Adenosis breast - a form of fibrous mastitis with more glandular component, is characterized as a high-grade hyperplasia is lobular breast cancer.Clinical signs of breast adenosis are: pain, Expander or pulling character in the gland, it engorgement in the luteal phase of the cycle.Increased breast engorgement is its diffuse nature of the entire gland seals, and maybe part of it.The boundaries of the seals in diffuse adenosis breast evenly transferred to the tissue surrounding the seal.
Adenosis breast cancer is found in patients at the end of the prepubertal period, women in the third decade of life.Also, this problem is known to the women in the first three months of pregnancy and extends itself to the second trimester.
reasons adenosis breast
Prior to the onset of menstruation breast development depends on the influence of estrogen, after menarche - estrogen and progesterone.The first is responsible for the development of ducts, connective tissue and its growth.Prog
all epithelial damage breast benign nature separated by histologic type in the hospitality categories: tissue damage without the active proliferation characteristic of proliferative responses of cells without atypia, atypical hyperplasia.When the glandular adenosis of the breast is not observed an active proliferation of cells in the tissues, because this form of the disease is considered the least dangerous option of all forms of mastopathy.
Under adenosyl involve benign lesions of the epithelium of the glandular breast tissue that does not lead to the emergence of invasive breast cancer.But adenosis can be either diffuse or focal.When breast adenosis there is excessive formation of fibrous tissue which is interleaved with normal glandular cells, thus damaging themselves mammary lobules.
main cause of breast adenosis are hormonal disorders.This concerns in particular the excessive production of sex hormones during puberty and pregnancy.With this hormonal disorders there is an increase in estrogen levels in the blood, elevated prolactin levels and decreased production of progesterone.It is a known mechanism for the development of any form of mastitis, but adenosis breast noted similar duration of hormonal imbalance.In order to determine the reason why developed adenosis, laboratory diagnosis is necessary to conduct blood tests for hormone ratio.
Often preceded by the appearance of adenosis breast hyperplastic processes of nature in the pelvic organs.To those include: endometrial hyperplasia, in which there is also an increased level of estrogen with reduced production of progesterone;dysfunctional violation of ovarian cyst formation, especially functional character;pathological processes in the thyroid gland (hypothyroidism and hyperthyroidism);fatty liver due to obesity or eating fatty foods and foods with digestible carbohydrates.
symptoms of breast adenosis
Adenosis breast cancer is divided into local and diffuse form.
At local adenosis, the formation of seals, with lobed structure.Moreover, each slice can be quite large sizes and can be surrounded by a fibrous capsule.Seals for local adenosis exclusively grouped at one site in the breast tissue.
In diffuse adenosis education do not have clear boundaries and a specific form.Uneven growth of formations and gives its name to diffuse adenosis of the breast.
In modern medicine, material five forms of breast adenosis.Sclerosing adenosis of the breast is characterized by localized proliferation of acini maintaining epithelial and myoepithelial layer.Such layers are surrounded by a basement membrane.But, given that constraint lobules acini surrounding tissue fibrosis sometimes can be quite pronounced when sclerosing adenosis, the configuration remains intact lobules.In the standard surveys, this configuration is easily visible.
When apocrine metaplasia observed form of adenosis burgeoning epithelium.Sometimes, this condition is called apocrine metaplasia, especially when it comes to the focus of adenosis with marked proliferation of the epithelium.When apocrine form pronounced polymorphism observed in the nuclei of cells that makes this form of something similar to infiltrating cancer.
form of adenosis Ductal breast ducts characterized by expansion, limited to the cylindrical cell metaplasia of the epithelium.
Mikroglandulyarnaya form of adenosis is a rare form characterized by a diffuse proliferation of the smallest ducts, where there is not any of their compression or sclerosis ducts.
Adenomioepitelialnaya form of adenosis adenomioepiteliomy characterized by the formation in the breast.It refers to alopecia adenosine.
Signs of breast adenosis similar to any other manifestations of mastopathy.Many women can detect breast adenosis themselves.
glandular adenosis, which is also called diffuse, manifests itself in the form of increased sensitivity and engorgement eve of menstruation, nipple itching, feeling of heaviness in the glands, discharge from the nipples.Moreover, the allocation can be both transparent and milk, brown or greenish hues.Bloody discharge from the nipple are the most dangerous symptoms of breast adenosis, which may indicate the development of malignancy.Such allocation at adenosis are relatively rare, and talk about the running course of the disease.
in focal adenosis breast symptoms are: pain in a particular quadrant of the breast, increase or asymmetry, breast cancer, detection seal, sometimes multiple character.At local adenosis can also be enlarged regional lymph nodes: in the armpits and above the collarbone.
Sclerosing adenosis breast
Skleroziruyushy adenosis of the breast - the defeat of the lobules of the breast with the rapid formation of tissue fibrosis, which are interspersed with glandular cells.Sclerosing adenosis is shown nodules, which are small, agile and compact.If internal examination and during Breast study are very similar to breast cancer.To eliminate cancer sometimes resort to biopsy a suspicious node.
The causes of sclerosing adenosis can be called a violation of the metabolism of estrogen, progesterone, and irregularities in the thyroid gland.Hypothyroidism (insufficient thyroid function) plays a significant role in the development not only of sclerosing adenosis, and other pathological conditions in the female body, including the mammary gland.
manifested sclerosing adenosis of the breast in the form of pain, pulling character.Sometimes this pain can wear and more pronounced, depending on the phase of the menstrual cycle (luteal phase pain increases).On palpation determined movable seal clear, regular shape with a dense texture.To confirm the diagnosis may require ultrasound breast and axillary lymph nodes when they increase that sometimes when sclerosing adenosis.Also conducts clinical research, biochemical analysis, tests for TSH, LH, FSH, etc. Mammography may give an incorrect result when a large similarity sclerosing adenosis breast cancer.
Treatment is carried out surgically by a sectoral resection.Operative procedures were performed under general or local anesthesia.Selection anesthesia depends on the number of nodes, their size, age of the patient and the presence of such diseases in which the use of a prohibited use of anesthesia.
During the resection, cosmetic and aesthetic point of view, many surgeons make the incision at the edge of the areola, regardless of the location of the node.Rezetsiruemy unit during operation can go on an urgent histological examination in order to clarify the nature of education for further tactics of conducting an operation in the case of the definition of atypical cells.
After the surgery (the next day), the patient was sent home with the use of analgesics for the relief of pain in the postoperative period.If you have a single node or nodes with no tendency to rise, sclerosing adenosis is not treated.Woman enough half-yearly check-ups of mammalogy and breast ultrasound.
Treatment adenosis breast
Treatment adenosis breast cancer in the first place, it depends on the form and nature of the disease.
In diffuse adenosis shown conservative treatment with hormone therapy.Therapy is the use of combined oral contraceptives and progestogen.In milder forms of adenosis used oral contraception at least six months.
It is the drug of choice Lindinet 30 by proven positive impact on the glandular adenosis, reducing its clinical manifestations.Patients in the first two months of the elimination of observed clinical signs of breast adenosis and normalization of menstrual function.
Gestagens appointed with more severe clinical manifestations of adenosis, especially amplified before menstruation.Assign Norkolut 5 mg / day, 0.02 g Pregnin 3p / day 2p Djufaston 10 mg / day progesterone oil 1% solution 1 ml / day.These drugs are administered in the luteal phase (with 16-25 days of the menstrual cycle).The positive effect of progestogens can be seen in two months after the start of therapy.Patients decreased breast engorgement, a decrease in pain, discharge from the nipples, until their termination.
progestin therapy should be carried out for at least 3-6 months.In some cases, oral contraceptives can be assigned to the type of Jeanine, Zhenegest Silhouette with integral component of dienogest at a dose of 2 mg.You can also use these contraceptives for the treatment of gynecological disorders (endometriosis).It should be noted that dienogest only has a small similarity with natural progesterone, but its activity as tall once it more synthetic.
Some specialists can prescribe homeopathic medicines (Mastodinon), but in practice they have only a temporary effect in the treatment of breast adenosis.Mastodinon may be used in conjunction with hormonal therapy.Independently as it can assign patients younger, nulliparous women, or in the presence of light phenomena mastodynia when breast adenosis.
Focal adenosis treated surgically.It is known that if the local units are not amenable adenosis regression even after successful hormonal therapy.Surgical excision is the method (resection) of the pathological site.In some cases, with suspected malignancy of the tumor (sclerosing adenosis, fibroadenomatosis etc.) Can be used excisional biopsy with frozen section of tissue.In addition to drug therapy treatment of breast adenosis complement the administration of vitamin B9, B1, B2, A, C, E, F, and a diet high in fiber.