advice of a specialist:

nodular compaction in tissues or on skin glands, especially soldered to tissues and to each other nodes;
the appearance of ulcerative lesions on the skin, in the areola, or crusts on or around the nipple;
localized or widespread swelling of the tissues of the mammary glands;
bloody, brown or black discharge from the milk ducts;
the appearance of areas of redness on the skin;
change in the shape of the breast, the appearance of tuberosity, violation of the contours of the glands or the areola;
the appearance of asymmetry in the location of the mammary glands;
inability to displace the gland.

Forms

ICD-10 is a generally accepted international classification diseases, among which there are all types of mastopathy. This is the main informative documentation used medical workers all over the world. Standardization and unification of diseases has the right to be reviewed only once a decade.

This classification is designed to create the most comfortable conditions for determining the analytical data of world statistics regarding the level of cases of diseases and deaths, which are periodically recorded and sent by various regions and countries of the world. Diagnostic indicators are described as an alphanumeric code, which is extremely convenient in the process of storing and retrieving the necessary information. Data from all over the world is carefully structured and processed.

Diseases and pathological conditions of the mammary gland in the ICD 10 list are in the subsection of diseases of the genitourinary system under the numbering N60-N64.

Diffuse fibrocystic mastopathy

Diffuse lesions of the mammary gland are characterized by excessive growth of areas of connective tissue of various shapes. This condition can disrupt the structure of the channels and the lobular structure of the glandular organ, contribute to the appearance of small cystic formations.

The diverse etiology of diffuse mastopathy can be associated with genetic predisposition, ecology, as well as multiple external factors. The determining reasons are the disorder of neurohumoral processes, increased estrogen synthesis and progesterone deficiency.

Depending on the structure and nature of tissue damage, the following types of diffuse mastopathy are distinguished:

pathology with the dominance of the glandular component (adenosis);
pathology with the dominance of the fibrous component (fibroadenomatosis);
pathology with the dominance of the cystic component (cystosis);
mixed course of FCM;
sclerosing type of adenosis.

The intensity of the detected violations makes it possible to divide diffuse mastopathy into a minor, moderate and severe form.

Nodular fibrocystic mastopathy

The term "focal fibrocystic mastopathy" is also often used for nodular FCM. Nodular mastopathy can be characterized by the growth of connective tissue areas and the formation of cystic formations resembling single or multiple nodes.

With this disease in the breast, you can palpate one or a group of nodules that have clear limited contours. Before the onset of menstruation, nodular formations may swell, increase, acquire some soreness. At the end of menstruation, it is easy to palpate painless nodules of various shapes, densely elastic consistency, with clear boundaries that are not soldered to the surrounding tissues. It is noteworthy that in a horizontal position, the nodules are palpated extremely weakly, if not completely absent.

Peripheral nodes usually do not increase.

Pain may be slight or absent at all, and the presence of nodules in women is more often detected completely by chance: thus, the manifestations of the disease can be very individual.

Nodular mastopathy is quite often the result of a diffuse disease.

Non-proliferative fibrocystic mastopathy

The medical term for non-proliferative fibrocystic mastopathy refers to a disease of the mammary glands that does not have characteristic features proliferation, namely, tissue growth of the glandular organ with the formation of a neoplasm and intensive cell division and reproduction. With this pathology, there is no increase in the number of structural elements of the tissue and the organ as a whole, there is no excessive growth of tissues, as in many other pathological conditions. There may be significant or localized swelling of the tissues, which cannot be called the formation of new structures.

Proliferation is a process of cell reproduction, which in most cases turns out to be the final stage of any inflammation, in which one can observe a clear separation of the pathological focus from healthy nearby tissues.

The non-proliferative form of FCM has a more favorable course and prognosis, but requires no less careful medical observation and treatment.

Mixed fibrocystic mastopathy

With a mixed form of fibrocystic mastopathy, the characteristic symptoms of all forms of the disease are combined:

signs of diffuse FCM with a predominant cystic component, when small cavity formations (capsules, or cysts) with liquid are formed in the mammary gland;
signs fibrous mastopathy with a predominant fibrous component, in which there is an proliferation of connective tissue areas in the gland;
manifestations of adenosis of the mammary glands (growth with a predominant glandular component) - excessive growth of glandular tissues, which is characterized by a significant increase in breast size;
cystic formations, or nodes, affect the mammary gland both in the form of single manifestations and total multiple tumors that are perfectly palpable in an upright position;
the simultaneous development of fibroadenoma is possible - a rounded, mobile and dense formation of a benign nature in the mammary gland.

This form of the disease is a somewhat neglected variant of the course of the disease, it is more difficult to treat and requires long-term therapeutic interventions.

Bilateral fibrocystic mastopathy

The name of this form of FCM speaks for itself - manifestations of fibrocystic disease with such a pathology are present on two mammary glands at the same time. Changes are expressed in hyperplasia of connective tissue, fibrous, glandular elements in both mammary glands, affecting the organs themselves and their milky canals, which contributes to the disruption of trophic processes and the formation of cystic formations.

Such a bilateral lesion of the mammary glands approximately doubles the risk of a malignant tumor, although FCM itself does not pose a life threat.

Bilateral fibrocystic mastopathy is a consequence of a persistent, long-term and serious violation of the hormonal balance in the body, so its treatment should be aimed primarily at restoring the normal natural level of hormones, identifying the cause of the imbalance (ovarian pathology, thyroid gland, adrenal glands, pituitary system, etc.).

Fibrocystic mastopathy in menopause

Violation of the regularity of the appearance of menstruation and their complete disappearance for a fifty-year-old female age is considered a normal physiological state, in addition, it determines the positive dynamics of the current pathological processes of the reproductive system of the body, up to complete recovery.

The risk of acquiring additional or exacerbating existing breast disease may increase when the onset of menopause occurs too early (before 45 years) or too late (after 55 years).

With the first symptoms of menopause, there is a significant change in hormonal balance. At this time, the breasts can cause pain and a feeling of tension and pressure.

Usually, the signs of fibrocystic mastopathy in this period weaken. Cystic formations, strands and nodes in the mammary glands can significantly decrease or disappear altogether, pain and heaviness in the chest gradually fade away.

Simultaneously with a decrease in ovarian function, the glandular tissue in the mammary glands gradually atrophies, and it is replaced by connective tissue and lipid areas.

Fibrocystic mastopathy and IVF

In vitro fertilization (IVF) is the so-called "test tube conception", sometimes the only way for childless couples to have a child. Before preparing for artificial insemination, you should go through many doctors to determine possible contraindications to the procedure. Often women are very worried about the presence of various forms of FCM: what will the doctor say, and is mastopathy a contraindication to IVF?

To be honest, their experiences are not groundless: during artificial insemination, the method of hormonal stimulation is used, and this can significantly complicate the course of the disease and provoke a rapid increase in cystic formations.

However, many doctors understand the importance of this procedure for a woman. It also takes into account the fact that the phenomena of FCM tend to regress during the period of breastfeeding. Therefore, often reproductology and mammology give permission to carry out the in vitro fertilization procedure even in the presence of fibrocystic mastopathy.

Complications and consequences

The most common consequences of FKM can be the following conditions:

an increase in the size of the cystic formation with a visual change in the mammary gland;
the development of a background inflammatory process with subsequent infection and suppuration of the cystic formation;
degeneration of a cystic formation into a malignant one;
rupture, violation of the integrity of the cyst.

Fibrocystic mastopathy cannot pose any immediate danger to the patient's life and does not cause significant discomfort and the inability to live a full life (in the absence of advanced stages with huge cystic formations).

The severity of the pathological process is aggravated only with the background development of an inflammatory reaction, the ingress of an infectious agent, and signs of suppuration of the nodes.

There are also cases of transformation of a cyst into a cancerous tumor, because it is known that the development of mastopathy significantly increases the risk of the formation of a malignant tumor.

Diagnosis of fibrocystic mastopathy

discover cystic FCM possible with independent palpation of the mammary glands. The method used to confirm the diagnosis ultrasound and mammography (x-ray of the breasts).

The mammography method is quite informative and determines the size, contours and number of cystic formations.

The ultrasound method provides an opportunity for a detailed examination of formations with an examination of the cystic wall.

Magnetic resonance imaging is used quite rarely, this method allows for a thorough examination of each layer of tissues and formations.

Aspiration biopsy of the breast determines the nature of the cystic formation, and pneumocystography can also demonstrate a similar result.

A histological examination of the material extracted during a biopsy is carried out without fail: this method is necessary to study the cellular structure of the cyst and allows you to refute the malignant nature of the formations, determine the presence of intraductal papilloma, or clarify the presence of inflammatory and purulent processes in the cyst.

Also, the standard diagnosis of mastopathy is impossible without palpation of the mammary glands and the collection of an anamnesis characteristic of this pathology. Sometimes blood tests may be ordered to determine the degree of hormonal imbalance.

ultrasound

The ultrasound method allows measuring the thickness of the layer of glandular tissue in each area of the mammary glands from the periphery to the peripapillary zone, as well as assessing the density of tissues in various areas of the organs.

The image obtained with ultrasound changes stably depending on the age of the patient: over the years, the thickness of the layer of glandular tissue decreases, and the density index increases, reaching maximum values by the age of 55.

The structure of the mammary glands varies significantly in adolescence, reproductive, menopause as well as during pregnancy and breastfeeding.

With fibroadenomatosis and diffuse mastopathy, the picture may be different depending on the dominance of any sign of the disease: it can be glandular hyperplasia, and cystic formations, fibrotic changes or mixed type of pathology. Often cystic manifestation FCM is combined with signs of fibrosis of glandular tissues.

The main ultrasound signs of fibrocystic mastopathy are:

fibrotic changes (fibrosis of areas of the milk canals and partitions);
discrepancy between the structure of the mammary glands and the age period of the patient;
lesions of the nipple and the surrounding area;
thickening of the layer of glandular tissues more than 14 mm;
expansion of the ducts of the breast;
detection of cystic formations.

Puncture

The puncture is usually performed by aspiration using a thin needle. The cystic capsule is punctured with a needle, which simultaneously aspirates the internal contents of the cyst. The procedure is not only diagnostic, but also therapeutic.

The cystic contents obtained by puncture usually have a yellowish-gray color, but with prolonged existence of the cyst, the fluid may become brown-black or greenish. Cytological examination of the contents is rarely carried out due to its low information content.

A puncture to collect cells from a tumor-like formation of the breast is a fairly popular research procedure. The obtained cell samples are mandatory sent for histological and cytological examination. Sometimes, at negative result aspiration may prescribe a second cell biopsy.

Breast puncture is a painless, but extremely informative procedure, which is essential for differential diagnosis fibrocystic FCM.

Treatment of fibrocystic mastopathy

The main measures in the treatment of fibrocystic mastopathy should be aimed at stabilizing the normal hormonal background in the female body.

Therapeutic methods of exposure are determined by a specialist on the basis of the results of analyzes of hormones in the blood, in particular, progesterone, estradiol and prolactin. In accordance with the results, drugs are prescribed that can correct the disturbed balance of hormones.

Treatment of mastopathy may include a puncture method of aspiration of fluid from the cyst with the further introduction of special preparations into the cavity that provoke obliteration of the cyst walls (sclerotherapy). This procedure is applicable to ordinary cystic formations without the phenomena of a malignant process and symptoms of an intraductal tumor.

In severe situations, characterized by the appearance of multiple cystic formations, excessive tissue growth, as well as suspected malignant degeneration of cells, the operation of sectoral resection of the mammary gland is used with mandatory histology of samples of removed tissues.

Alternative treatment

Alternative treatment of fibrocystic mastopathy is used for unstable and mild symptoms of the disease; with nodular FCM, a slight decrease in formations is noted, however, recurrence of foci of pathology is not excluded.

Cabbage leaves are also effective in the treatment of mastopathy. Usually cabbage leaves are applied at night, or a compress is made: the mammary gland is smeared with unsalted butter, a clean cloth is applied and a mixture of ground cabbage and sour milk is applied. You can use this compress both day and night, after wrapping the chest with cellophane.

Using a mask of castor oil (100 g), honey (2 tablespoons), lemon juice (from 2 lemons) and ground burdock root (to the consistency of sour cream) will help with varying degrees of disease development. All components are mixed and applied to a clean linen napkin. The constant use of the mask allows you to achieve recovery within a month after the start of treatment.

Also popular are herbal remedies and herbal preparations.

Herbal treatment

Very effective in women's diseases recognized Altai grass boron mother. It is used for hormonal disorders in the body, to restore metabolism, the function of the endocrine system, has a beneficial effect on the condition of the ovaries, Bladder, mammary glands. The tincture of this herb is prepared as follows: 0.5 l of high-quality vodka is poured into 50 g of boron uterus, insisted for 2 weeks in a dark place (not in the refrigerator). Take a teaspoon three times a day before meals, the duration of admission is about six months, with interruption of treatment during menstruation.
Red brush grass perfectly cleanses the genitourinary system and stabilizes the endocrine system. The tincture of this herb is used three times a day, half a teaspoon in half a glass of water, taken with meals for a month, taking a break during menstruation.
Burdock root can be poured with three glasses of boiling water (for 60 g of leaves), insist for 4 hours, strain and drink a glass three times a day before meals.
Yarrow, motherwort and string - mix 2 tablespoons of raw materials and pour a liter of boiling water. Take 1 glass before meals. Excellent remedy with diffuse mastopathy.
Mix the same parts of honey, lemon juice, radish juice, carrot and beetroot juice with an equal share of Cahors wine, take 2 tablespoons of the mixture before meals until the symptoms of the disease disappear completely.

Operation

An operative method of treatment is used for fibroadenoma or some large cystic formations.

For minor tumors and nodes, sometimes it is enough to use conservative therapy and periodic observation by a specialist.

The following methods are usually used surgical treatment diseases:

sectoral resection (the formation is removed simultaneously with the area of the breast);
enucleation of cystic formation (husking and removal of the cyst itself).

The use of surgical treatment should be justified and used in the following indications:

based histological examination confirming suspicions of malignancy of tumor cells;
with an intensive increase in education (the tumor is observed for three months);
with repeated recurrence of nodular FCM after conservative or sclerotherapeutic treatment of the disease.

Surgery is performed using general or local anesthesia, the duration of the operation is about 40 minutes.

Drug treatment

Medicinal preparations that are used in the treatment of mastopathy should first of all be aimed at eliminating the causes of the disease, improving the body's immunity, and treating the pathology of the ovaries and thyroid gland.

Hormonal agents: progesterone, duphaston, utrozhestan, etc.
Contraceptives - used to regulate the menstrual cycle.
Estrogen inhibitors.

With severe pain, analgesics, diuretics (relieve swelling of the gland before menstruation), and homeopathic remedies are used.

Starting from the age of forty, steroid preparations methylandrostenediol, methyltestosterone, testosterone injections can be prescribed.

With insufficient function of the corpus luteum, drugs or injections of progesterone are taken in the second phase of the cycle.

Iodine preparations may be prescribed for insufficient thyroid function.

The effectiveness of these funds is varied. However, the benefits of treatment are felt as a result of the complex effects of drugs: analgesics, bromocriptine, vitamins, homeopathy, potassium iodide, contraceptives, herbal remedies, tamoxifen, danazol, progestogens, etc.

Mastodinon

The drug Mastodinone is a homeopathic remedy that is very popular among women who have problems with the menstrual cycle, breast pathology, PMS.

The drug is popular primarily for its effectiveness, as well as the natural origin of the composition of the product: the medicine is based exclusively on herbs.

Mastodinone eliminates various menstrual irregularities, helps with fibrocystic FCM, relieves concomitant signs of PMS.

The drug helps to reduce the synthesis of prolactin by the posterior pituitary gland, which allows you to influence the processes of pathological proliferation of breast tissues.

Taking Mastodinon is extremely rarely accompanied by side effects due to the presence of exclusively natural components in the preparation.

Mastodinone with fibrocystic mastopathy is used 30 drops or one tablet twice a day. Can be diluted with a small amount of liquid.

The drug should be taken continuously for at least 90 days, the visible effect appears already in the second month of admission.

Mastodinone can be taken for quite a long period, if there are proper medical indications for this.

Homeopathy

The use of an alternative method of treatment with homeopathy has long proven itself on the good side: homeopathic remedies do not accumulate in the body, do not provoke allergic and adverse reactions, are suitable in the treatment of pregnant women and nursing mothers, the elderly and small children.

Homeopathy allows you to cure the disease within 2-5 weeks, and relapses after taking the drugs are extremely rare.

In the inflammatory process in the tissues of the gland, drugs based on Apis (apis mellifica) work well, and belladonna will relieve swelling and burning sensation in the mammary glands.

Significant suppuration of the gland, accompanied by high temperatures and dull pains, is the reason for prescribing preparations prepared from bryony and bufo plants. Breast disease caused by trauma will help cure Pulsatilla extract.

Despite the fact that homeopathic preparations have practically no contraindications and cautions in use, the use of funds should be discussed with the doctor. He will help you choose the right drug which will make the treatment of the disease even more effective.

vitamins

Drug therapy of fibrocystic FCM is often supplemented with vitamin complexes containing vitamin A, B1, B2, B6, PP and ascorbic acid, as well as vitamin E.

Vitamin E has a special role in therapeutic measures in the fight against the disease. This vitamin has antioxidant properties, enhances the action of progesterone, takes part in the regulation of fat metabolism, and alleviates the manifestations of premenstrual syndrome.

The antioxidant properties explain the anti-inflammatory and regenerative effects of the drug. However, for its effectiveness, it is required to take vitamin E for at least three months.

B vitamins are also important in the treatment of mastopathy. They are responsible for the normal functioning nervous system and normalize energy metabolism. performance immune system, cell division and growth are provided by these vitamins. It is especially necessary to take vitamin preparations for people who are characterized by mental and emotional stress, stress, and chronic diseases.

You can improve the intake of vitamins in the body by taking vitamin complexes or provide your diet with a sufficient amount of vegetables and fruits.

Nutrition and diet

The principles of changing nutrition in fibrocystic mastopathy are aimed at stabilizing the hormonal background in the body.

It is recommended to introduce foods containing fiber into the diet - these are all types of cereals, parsley, dill, various greens. It is important to use natural estrogens - these are peas, beans, lentils, chickpeas, mung beans, cabbage (white, Brussels sprouts, Peking, broccoli, Savoy, cauliflower). Needless to say, how much the body needs vitamins, minerals contained in citrus fruits, dried fruits, other fruits and vegetables.

Iodine, which is rich in seafood, fish, is also useful for the endocrine system. The source of the necessary phospholipids will be dishes from the liver, dairy products.

It is recommended to limit the consumption of animal fats, fast carbohydrates, monitor the calorie content of the diet: being overweight adversely affects the health of the mammary glands and the reproductive function of a woman.

The diet for fibrocystic mastopathy should be balanced, rich in vitamins and dietary fiber. Great importance should also be given to the drinking regimen: a sufficient amount of liquid will allow you to quickly stabilize metabolic processes in organism. One and a half liters of clean water per day is the optimal amount of fluid for the normal functioning of the body.

In addition, for the successful treatment of FCM, it is necessary to exclude from the diet products containing methylxanthines - these are black tea, coffee, cocoa, Coca-Cola, chocolate.

What should you know about this fairly common women's problem? Candidate of Medical Sciences, surgeon-oncologist of the St. Petersburg hospital "LOMO" Igor Alexandrovich CHIZH advises.

What should you know about this fairly common female problem? Candidate of Medical Sciences, surgeon-oncologist of the St. Petersburg hospital "LOMO" Igor Alexandrovich CHIZH advises.

risk group. According to various sources, from 20 to 60% of all women suffer from mastopathy. Most often it worries young people. The peak incidence occurs in 20-30 years. This is explained quite simply - the appearance of mastopathy is associated with hormonal imbalance.

It is often combined with various gynecological complications - ovarian cysts, menstrual disorders, fibroids or infertility. Therefore, breast problems are very often detected by gynecologists. Having made their diagnosis, they look for other manifestations of hormonal disorders. And very often these searches lead to the discovery of mastopathy.

Essence. Mastopathy is a violation of the structure of the mammary gland. Connective tissue grows in it, and cysts appear.

Symptoms. A fairly typical clinic - the chest is rough and sore before the onset of menstruation.

But in some cases, a woman does not even know that she suffers from mastopathy: she does not manifest herself in any way. And it is revealed by chance, and then the tactics of most doctors is waiting. That is, doctors recommend their patients regular examination, which should be carried out at least once a year. If such preventive examinations do not show the further development of the disease, then there is nothing to worry about.

If the symptoms of mastopathy are very pronounced - the chest hurts before each menstruation, seals are felt in it, then it should be treated.

Methods of treatment. In each case, they are different. Therapy is selected individually. Sometimes vitamins A and E are prescribed, sometimes certain dietary supplements are prescribed.

But most often, treatment is aimed at normalizing the hormonal background. This is achieved with the help of contraceptive preparations containing a well-defined amount of hormones. They have a beneficial effect on the course of some gynecological diseases and eliminate the cause of mastopathy. Her symptoms may disappear or decrease as early as 2-3 months after the start of taking contraceptives. If this did not happen, then the doctor should think about changing the drug - it is likely that the ratio of hormones was not chosen correctly.

With mastopathy, diet is very important. It has been proven that the course of the disease is adversely affected by the consumption of coffee, cola and cocoa. These drinks should appear as rarely as possible in a woman's diet. But some well-known products, on the contrary, are able to protect against almost all diseases of the mammary glands, in particular from mastopathy.

Cabbage has a similar effect. It contains indoles - substances that have a beneficial effect on the hormonal background of a woman.

It is also very good to eat more soy products - bean curd, soy flour, soy milk or soy meat.

It is important. Mastopathy - benign tumor. But sometimes it can degenerate into a malignant one. Given this danger, women should definitely conduct a self-examination of the mammary glands. This should be done every month on the 5-7th day of the menstrual cycle.

How to palpate the chest?

Palpation - that is, palpation - is carried out with fingertips. The left gland should be palpated with the right hand, and right gland- left.

Each mammary gland must be conditionally divided into four parts, mentally drawing two lines perpendicular to each other through the center of the nipple. Particular attention should be paid to the upper outer quadrant, which is located closest to the armpit.

Palpation should begin with him and move clockwise, feeling first the outer half of the chest, and then the inner. The first is superficial palpation, then the pressure increases and the deeper layers are examined. In this case, the fingers should make circular or sorting movements - it is not necessary to press hard on the chest.

This procedure must be carried out carefully, slowly, methodically feeling each part. Then the woman will have a great opportunity to assess the condition of the mammary glands.

Any change from the previous self-examination is a reason to see a doctor. If the picture does not change, then everything is in order. No extraordinary visits to the mammologist are needed. Enough scheduled inspections.

Fibrocystic mastopathy (FCM) is a disease of the mammary glands, accompanied by the formation of seals. The disease has diffuse and nodular forms. Changes in the gland are proliferative and regressive in nature with the appearance of an imbalance between the stroma and epithelial tissue. The ratio can vary greatly, and most often such disorders are accompanied by the appearance of nodes that can be palpated.

diffuse form

Diffuse fibrocystic mastopathy of the mammary glands has a classification depending on the histological structure:

FCM with a predominance of the glandular component. This disease is also called adenosis. For a disease of this type, pain in the gland, engorgement, compaction of its individual sections are characteristic.
FCM with a predominance of the fibrous component. Often the disease is accompanied by a complete narrowing of the ducts, which leads to severe pain.
FCM with a predominance of the cystic component, the formation of which occurs from atrophied lobes and altered ducts.
Mixed - the most common option.

According to the degree of proliferation, the disease is divided into proliferating mastopathy and non-proliferating. If the changes occur with proliferation, most often small papillomatous growths begin to form in the duct or cyst. Such a disease of the breast is dangerous because atypical cells characteristic of a precancerous process can develop.

Nodular form of the disease

Most often, a violation in the hormonal system leads to the appearance of nodal FCM. Fibrocystic mastopathy is characterized by such symptoms as soreness in the mammary gland in the period before the onset of menstruation, discharge from the nipples.

Nodular fibrocystic mastopathy develops as a result of:

pathologies in the reproductive organs;
violations in the hormonal balance, including IVF;
changes in the endocrine organs;
taking contraceptives and other hormonal drugs;
bad ecology;
hereditary predisposition.

Usually nodular fibrocystic mastopathy is provoked by the predominance of estrogens, prolactin and deficiency of substances produced by the thyroid gland.

Often abortions lead to fibrocystic mastopathy. This process is accompanied by sharp fluctuations in the hormonal system. The same changes may occur when preparing a woman for IVF.

The most susceptible to the appearance of fibrocystic mastopathy with the presence of nodes are women from 30 to 55 years old.

Types of nodular mastopathy

Nodular fibrocystic mastopathy is divided into:

fibronodular;
diffuse-nodular;
cystic-nodular.

Fibronodular disease of the breast is characterized by the predominance of fibrous tissues with the formation of nodes. This pathology is benign and hormone-dependent. The glands most often remain symmetrical. The pain is either constant or intermittent. There may also be colorless or yellowish discharge. Changes can appear both on one iron, and on both. Diagnosis of this type of fibrocystic mastopathy should be carried out thoroughly, since the picture of this disease is often similar to a malignant lesion of the breast.

Diffuse nodular disease is characterized by the appearance of fluid-filled cysts. Such formations can vary in shape and size. They are usually round and painful. Often the pain radiates to the arm and shoulder blade. Such a disease in initial stage usually does not show up. More often, a woman discovers nodes in the breast by chance or during self-examination. In this case, you should immediately contact a mammologist. Before menstruation, usually cysts can increase, become painful. The discharge is more like colostrum.

The cystic-nodular form is characterized by clear nodes of various sizes. Pathology should be differentiated from a malignant tumor.

Mastopathy and IVF

Often, women who are going to conceive a child using IVF and have a history of mastopathy worry that this pathology may become a contraindication to IVF.

Unfortunately, IVF can provoke symptoms of fibrocystic mastopathy in women who do not have problems in this area against the background of hormone stimulation. With the already existing fibrocystic mastopathy, IVF can become an impetus for the rapid development of the pathology with an increase in the cystic component and the growth of gland tissues.

Fibrocystic mastopathy can progress during the onset of pregnancy. But doctors take into account the fact that fibrocystic mastopathy may regress with breastfeeding. That is why, most often, experts allow IVF to be performed in the presence of this pathology.

Sometimes, if there are large formations, it is recommended to remove them before the procedure so that there are no serious consequences. Often, with the existing fibrocystic mastopathy, they try to reduce changes in the glands with the help of homeopathic or medical preparations, and then IVF is already carried out.

If fibrocystic mastopathy is moderate, the procedure is carried out without treatment of the mammary gland. Sometimes, before stimulation for IVF, they are prescribed strict diet, the use of ointments.

Fibrocystic mastopathy and menopause

When you enter menopause, changes in the hormonal system also begin. This can be an impetus for the development of fibrocystic mastopathy, especially if menopause begins very early or, conversely, late. Due to hormonal imbalance, changes in the glands may be accompanied by sensations of heaviness, soreness, tension.

There are also cases when fibrocystic mastopathy disappears in menopause. Reduced or completely resolved cysts, nodes.

Due to the fact that the function of the ovaries is reduced, in women there is atrophy of the glandular tissue with the development of the connective tissue component.

Treatment of the disease

Mastopathy is treated after an examination, including the determination of hormones. Based on these analyzes, hormonal imbalances are corrected.

In the presence of cysts, sclerotherapy can be performed, before which fluid is pumped out of the cystic formation. This method is carried out only if there are no signs of an intraductal tumor and a malignant process.

If a large number of cysts appear or too much tissue growth, as well as a suspicion of a malignant component, a sectoral resection is performed followed by histology.

The disease can also be treated with homeopathic remedies. In the presence of severe swelling of the gland, diuretics are prescribed. Since stress can affect a woman's hormonal levels, mild sedatives can be taken. At severe pain painkillers are prescribed in the mammary glands.

Experts often prescribe multivitamins and ginseng tinctures as strengthening agents.

Physiotherapy for mastopathy is prescribed extremely rarely, as there is a danger of activating the pathological process. Radon baths are taken in the absence of suspicion of a malignant process. Mud baths are sometimes prescribed by specialists for women with minor benign changes. Baths with hydrogen sulfide in diseases of the mammary glands are contraindicated.

The main preventive measure is self-diagnosis of the mammary glands for the presence of changes and seals. When finding formations, detecting asymmetry of the glands, the appearance of secretions, you should visit a mammologist.

Also, do not forget about the control of the thyroid gland. In the presence of hypothyroidism, iodized foods should be included in the diet.

Also, the most important measure to prevent the development of mastopathy is pregnancy and breastfeeding for up to a year.

Often, doctors with the growth of breast tissue recommend that women become pregnant. But how are mastopathy and pregnancy related? We tell.

Women of reproductive age very often face such a disease as fibrocystic mastopathy. Many experts in this situation advise the patient to become pregnant as soon as possible and start breastfeeding. Let's see how compatible mastopathy and pregnancy are, what risks exist.

What is mastopathy?

This is a disease in which the structure and shape of the mammary glands changes, their tissues grow pathologically, discharge from the nipples is often present, swelling and soreness of the breast are noted.

The cause of pathological changes is often hormonal disorders, trauma, inflammation in the pelvis. A disposing factor is also heredity and the absence of pregnancy and childbirth in a woman under 30 years old.

Mastopathy is more common at the age of 30-50 years, but it can also occur after puberty. The disease is very common pathological changes specialists find mammary gland tissues in about 50% of women.

How does mastopathy manifest itself during childbearing, and can pregnancy be healed? In 80% of cases, pregnancy and prolonged breastfeeding lead to a complete cure for a woman. First of all, this is due to hormonal changes in the body. Experts identify several positive aspects of pregnancy with mastopathy:

As you can see, mastopathy and pregnancy are fully compatible. The only thing that doctors warn about is the danger of lactostasis immediately after the birth of a child. In this case, the condition of the mammary glands can noticeably worsen. This usually happens if a woman refuses to breastfeed her baby, incorrectly or too rarely applies it to her. Most often, lactostasis occurs in the first 2 months after childbirth, therefore, during the establishment breastfeeding a woman is recommended to be observed by a specialist.

The danger of in vitro fertilization

If we talk about how compatible mastopathy and IVF, then here the situation looks a little different. The fact is that during in vitro fertilization, a woman is required to be prescribed hormonal stimulating therapy, which ensures the survival of eggs. Such preparation can be an impetus for the rapid development of mastopathy, and during pregnancy, tissues will begin to grow. That is why before IVF, all women need to go for a consultation with a mammologist.

It is possible to do in vitro fertilization with mastopathy only if large cysts and nodes are not detected. However, if the lump is larger than 2-3 mm and tends to grow, the doctor may recommend surgical removal of the lump.

As you can see, mastopathy during childbearing and during breastfeeding can completely disappear. This is an excellent method of disease prevention. But when planning IVF, you need to be careful, because in this case, the risk of progression of mastopathy during pregnancy increases.