One of the varieties of breast pathology is fibrocystic breast disease. Often, this pathology is a random finding during routine inspections and asymptomatic. The disease occurs in women older than thirty years in the menopausal period, it is much less likely to be diagnosed and characterized by a lack of new formations.

Regulation of development and function of the breast

The regulation of growth and development of breast cancer occurs under complex hormonal influence. The main role played by estrogen, progesterone and prolactin. In the first phase of adolescence, before menarche, development of breast estrogen effect, and during the second phase of estrogens and progesterone. Because of the effects of estrogen occurs the growth and development of the milk ducts, and connective tissue of the breast, whereas progesterone is responsible for the growth and development of glandular tissue, the increase in the growth of the lobes and alveoli. The main role of prolactin is to stimulate the secretion of milk laktotsitami (mammary cells). Also under the influence of prolactin in breast estrogen increases the number of receptors. In addition, the regulation of the development of the mammary glands involved and STH (growth hormone), which in its physiological effects similar to prolactin.

During pregnancy, there is an intensive growth and development of the mammary glands, which the action is carried out an increasing number of placental estrogen, progesterone, and lactogen and pituitary prolactin. In the postpartum period is "off" the hormonal influence of fetoplacental complex mainly due to the decrease in progesterone levels, but increases the formation and secretion of prolactin, as well as its activity. Thus, prolactin is a powerful stimulator of lactation affects the content in milk proteins, fats and carbohydrates. After the cessation of breastfeeding Breastfeeding: notes   in the breast occur ivolyutivnye (reverse development) process.

Thus hormonal influences subjected parenchyma, which is directly acting pregnancy estrogen, progesterone, prolactin and growth hormone, and during pregnancy estrogen, progesterone, prolactin, lactogen and. To a lesser extent subject to hormonal influences the stroma, which is possible under the influence of estrogen hyperplasia. The relationship of fatty tissue hormones and not well understood. It is known that adipose tissue cells (adipocytes) accumulate estrogens, progesterone and androgens. Under the influence of the enzyme aromatase, androgens are converted into estrogen. Such a process increases with age, it is probably one of the factors increase the risk of breast cancer.

Forms of fibrocystic breast

In clinical practice, commonly used classification of fibrocystic breast, which allocates diffuse and nodular changes in the breast are well visible on X-ray and ultrasound scans, as well as histologically.

Classification of fibrocystic breast:

• Diffuse (common form) fibrocystic breast

Among the diffuse forms of fibrocystic breast distinguished: with a predominance of glandular component (adenosis), with a predominance of the fibrous component, with a predominance of cystic component and mixed form.

• Nodular (limited pockets of mastitis)

Diffuse and nodular fibrocystic breast disease can have both proliferiruschuyu and non-proliferative form.

When proliferuruyuschey form in the epithelium that covers the milk ducts, develop Intraductal papilloma, and in the epithelium covering the walls of the cysts - tsistoadenopapillomy. Thus development of malignant changes in proliferating epithelium. Proliferative form usually associated with hormonal disorders and occurs in women under the age of thirty years. Patients complain of swelling and engorgement, I have very strongly expressed painful syndrome.

When neprofiliruyuschey cysts arise form different diameters, they may be a few millimeters in size, and up to several centimeters (1-2 cm). At first these formations occur in the form of a bunch of grapes, then brush fibrosing.

Fibrocystic breast disease with a prevalence of glandular component (adenosis)

Histologically, this form of fibrocystic breast Breast when breast hurts   characterized as vysokoiferrentsirovannaya, neosumkovannaya (uncoated) hyperplasia, lobular breast cancer. Symptomatic it manifests tenderness and engorgement and swelling of the breast, as well as diffuse seal the entire gland or a portion thereof. Pain and bloating worse in the premenstrual period, the so-called premenstrual syndrome. Adenosis often observed in young girls at the end of puberty, and women in early pregnancy (this condition is reversible). When X-ray observed multiple shadows of irregularly shaped and with unclear boundaries. In some cases, when the shadow of an extensive process captures all the mammary gland.

Fibrocystic breast disease with a prevalence of fibrous component

For this type of mastitis characterized by fibrotic changes interlobular connective tissue, intraductal epithelial proliferation, which leads to a narrowing of the ducts until it is completely imperforate. Patients complain of expressed breast tenderness at palpation (palpation) cancer determined seal tyazhistye sites. When X-ray rendered dense, homogeneous areas with severe tyazhistostyu. Fibrotic processes predominate in premenopausal women.

Fibrocystic breast disease with prevalence of cystic component

In this form of the disease characterized by the presence of multiple cysts elastic consistency and fairly well demarcated from the surrounding breast tissue. As with other forms of fibrocystic breast characteristic clinical sign is pain, amplifying the eve menstrutsii. Cyst formation is inherent in women older than 54 years. In premenopausal cysts found in 25% of women with fibrocystic mastopathy, and in postmenopausal - 60% of women. Histology cystic mastopathy is characterized by the presence of multiple cysts that are formed from advanced atrophic lobules and ducts. Also characteristic changes of interstitial tissue.

Nodular fibrocystic breast

When the nodal form of mastitis are nodes that are local in nature, in the form of single or multiple nodes. During palpation determined by the individual education, not soldered to the skin. Such education increases before menstruation and decreased thereafter. In this form of fibrocystic breast pain in the mammary glands are most pronounced and radiating (give) in the shoulder blade and arm.

Prevention fibrous mastitis kistolznoy

First of all women with mastopathy, recommends limiting stress (and overly emotional woman doctors recommend herbal teas and tinctures soothing herbs) and comply with certain dose. In addition, it is necessary by taking certain medications, such as Mastodinon. The diet should limit the use of chocolate, strong tea and coffee, and salt. Use iodized salt, it is desirable to expand the diet by seafood. For the prevention of cyclic mastalgia (pain and engorgement at the end of the second phase of the cycle) is recommended to take infusions and decoctions diuretic herbs Diuretic herbs: a force of nature guard health   (sheet of cranberries, bearberry, birch buds). By choosing a bra should be approached responsibly: it should be of adequate size, without "stones" and on wide straps. Where possible, eliminate stress, and overly emotional woman doctors recommend herbal teas and tinctures of soothing herbs.

Anna Sozinova

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