Mastopatia - is the process of pathological character with a distinct range of cell proliferation in breast tissue and broken ratio of connective and epithelial components.Under mastopathy dysplasia means a group of processes, mainly with benign course with the breast health, with increased cell growth in its tissues.This disease affects women of reproductive age.In postmenopausal breast disease is relatively rare, and more than half of the cases, we can talk about the possible presence of a malignant process.
Causes of mastitis
The main function of the breast is considered production of breast milk for feeding the baby.The structure consists of glands: connective, glandular and fatty tissue.The size and shape of the mammary glands determines the ratio of all of these tissues.
Monthly breasts cyclical changes occur that are also in the uterus.This process is regulated by the female hormones.It is known that the breasts are easily hormones, like pelvic organs.In pathological
adipocytes and adipose tissue of the breast is a depot estrogen, androgen and progesterone.Adipocytes are not involved in synthesis of the hormones, but have a tendency to seize them from the plasma.Under the influence of aromatase androgens converted into estrone and estradiol.This process is enhanced with the passage of age, which is considered a factor for the development of breast cancer.The development of pathological processes in the breast is determined as receptor system involving therein.During menopause receptor system over time loses its function.
causes leading to the development of hormonal function with mastitis can be both hormonal nature and ekstagenitalnogo.
The causes hormonal nature should include, first of all, breach of relations and functions of estrogen and progesterone.Estrogens are those hormones that are produced in the first phase of the cycle (follicular) and are responsible for the functioning of the follicular unit.The look and mood of women also depend on the activity of estrogen.It is known that in the first phase of the cycle in a woman observed a moderate appetite or decrease, improvement of complexion and condition hair, breasts soft and painless.In the second half of the cycle (luteal) comes to replace the estrogen hormone progesterone, which prepares a woman's body for a possible conception.During this period the woman may notice increased appetite, libido, small weight gain, increase in body temperature up to 37.2 ° C, a slight rash of acne on the face and body.
Ovulation occurs between the follicular and luteal phases of the menstrual cycle.The corpus luteum produces progesterone in the ovary until 16 weeks gestation when conception occurred, or the end of the cycle, if there was no conception.Estrogens are produced at this time in a minimum amount.But if there is a violation of the functioning of these hormones, ovulation may not occur, or may occur miscarriage.Similarly, such processes lead to the development of mastitis breast.Hyperestrogenia is a major cause of mastitis, not only for but also for gynecological problems (endometrial hyperplasia (a precancerous condition)), fibroids and uterine lipoma, functional ovarian cysts, polycystic ovary syndrome, etc.).
not the last role in the development of breast pathology played liver disease.The liver is exchanged fermentation and cells from their division.Liver promotes inactivation of steroid hormones.Hepatobiliary disorders initiator complex may be presented for the formation of a long-persistent hyperestrogenism.This is because sustained estrogen metabolism in the liver.Heredity also is not the last, but only if the breast was in blood relatives.Disturbances in the endocrine system also have an impact on the overall hormonal status and are due to gipotirioza, diabetes, lack of iodine.This entails a mental disorder, the absence of a full-fledged sexual activity, the emergence of neuroses and stress.
Other causes of breast mastitis include: drinking alcoholic beverages, smoking, abortion, habitual miscarriage, increased body weight.
Symptoms and signs of mastitis
Clinical manifestations of diffuse nature of mastitis include engorgement with drawing by pain and breast swelling.In another way, this condition is called mammalgia.These symptomatic manifestations can be sustained or recurring (the second phase of the cycle).But cyclical pain in this form of mastitis may allow to distinguish benign from malignant for it.Pain in such mastitis can be of different intensity: as a tingling sensation in the chest pulling character and severe pain, which may occur by contact with clothing.
During manual breast examination at the diffuse form of mastitis can reveal fine grain and distinctive tyazhistost and sharp lobulation.These are signs of mastitis in both breasts, but most often in one gland pain are more pronounced.The seals may be in the nature of nodes with fuzzy boundaries.
Mastopatia fibrocystic nature with a predominance of glandular tissue (adenosis) may manifest as pain in the breast and nipple discharge.In this form of mastitis aching pain may be the only symptom.Discharge from the nipple appear if the breast has a similar shape for long.On the eve of menstruation breasts may condense to acquire the characteristic of hardness and can be pressure-sensitive nipples, and sometimes, randomly allocated and the type of clear liquid colostrum.
In the initial stage of mastitis such women can not complain at all, considering a certain tenderness and engorgement on the eve of the critical days of the absolute norm.Meanwhile, the breast continues to develop.
lobular breast is the form, which is characterized by the localized appearance of lumps or lesions in the breast that can not be regression, despite the phase of the cycle.When focal mastitis pain may be localized in nature in that quadrant of the prostate where the knot.Clinical manifestations of this mastitis can change character throughout the menstrual cycle.Before the critical days pain usually increases with irradiation in the shoulder or arm, and the seal is increased in size.Sometimes the pain can give not only to the shoulder, arm and neck, but in several areas.
When glandular adenosis, as a form of mastitis, often a grain of mammary glands.Selection in the colostrum appear with pressure on the nipple.Their volume changes over the menstrual cycle.
It should be noted that any form of mastitis with the onset of menstruation subsides.Seals are reduced in size, they may disappear altogether.The very breast is soft, painless to the touch.In addition to all of the above can be lymphadenitis in the armpits, under the collarbone and above the clavicles.Common symptoms of mastitis include: dry hair and skin on the face, weight gain, migraine, sleep disorders.
mastitis divided into several forms.Fibrous-diffuse breast is considered more common form among other forms of mastopathy of mammary glands.The main reason for its development is an increased amount of estrogen and progesterone reduced amount.Mastopathy diffuse fibrosis is characterized by morphological and histological changes in the structure of the breast, because of which there is a violation relationships between epithelial and connective components.Such changes in the cellular composition of the initial development of the talk about diffuse fibrous mastitis.The mammary glands grow connective tissue structures, which are nodules and cords.The treatment of this form of mastitis is performed using hormone therapy, homeopathy, herbal medicine, diet and vitamins.
fibrocystic breast disease is also quite common form of breast mastitis.It begins to be dangerous when there are elements of atypical cells in tissues.Characterized by the presence of cysts in the breast tissue, which can be both single and multiple.Accompanied by a not very severe pain.Cycled usually has no pain with this form of mastitis.Treatment is carried out conservative and surgical ways.
lobular breast disease characterized by the formation of foci or nodes in the breast.Lobular breast (nodes) can be characterized by the presence of fibroadenomas, cysts, lipomas and other entities in the breast tissue.Manifest itself as a seal that can be both movable and fixed on palpation.When fibroadenoma may experience symptomatic signs of cyclical, amplifying the end of the cycle.Treatment of mastitis such option is held exclusively by surgery because the tumors are not served self-regression.
There is also a form of mastitis as adenosis.It is divided into local and diffuse form.If there is a local form of adenosis appearance of seals that have lobed structure.Each slice of cancer can be as high as the large size and can surround a fibrous capsule.Seals in the form of local adenosis grouped only one site in the mammary gland.When the diffuse form of adenosis have seals has no clear boundaries and a certain form.The chaotic proliferation of such entities and causes diffuse form of adenosis.
There are also five species of adenosis of mammary glands.Sclerosing adenosis is characterized by focusing on one area of proliferation of acini with preservation of all epithelial layers.These layers are surrounded by a basement membrane.But tightness acini that surround fibrosis tissue slices can be quite pronounced.In this configuration slices maintained.When Breast study this configuration is clearly visible.Apocrine adenosis When it comes to severe epithelial metaplasia.Sometimes, this condition may be called apocrine metaplasia, especially when talking about the outbreak adenosis sharply epithelial proliferation.Apocrine form is characterized by a pronounced polymorphism in the nuclei of cells, making this form similar to the infiltrative cancer.
Ductal adenosis is characterized by dilated ducts, cylindrical cells with epithelial metaplasia.
Mikroglandulyarny adenosis is a rare form, which is characterized by extensive proliferation of tiny ducts where they will not be crushed or sclerosis.
Adenomioepitelialny adenosis adenomioepiteliomy characterized by the appearance in the breast tissue.
Treatment of mastitis
Treatment of mastitis is to use several methods, because it is quite difficult to cure mastopathy.Before treatment, it is necessary to conduct a comprehensive study, which is to collect anamnesis, conduct breast ultrasound, mammography, thermography, and so on. When collecting history heredity established patient (presence of cancer of the reproductive organs in the mother and other blood relatives).
Basically, the development of mastitis favor menstrual dysfunction.During the inspection mammologists breast is determined by the symmetry of their location, shape and quantity.Take into account the state of the contours and shape of the nipple, the appearance of the skin, color and texture of the areola, the availability of advanced subcutaneous veins.
When fiziokalnom breast examination conducted palpation fingertips, from the nipple in the radial direction.Inspection is carried out in a vertical position, but can also be carried out in a horizontal position and women.If any seals are estimated its boundaries, consistency, size and mobility.Also palpable axillary region, subclavian and supraclavicular lymph nodes.
mammography is widely used as a method of diagnosis.It is carried out in the follicular phase of the cycle.The method of thermography in the diagnosis of mastitis is to measure the temperature of the skin, which is fixed on the film.The temperature of the skin over any entities is much higher than the temperature of the healthy parts.And over the formation of malignant origin, it is the highest.If there is a discharge from the nipples, then resorted to contrast with the introduction of mammography urotrasta.This research carried out exclusively in a hospital.In addition to these diagnostic methods are used: Ultrasound, radioisotope diagnosis, lymphography, biopsy with further biopsies.
oral contraceptives justified under these circumstances, when there are symptomatic manifestations of mastitis.It is important to observe the dosage in their appointment.Estradiol in these medicaments should not exceed 0.03 mg.These include Regulon OK, Jeanine, Lindinet 30 Novinet etc.
treat cystic mastopathy carried out, taking into account: the nature of the disease, the physiological activity of the ovaries, the severity of proliferation.Qualitative treatment of mastitis cystic nature is conservative in conjunction with surgical method.During the surgical method in a cyst under the control of US - the sensor is introduced and the puncture needle aspirate the contents.Glued cyst that does not give her the newly formed.After carrying out such an operation cystic content is sent to the cytology.
the presence of multiple cystic cavities performed exclusively hormonal therapy with watchful waiting.Because, if such a picture of cystic mastopathy surgical method is only resection of the entire gland, which is highly undesirable for the majority of patients, especially reproductive age.
therapy in cystic mastopathy apply progesterone derivatives, testosterone derivatives, COC antiprolaktinovye drugs and anti-estrogens.The most common treatment regimens similar form of mastitis is the appointment of progestogens and COCs.Progestins have the effect of slowing down gonadotropic pituitary function.They also possess antiestrogenic effect in breast.It accepted only in the luteal phase of the cycle, which substantially reduces the symptoms of mastitis in the form of engorgement glands and mastalgia.Receive OK should continue for at least six months to determine their performance.
diffuse form of mastitis treatment is to appoint anti-oestrogens, progestogens and some COCs.Tamoxifen, for example, is able to block receptors in the breast tissue, because of which decreases the physiological activity of estrogen.In addition, the anti-estrogens reduce the symptoms of pain in the mammary glands, normalize the menstrual cycle and reduce blood loss during menstruation.But long-term use can lead to the development of hyperplastic processes in the pelvis.Properly selected oral contraceptives in the treatment of this form of mastitis has a positive effect on the disease.