FAM of the mammary gland is short name a disease such as fibroadenomatosis. This is a pathology characterized dystrophic changes in breast tissue. The result of this is the formation of multiple nodules, dense and immobile.
Causes of fibroadenomatosis
The main reason for the development of fibroadenomatosis is hormonal imbalance. Disturbances in the hormonal system occur in such cases as:
- Experienced stress, as well as constant psycho-emotional stress. These factors negatively affect the function of the endocrine system.
- Sexual disorders.
- Diseases of the female reproductive system, caused, for example, by abortion, or other inflammatory processes.
- Early termination breastfeeding and complete abandonment of it immediately after the birth of the child. This often becomes the reason stagnation in the mammary glands.
- Functional disorders thyroid gland which can cause hormonal imbalance.
- Liver diseases in which half-life products of hormones are not completely eliminated from the body. It is the liver that takes part in this process. Due to the fact that hormones are not completely eliminated, their imbalance is observed.
Signs of FAM of the breast
The main symptom of fibroadenomatosis is pain. Painful sensations intensifies before the onset of menstruation. The nature of the pain rarely changes; it is mainly stabbing and burning. In addition, signs of the disease are:
Feeling of tightness in the chest;
Nipple discharge;
Increase lymph nodes in the axillary region;
Swelling of the mammary gland and hardening of its structure.
Pain intensifies after stress or physical activity. All these signs make it easier to make a diagnosis, and doctors understand what kind of pathology it is already at the stage of the initial examination.
Concomitant disorders with fibroadenomatosis are failure menstrual cycle, psycho-emotional instability, inability to get pregnant, problems with hair, nails and skin.
Treatment fibroadenomatosis
Therapy is aimed at stabilization hormonal levels and elimination of associated symptoms. In order to prescribe the correct treatment regimen, it is necessary to find out what exactly triggered the development of the disease. In addition, when choosing therapy, they are guided by the patient’s age, stage of the disease, metabolic characteristics and the presence of concomitant pathologies.
The standard treatment regimen includes hormonal and vitamin preparations, adaptogens and antidepressants. Pain syndrome is eliminated with the help of NSAIDs. These same drugs will help remove inflammatory process.
There are a number of drugs that are most often used to treat fibroadenomatosis:
Drugs that normalize thyroid function;
Estrogen inhibitors (Tamoxifen);
Drugs that inhibit the synthesis of gonadotropic hormones (Danazol);
Drugs that inhibit the production of prolactin (Parloderl);
Per oral contraceptives, normalizing the menstrual cycle (Zhanine, Tri-regol);
Progesterone (Luteina, Utrozhestan);
Hepatoprotectors (Gepabene, Essliver, Essentiale);
Homeopathic medicines.
Drug therapy will be more effective if you adhere to certain dietary restrictions. It is necessary to give up coffee, black tea, and chocolate during treatment.
There are cases when conservative treatment does not produce results and it is necessary to resort to surgical intervention. It consists of sectoral resection of the mammary gland. The removed pathological material is sent for histological analysis to exclude a malignant process.
Treatment of FAM of the mammary gland with folk remedies
IN complex therapy fibroadenomatosis is often used folk recipes. They are used to stabilize hormonal levels, activate protective functions, and provide a sedative effect. There are products based on herbal raw materials, which are similar in action to hormonal drugs. These include corn silk, valerian root, Birch buds, rose hips, nettle leaves, burdock root.
Fresh cabbage leaves or burdock leaves are used as compresses. They are applied to the sore breast at night for two months.
Using herbal infusions can be achieved complex action. The point is that everything herbal ingredients, complement each other well. The course of treatment with folk remedies is usually long and ranges from two to three months. Herbal preparations not used as primary treatment. It is prescribed only as complex therapy.
Video on the topic of the article
Often, after an examination, seeing the diagnosis “FAM of the breast” in the conclusion, a woman has no idea what it is, how the disorder manifests itself and why it is dangerous. Let's look at the disease in more detail, name the existing forms of the disease, give brief description each of them.
FAM of the mammary glands - what is it?
Fibroadenomatosis - this disease is usually understood as a combination of pathological processes, which suggest a change in the ratio of the glandular and connective tissue components in the breast.
What are the reasons for the violation?
It is worth noting that doctors most often name hormonal imbalance as one of the main reasons. female body. In turn, this phenomenon may be due to:
- frequent stressful situations associated with prolonged psychological stress, dissatisfaction social conditions and etc.;
- diseases reproductive system, predominantly inflammatory in nature, also the presence of fibroids, endometriosis, polycystic ovary syndrome;
- late start menstrual bleeding;
- late pregnancy;
- short duration of lactation;
- endocrine disorders: diabetes, hypothyroidism;
- liver diseases.
There are many classifications of this disease. At the same time, doctors were never able to come up with a single one.
Most often, depending on the nature and extent of the lesion, the following are distinguished:
- Focal form. Speaking from what it is focal FAM mammary gland, it must first be said that this is a benign process. In this case, there is a replacement with separate areas glands of glandular tissue fibrous. Externally defined as one or more dense nodules that are easily palpable. Painful sensations are mild or completely absent.
- Localized form. If we consider local FAM of the mammary gland, then it must be said that this is a disorder in which the compaction causes pain when palpated. Moreover, the boundaries of the formation themselves have clear edges, skin above them are changed.
Depending on the histological characteristics, there are:
- cystic FAM of the mammary glands - this means that there are several or one cyst in the breast - a cavity filled with fluid. Moreover, they can be located singly or form groups; they have smooth, clear edges.
- glandular FAM indicates that the fibrous component of the mammary gland has grown. Usually, this form noted after injuries and chest surgeries.
This classification is quite primitive and does not reflect the full picture. possible forms violations. Determining the exact type of disease is only possible with a comprehensive, thorough diagnosis.
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Diffuse FAM of the mammary glands - what is it?
Quite often, after undergoing a breast examination, women cannot understand what it is - diffuse FAM, written in the conclusion. This abbreviation is commonly understood as fibroadenomatosis, a disease in which cysts (fluid-filled cavities) form in the connective tissue of the gland.
What are the signs of diffuse FAM of the mammary glands?
This disease does not develop suddenly; symptoms increase gradually. That is why a woman should pay attention to her feelings and the state of her body.
The main signs of diffuse FAM include:
- soreness in the mammary gland: stabbing, aching pain that intensifies before menstruation and fades after;
- feeling of breast fullness (swelling, heaviness);
- discomfort, feeling of tightness;
- the appearance of discharge from the nipples (bloody, serous, purulent, milky);
- menstrual irregularities;
- palpation of tubercles in the gland during palpation.
How is diffuse FAM of the mammary glands treated?
Therapeutic measures depend entirely on diagnostic indications, woman’s age, body condition, stage of the disease. First of all, it is carried out conservative therapy, the basis of which is the stabilization of hormonal levels. In this case, drugs such as:
- antiestrogens (Tamoxifen);
- progesterone drugs (Duphaston);
- androgens (Danazol);
- antiprolactins (Bromocriptine).
IN complex treatment diseases, iodine preparations (Iodamarine) that normalize the functioning of the thyroid gland and liver (Essentiale) may be prescribed.
If the course taken hormone therapy did not bring results, may be prescribed surgery, especially when there is a suspicion that the nature of the formations has changed to malignant.
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When do breast tumors and cysts appear?
The structure of the female breast is connective and fatty tissue that surrounds the lobes and ducts. Due to hormonal changes and stress, a cavity with a capsule may form, in which fluid will begin to accumulate.
This is how a breast cyst appears; it can go unnoticed or cause discomfort to the woman. TO dangerous consequences, such as cancer, such pathology does not lead.
Capsule structure
The shape of a breast cyst is a ball. Its minimum value is 0.2 cm; diagnostics cannot determine less. The maximum, as a rule, does not exceed 5 cm. At first the capsule has soft walls, but as they grow they become denser and acquire solid structure. This occurs due to the thickening of connective tissue.
Reasons for education
The reasons for the accumulation of fluid and dilation of the duct are based on hormonal imbalance in the reproductive system. Associated with her endocrine system, therefore, a breast cyst may also indicate thyroid disease. Women aged 30-50 years are susceptible to pathology.
However, regardless of age, breast cysts can appear under certain conditions. Namely in women:
Have not given birth
Taking oral contraceptives
Those who have undergone breast surgery, abortion, mastitis
Having a genetic predisposition
exposed to severe nervous stress.
Based on these root causes, mastopathy, local fibrosis of the mammary gland, and diffuse fam (diffuse fibroadenomatosis) develop. These pathologies are known for the formation of cavities with fluid of various types, which are most noticeable during pregnancy and before menstruation.
Stress itself does not cause these diseases, but it leads to hormonal imbalances. Doctors advise drinking valerian or motherwort during stress.
When there's nothing to worry about
The appearance of a capsule with liquid does not always mean that there are diseases of the mammary gland that need to be urgently treated. The condition is triggered by frequent visits to the sauna, approaching menstruation, pregnancy, and weight gain. When these conditions are eliminated, recovery can occur.
Varieties by growth habit
Depending on the degree, quantity, and location, breast cysts have several varieties. Classification is based on palpation and diagnostic data.
By size:
The capsule identified by palpation is considered large
Determined only by ultrasound is considered small, regardless of the exact size.
By location:
Local breast cyst is 1 neoplasm in one lesion
Multiple formations are several capsules in 1 or both breasts
Read also: What can you find out after breast puncture?
An isolated cavity is located at the end of the duct and is separated by overgrown tissue.
By structure:
1-chamber (has 1 cavity)
Multi-chamber (several cavities separated by walls).
Fibroadenomatosis as the main disease
As a rule, a cavity with fluid means that fibroadenomatosis of the mammary gland is developing, which determines not the pathology, but the condition of the breast. Another name is fibrocystic disease. In this case, when strong filling There is pain in the breast, a feeling of fullness. These symptoms are especially severe during a woman’s pregnancy.
Signs of the appearance of a capsule with liquid
The formation has no symptoms, but as it grows it leads to discomfort. In similar diseases of the female breast, when capsules with liquid are formed, the following are observed:
Breast engorgement, pain before menstruation
When the nerve endings are compressed by the capsule, the tugging pain and burning sensation do not stop.
When is a tumor diagnosed?
During diagnosis, it may turn out that it was not the capsule that was palpated, but breast fibroadenoma, a disease with a similar prognosis. However, in this case a tumor forms. It has similar clinical features and benign growth.
Classification of fibroadenoma
Tumor of this type is divided into the following types:
Fibroma
Adenoma
Fibroadenoma.
Breast adenoma differs from fibroadenoma in the predominance of glandular tissue. A fibrous tumor is a nodular neoplasm that leads to scarring at the site of the lesion. Fibrous adenoma is palpated as a regular round nodule. That is why fibroadenoma and breast fibroma are a type of nodular mastopathy. However, diseases are treated not with medication, but with surgery.
Oncology factor
If the neoplasm grows rapidly, a leaf-shaped fibroadenoma of the mammary gland (phyloid) with a high oncogenic factor most likely develops. The leaf-shaped structure of the tumor is the determining reason for urgent surgery. In this case, pregnancy is not a contraindication to its implementation. This is due to the fact that the tumor can grow even faster during pregnancy.
Fibrous nature of the tumor
In the case when a mammary adenoma acquires fibrous properties, connective tissue is included in the process, which also grows. A fibroadenoma or fibroma of the mammary gland is formed - a neoplasm with fibrotic changes. Determination of the microscopic nature is important for the prognosis of the disease.
Fibroadenoma, fibroma and breast adenoma have similar symptoms. Namely:
Painless condition
Clear borders, round shape
Benign prognosis.
This does not take into account advanced cases when the tumor clogs the duct. Then the skin color changes to red, bluish, and deformation of the breast is visible. Microscopically, a mammary adenoma contains cells that can secrete secretions. This is why the formation of cysts occurs in this pathology, but such cases are rare.
Microscopic differences
In general, breast fibroadenoma consists of 2 types of epithelium:
Read also: Pathological discharge Colostrum: treatment of galactorrhea
Fibrous stroma
Glandular tissue.
If 1 of these types of epithelium predominates, the disease changes its name. For example:
When there is more fibrous stroma, benign breast fibroadenoma develops
If there is more glandular tissue, an adenoma is observed.
These types of disease are not different from each other external signs. They are only noticeable cellular level.
Provoking conditions for tumors
It should be noted that breast adenoma increases in women during pregnancy, menopause, and before menstruation. This confirms the hormonal nature of the pathology, its dependence on the level of estrogen. For example, during pregnancy the body experiences hormonal shock, which also affects the condition of the breast.
When breast fibrosis develops, the fibrous epithelium grows, causing focal changes. This means that the epithelium becomes larger than it should be in this particular place of the breast. It is necessary to make a diagnosis, because breast fibrosis can turn out to be malignant (in rare cases).
Diagnosis of breast diseases
Diagnostics is based on research methods that determine the size of the tumor:
Ultrasound (age up to 30 years)
Mammography (after 45 years)
Ultrasound + mammography (at 30-45 years old).
And cytologically, focal fibrosis of the mammary gland is examined after puncture or biopsy. The woman is prescribed a procedure to remove fluid or tissue from the tumor. All types of these seals are characterized by mobility, which is easily determined by palpation. By comparison, a cancerous tumor is immobile.
Diagnosis of several diseases
Often, breast fibroma signals the development of nodular mastopathy. In this case, a condition is diagnosed when the connective tissue grows to form cysts. Thus, fibroadenomatosis of the mammary gland (mastopathy) and tumor are observed. As a result, multiple diagnoses are made.
How is the treatment method chosen when breast fibroma and mastopathy with cyst formation are observed? It is advisable to perform an operation, since the doctor can remove both tumors through the incision. Such an intervention can be performed during the patient’s pregnancy if the nature of the tumor requires urgent surgery.
In the case of a diffuse form of mastopathy, diffuse famma of the mammary glands, diffuse fibroadenomatosis, when cysts form in large quantities. Multiple lesions affect the entire cavity of one or both breasts. The disease is palpated as granular lumps, often painful. It is less common during pregnancy than during menopause.
Conclusion
The listed diseases of the female breast are characterized by the same symptoms. These are seals, nodules, cavities with benign fluid. If any of these are detected, you should consult a doctor immediately to rule out a malignant factor and preserve your health and life.
Fibroadenomatosis of the mammary gland. Treatment with folk remedies
Fibroadenomatosis of the mammary gland
Treatment with folk remedies
Hello dear readers and guests of the blog “Recipes” traditional medicine»!
● Despite pain in the sternum, eternal nervousness, painful menstruation and the discharge of “milk” during menstruation, the woman of the 21st century rushes forward, not paying any attention to these ominous signs.
But this is fibroadenomatosis of the mammary gland or, more simply, mastopathy. Fibroadenomatosis is one of the forms of tumors that is 90% curable with conservative therapy or surgically, and only the remaining 10% of cases develop into malignant neoplasm. However, both benign and malignant tumor definitely needs to be treated.
Mechanism of development of breast fibroadenomatosis
● Mastopathy is often called by mammologist doctors a “hysterical” tumor or a disease of old maids. What is this connected with? It’s very simple - after 25 years of age, a woman’s breast tissue begins to degenerate, forming cysts and nodules, so women who did not breastfeed before the age of 25 almost always develop this disease.
Another question arises: “Why hysterical swelling?” The explanation here will take a little more space.
● A woman’s hysterics are associated mainly with the hormone prolactin, which is produced during stress and its amount in the blood decreases most effectively during sex.
Increased levels of prolactin contribute to the development of painful menstruation and irregular periods. blood pressure on the first day of the cycle.
As a rule, mammologists and gynecologists recommend that women who have not breastfed a child and have not given birth before the age of 25, respectively, undergo a general ultrasonography(ultrasound) once every six months or a year to promptly detect neoplasms of the ovaries and mammary glands in order to avoid surgical treatment.
● What types are there? benign diseases mammary gland:
1. Mastalgia may be a harbinger of fibroadenomatosis.
2. Diffuse fibroadenomatosis (mastopathy): fibrocystic, fibrous.
3. Localized fibroadenomatosis
● Mastalgia manifests itself in the form of stabbing pain of short duration or many days. When palpated, breast tenderness is determined, although there are practically no lumps.
But this may be the so-called premenstrual breast tension syndrome, which develops in the second half of the menstrual cycle.
● Diffuse fibroadeomatosis is expressed by compactions that do not have clear boundaries, are mobile and not connected to adjacent tissues.
Localized fibroadenomatosis is already a compaction (seals) with clearly defined boundaries. Depending on the predominance of glandular or fibrous tissue, nodular forms of tumors are divided into adenomas or fibroadenomas.
Conservative treatment of fibrodanomatosis
● In case of localized fibroadenomatosis, the tumor is removed surgically - sectoral resection of the mammary gland with mandatory histological examination.
When breast cancer is detected, available methods of treating the malignant tumor are used. After the operation the patient long time is under dispensary observation.
● For diffuse fibrodenomatosis, conservative therapy is carried out, which aims to eliminate subjective manifestations, the causes of the disease and reduce the risk of breast cancer.
The doctor prescribes vitamins A, E, progestins, sedatives, diuretics, parlodel.
Homeopathic method of treating illness
● The most tropic (closest) to breast tissue is the drug starfish or Asterias Rubens. It is used for severe pain in the mammary gland of a pulling or shooting nature.
The gland tissues are heavy and swollen. The skin over the lesion is swollen, hyperemic (red). This remedy is especially indicated for high risk degeneration of breast tissue into a malignant tumor, but it is also effective in the later stages of breast cancer:
Prescribed in a six hundred dilution (C6) 5 drops or peas 2-3 times a day in long courses (up to several months; the predominant side is the left.
● Other effective drug– Phytolacca. Provides prevention of degeneration of glandular tissue into tumor tissue, mainly in the mammary glands.
Eliminates pain when touching swollen mammary glands, radiating throughout the body. As in the previous case, the drug can be used successfully in the presence of a malignant process:
Dilution 3 is taken five peas or drops three times a day for a long course; the predominant side is the right.
● Pulsatilla is prescribed for pain and heaviness in the mammary glands that appears before menstruation and goes away after. Especially when the patient is easily vulnerable and needs sympathy.
Fibroadenomatosis of the mammary gland - what is it? Almost every woman knows about the existence of many types of breast tumors and, having discovered lumps in her breast, hopes that these formations are not malignant. Many breast diseases are benign. One of these is fibroadenomatosis of the mammary gland.
Fibroadenomatosis is one of the types of benign breast lesions caused by hormonal imbalance. Fibrocystic disease or fibroadenopathy is one type diffuse mastopathy mammary glands.
Types of f ibroadenomatosis
The disease is accompanied by the formation of cysts in the breast due to pathological proliferation of connective tissues. It is a nodular form of mastopathy, having clear contours and a fine-grained surface.
According to ICD-10 (International Classification of Diseases) it has code No. 60.2.
Distinguish the following types fibroadenomatosis of the mammary gland:
Leading clinics in Israel
Fibroadenomatosis of the mammary gland mixed type– combines the features of several types of fibroadenomas. With this type of disease, the seal grows inside and outside the duct.
In medicine there is such a thing as SUSP fibroadenoma. This means suspicion of fibroadenomatosis of the mammary gland. Fibroadenomatosis is also divided into types such as clearly expressed, slightly expressed and moderately expressed . But there are no exact characteristics for these types of fibroadenomatosis.
Treatment of breast fibroadenomatosis
Breast adenomatosis is treated based on the woman’s age, type and stage of the disease. In this case, the results of tests for hormones and endocrine diseases.Two types of treatment are used:
- conservative treatment;
- surgical intervention.
Conservative treatment means treatment medicines. This method is used in the presence of small cysts and for the treatment of diseases that cause the development of fibroadenomatosis.
To restore hormonal levels, the following drugs are used:
- Eutirox – for the treatment of thyroid diseases, hypo- and hyperthyroidism;
- Tamoxifen – reduces the production of estrogen in the ovaries;
- Janine – restores the menstrual cycle;
- Danazol – contains androgens, reduces the production of pituitary hormones that affect the production of estrogen;
- Duphaston – increases progesterone levels;
- Dostinex - reduces the concentration of prolactin in the blood.
In addition to this, vitamin complexes are mandatory prescribed, containing vitamin A, which weakens the effect of estrogen hormones, vitamin B, which reduces the production of prolactin, vitamin E, which enhances the effect of progesterones, as well as vitamins C and PP to strengthen blood vessels and improve blood circulation.
Also appointed sedatives, painkillers for plant based(mamoclam) and drugs to normalize liver function (karsil, essentiale forte).
As an addition, treatment with folk remedies is also used. Plants contain phytohormones that normalize the production of estrogen, progesterone and prolactin. For making folk medicines They use jasmine, pomegranate, plantain, sage, garlic, barley, calendula, marshmallow, etc.
Before use folk remedies you need to consult your doctor.
By using surgical intervention A large fibrocystic lesion localized in a specific area of the breast is removed. The lesion is excised. It is possible to remove a separate sector of the mammary gland. When multiple fibroadenomas located throughout the entire volume are detected, the affected gland is completely removed. After the operation, the excised area of fibrosis is sent for analysis. This type treatment can guarantee a complete cure. After surgery, you may experience fever, redness of the skin, and soreness.
Prevention of breast fibroadenomatosis
One of the most important measures to prevent fibroadenomatosis is strengthening the immune system, namely balanced diet, rich in vitamins, application vitamin complexes, which contain iodine, which improves the functioning of the thyroid gland, selenium - has an anti-cancer effect and other important elements.
It is necessary to stop smoking, not drink alcohol, wear comfortable underwear, avoid trauma to the chest, and be less stressed. To maintain normal hormonal levels, it is necessary to have regular sex life, breastfeed as long as possible, avoid abortions, and use contraceptives correctly. Every month you need to independently palpate the sternum and, if possible, seek advice from a mammologist.
Fibroadenoma and IVF
The IVF procedure for breast fibroadenomatosis causes a lot of controversy, since fibroadenomatosis is a hormone-dependent disease. During the IVF procedure they use hormonal drugs, which can accelerate tumor growth and increase pain.
It is unknown how the body might behave in this case. The question of whether the procedure is worth it in vitro fertilization In case of fibroadenomatosis, the oncologist decides.
Fibroadenosis prognosis
Fortunately for most patients, fibroadenomatosis of the mammary gland is treatable complete cure. In most patients, cure is possible by normalizing hormonal levels. The earlier the disease is diagnosed, the faster it can be cured by resorting to a more gentle method of therapy.
According to many doctors, the development of many diseases is associated with psychosomatics. By this we mean that any disease can begin to develop from the state of mind, various experiences and thoughts, mood and self-hypnosis. Therefore, every person must lead correct image life, relax more and take care of your health, avoiding frequent stress, negative emotions and experiences.
Video on the topic
Fibroadenomatosis (FAM) of the mammary glands is very common pathology, which occurs, according to various authors, in 30–60% of all women. In 1984, WHO proposed the term fibrocystic breast disease for this pathology.
IN International classification diseases (X) this nosological form is designated as benign mammary dysplasia. In foreign literature, the term “benign breast disease” is often used. IN Russian literature The terms FAM, dyshormonal mammary hyperplasia, and mastopathy are usually used. In 1985, the Russian Ministry of Health proposed a convenient clinical and radiological classification of mastopathy, which is most often used today. Mastopathy, according to this classification, is divided into 2 main forms, each of which has subtypes. In particular, they distinguish:
1) diffuse mastopathy:
a) with a predominance of the glandular component (adenosis);
b) with a predominance of the fibrous component (fibrosis);
c) with a predominance of the cystic component (multiple cysts);
d) mixed form (glandular-cystic).
2) nodular mastopathy:
a) fibroadenoma;
IN oncology practice The term FAM is more often used, which will be used further. With FAM, patients usually complain of mastalgia (pain in the mammary glands), premenstrual tension syndrome (heaviness and swelling of the mammary glands during the premenstrual period), dysalgomenorrhea (painful, unsystematic periods). Palpation reveals compactions and swelling in the mammary glands; with echographic and mammographic studies - cysts and fibroadenomatous changes; morphological examination reveals hyperplasia of epithelial cells and fibroblasts in the lobular and ductal structures of the mammary glands, sclerosis and atrophy.
The problem of FAM is very relevant, since, according to surveys, at an outpatient appointment with an oncologist, up to 50% of patients are patients with this pathology. FAM as a separate nosological entity was identified at the end of the 19th century, and for several decades this disease was considered as a stage preceding the onset of breast cancer. Currently, views on FAM have undergone significant changes. Generally this pathology is not a precancer or stage of an oncological process in the mammary glands. Precancer of the mammary glands - morphological concept, it includes ductal atypical epithelial hyperplasia and carcinoma in situ, lobular atypical epithelial hyperplasia and carcinoma in situ; in the presence of these changes, the risk of invasive breast cancer (BC) increases by 2.5-10 times or more. FAM is considered as one of the many risk factors for breast cancer. Precancerous changes are found in only a small proportion of women with FAM. However, the role of FAM in the development of breast cancer should not be underestimated.
There are 4 groups of evidence linking FAM with breast cancer:
1) FAM and breast cancer have common risk factors;
2) the causes and mechanisms of development of FAM and breast cancer have common features, a key role is played by a relative or absolute excess of estrogen - long-term chronic hyperestrogenism;
3) when removing mammary glands due to cancerous tumor Various morphological manifestations of FAM can often be found in tissues;
4) in retrospective and prospective epidemiological studies, previous FAM is more often identified in patients with breast cancer.
However, the issue of the relationship between FAM and breast cancer is controversial. According to various authors, FAM can increase the risk of developing breast cancer by 1.5 times or have no effect on it at all. All women suffering from FAM cannot be considered at risk for developing breast cancer. Most essential at the same time they have morphological changes mammary tissue. According to epidemiological studies, in patients with FAM, with hyperproliferation of the epithelium without atypia, the risk of developing cancer increases by 2–3 times, with hyperproliferation of the epithelium with atypia – by 5–7 times. Monitoring women suffering from FAM and providing therapy for this disease is aimed at preventing breast cancer. However, the scientific and practical aspects of the problem of FAM continue to remain controversial in oncology. In addition, modern medicine simply does not have the technical capabilities to adequately monitor and treat the huge contingent of women suffering from FAM. Unfortunately, in our country, the efforts of the oncology service aimed at identifying, treating and clinically examining patients with FAM did not lead to the goal of reducing the incidence of breast cancer.
For nodular forms of FAM, sectoral resection of the mammary gland with urgent histological examination of the gross specimen is indicated. Using two semi-oval incisions in the radial direction relative to the areola, the affected sector of the gland is excised to the fascia major pectoral muscle, and then the wound is sutured in layers (Fig. 3).
Depending on the results of an urgent histological examination, the operation is either completed if the process is benign, or (if cancer is detected) it is expanded to the extent of a radical operation.
Diffuse forms of FAM are subject to conservative treatment, which is aimed at regulating dysfunction of the glands internal secretion, treatment of diseases of the female genital organs, suppression of proliferative processes in the mammary gland.
Rice. 3. Excision of the breast sector. (Credited from: Atlas oncological operations. Ed. B.E. Peterson. M., 1987)
To remove pain syndrome Electrophoresis with novocaine and potassium iodide is used. To reduce proliferative processes in the mammary gland in women under 40 years of age, treatment with microdoses of iodine is recommended ( water solution 0.25% potassium iodide during the intermenstrual period, 10 ml 1 time per day after meals for 1 year). The use of microdoses of iodine is based on stimulation of the production of luteinizing hormone by the pituitary gland. This hormone normalizes the function of ovaries with a disturbed luteal phase and restores the normal cycle of changes in the mammary gland. In case of insufficient function corpus luteum in the second half of the menstrual cycle, progesterone is used.
Good afternoon FKM was installed 15 years ago. Periodically pumping out cysts, 2 resections of fibroadenoma of the left breast in 2013, 2014, and recently had a trephine biopsy (painful thickening of the left breast) Result: picture of proliferating fibrous mastopathy D2 ductal epithelium. The doctor advised to do a repeat and collect tests for the operation, because he suspects a malignant formation. Are the doctor’s actions justified?
Answers the question: Krasnozhon Dmitry Andreevich
Hello, Natalia. Yes, I agree with your doctor. If during puncture data are obtained that there are proliferative changes, then it is better to remove such a section of the mammary gland. It is possible that breast cancer may develop in this area over time.
Hello, the doctor said that I have localized fibroadenomatosis of the mammary gland and that it urgently needs to be removed. Is this disease bad and does it need to be removed?
Answers the question: Krasnozhon Dmitry Andreevich
Hello Alida. Surgical interventions for localized fibroadenomatosis are performed in two cases - if breast cancer cannot be ruled out and if puncture results in evidence of a proliferative form of fibroadenomatosis - a situation when intensive cell division (proliferation) occurs in the mammary gland, which may be a precancerous condition. In any case, you need to rely on the opinion of your doctor.
Hello, Dmitry Andreevich, please explain. I am 38 years old. I discovered a lump in my left breast, I made an appointment with a mammologist. I had an ultrasound and a mammogram (the conclusion was that the mass was 30/34 mm, the visible contours were quite clear, partially covered). A trephine biopsy was performed under ultrasound control - a histological examination-conclusion" within the morphological material sent. The picture corresponds to nodular FC of the breast disease, a proliferative form with widespread myoepithelial hyperplasia, small cystic transformation of the ducts B2 - to B category (benign changes)." Tell me, is the only treatment surgical and, if so, how is it removed? Is it possible to plan a pregnancy after? Thank you very much in advance.
Answers the question: Krasnozhon Dmitry Andreevich
Hello, Angelica. We are talking about a localized form. Judging by the histological conclusion, we are talking about a precancerous condition. Usually in such cases I recommend sectoral resection - removal of a given area in the mammary gland. If during a planned histological examination no evidence of breast cancer is obtained, then planning a pregnancy after surgery can be done already 2-3 weeks after the wound has completely healed. In any case, you need to rely on the opinion of your doctor.
Hello! Dmitry Andreevich, tell me, I was diagnosed with angular mastopathy with proliferation of streaming epithelial cells with degenerative changes, a formation measuring 19x7 mm in the left breast, the attending physician recommended surgery, but I’m currently breastfeeding and what should I do? The surgeon says that after the end of lactation, 2 months still have to pass, but I read that nodular mastopathy is dangerous and it’s better not to waste time, I’m afraid I’m terribly wasting time, please advise what to do
Answers the question: Krasnozhon Dmitry Andreevich
Hello, Ekaterina. If the doctor, upon examination and examination, believes that the tumor is suspicious for breast cancer, then surgery shown. If there is no suspicion of breast cancer, then for localized fibroadenomatosis, surgery can be performed even after breastfeeding ends. In any case, you need to rely on the opinion of your doctor.
Hello Dmitry Andreevich! Today I received the mammogram result and received a referral to an oncologist. "In both the yellow and yellow cells, there is fatty involution and diffuse fibromatosis. On the right side of the square, there is a shadow of up to 2.0 cm, similar to local fibrosis. "What is this? Isn't this cancer?
Answers the question: Krasnozhon Dmitry Andreevich
Hello, Elena. We are talking about the manifestation of fibrocystic disease of the mammary glands. Localized fibroadenomatosis is an area of remaining breast tissue. When localized fibroadenomatosis is detected in women over 35 years of age, I usually recommend surgery. In any case, we need to look at you to say definitely.
Hello. Six months ago I had a sectoral resection of the mammary gland again. Conclusion: “The histostructure and phenotype correspond to proliferative fibrous dysplasia with a radial scar, focal regular ductal hyperplasia with apocrine metaplasia of the epithelium, and a focus of sclerosing adenosis.” The fact is that after the operation, my operated breast began to hurt (pulling and cutting pain), radiating to the armpit. I came for an appointment, the doctor said that the ultrasound did not show any formations, there were tissue changes in the area postoperative suture– fibrosis and he doesn’t see anything wrong with it. Please tell me - can fibrosis cause such painful discomfort? And is he dangerous? Tell me, is it possible to treat it? And How? Thank you.
Answers the question: Krasnozhon Dmitry Andreevich
Hello, Tata. Obviously, such a change in tissue, which can be regarded as precancerous, arose against the background of severe fibrocystic disease. After sectoral resection for fibrocystic disease healing does not occur optimally; it happens that fibrosis forms and aseptic inflammation occurs (an inflammatory process without the participation of bacteria). There may be pain in such cases. I recommend that you conduct regular monitoring.
Hello doctor, I was diagnosed with a proliferative form of fibrocystic breast disease, nodular form. Chronic periductal mastitis. What does this mean?
Hello Elmira. We are talking about one of the forms of fibrocystic disease of the mammary glands. A localized or nodular form of fibroadenomatosis indicates that there is an area of fibroadenomatosis that is denser than the rest. But the proliferative form indicates that in this area the cells are dividing intensively. The proliferative form of fibrocystic disease may be a precancerous condition. In such cases, I usually suggest performing a sectoral resection of the mammary gland and removing the tumor, followed by histological examination. If breast cancer is detected during urgent histological examination, it will be necessary to perform radical surgery(mastectomy, mastectomy with simultaneous reconstruction, organ-conserving surgery), the scope of which must be discussed with the surgeon who will operate on you. In any case, you need to rely on the opinion of your doctor.
Hello, I am 37 years old and I am preparing for IVF. I have a local fam of the 1st breast 12.0*7.0 mm, without pathological blood flow. Earlier (in the summer of 2016) signs were diagnosed diffuse femme. How long will the treatment be, is full recovery possible and is local fam a contraindication to IVF?
Hello Olga. Localized fibroadenomatosis may be a contraindication for IVF. We need to look at you (it is necessary to assess how suspicious the area of localized fibroadenomatosis in the mammary gland is and whether a biopsy is required) in order to say definitely. Treatment for localized fibroadenomatosis is usually surgical.
Hello Dmitry Andreevich. IN Once again I am contacting you because I am very worried about the upcoming operation, which will only take place at the end of January. What do you think I should expect, what is the prognosis? I planned to do an MRI, but the machine broke down. MMG: Diffuse FCM. LOC fibrodenomatosis on the right in the upper outer square of the right breast, area of the seal with unclear contours up to 13-10 mm. CI pronounced proliferation of lobular epithelium. I will be very grateful for the answer.
Hello, Tonya. Most likely, we are talking about localized fibroadenomatosis - a manifestation of fibrocystic disease, when an area is formed where active cell division occurs. Highly proliferative forms of localized fibroadenomatosis are often regarded as precancerous conditions. The purpose of the operation is to remove the suspicious area and conduct a histological examination and, accordingly, exclude breast cancer. In any case, you need to rely on the opinion of your doctor.
Dear Dmitry Andreevich, three years ago I underwent an IVF procedure; during the examination, 2 fibrocystic formations on an ultrasound, then I did not give it any importance, since nothing bothered me, about 2 months ago I began to be bothered by noticeable pain in the chest (left), two tumors appeared that were visible and easily palpable, left breast has become larger, the pain is quite intense, an ultrasound has already found three cysts, and the 2 that were there three years ago have become much larger, almost tripled in size, the doctor prescribed mastodinone and monitoring once a year, but the pain still does not go away, formations These are quite dense and painful to the touch, is it possible to say with certainty only by ultrasound that these formations are benign and not dangerous? Or is it still worth doing some additional research? I'm afraid to miss time. Thank you very much in advance for your answer.
Hello Anna. I would most likely suggest performing a biopsy in your case to confirm the nature of the lumps. In any case, you should follow the recommendations of your doctor.