Fibrocystic breast changes

The term is understood to mean a variety of proliferative breast disease or degenerative remodeling of the mammary gland parenchyma, which are usually caused by hormonal imbalance between estrogen and progesterone. This mainly affects between 30 and 50 years women. After section statistics on the incidence of mastopathischen changes are in about 50% of the examined mammae, in the 8th decade of life even more than 80% changes in the sense of mastopathy ago. The transitions between the old physiological and "real" mastopathischen changes can be fluent and often cause problems in the histopathologic diagnosis. ( Remmele, pathology, Volume 4, page 185 )

Pathogenesis

Mastopathy is based on a displacement of the hormonal balance of estrogen and progesterone in favor of the estrogen. Trigger for this could be:

  • Estrogen stimulus
  • Progesterone deficiency
  • Hyperprolactinemia
  • Hyperandrogenism
  • Deficiency of thyroid hormones ( hypothyroidism)

Under the influence of estrogen leads to an increased proliferation of the glandular tissue, which can lead to increased secretion and thus duct dilatation and cyst formation.

It divides the mastopathy in three grades:

  • Simple breast disease (grade I ) - 70 % without epithelial
  • Simple proliferative breast disease ( grade II ) - 25 %, activation and proliferation of epithelial character
  • Atypical proliferative breast disease (grade III ) - 5 %, moderate Anaplasiezeichen of epithelial cell proliferation and strong

Symptoms

The appearance is determined mainly by nodulation, increased premenstrual breast pain ( mastalgia ) and the (rather rare ) secretion from the nipple.

Diagnostics

In addition to the medical history and examination, the diagnosis of breast disease is mainly provided by sonography. The clinical diagnosis of fibro- cystic breast disease requires further clarification in order not to overlook proliferations in terms of a precancerous lesion. As differential diagnoses of breast disease, especially breast cancer and benign breast tumors are excluded.

Therapy

The treatment of breast disease depends on the clinical picture; with mild forms are mainly the treatment of premenstrual pain and enlightening conversations in the foreground. The use of progestogen -containing gels can feel a subjective improvement of pain. Also androgenhaltige gels or systemic administration of progestins may be attempted. In the case of breast disease with nodules, excision and histological examination in must be considered. Repeated high grade mastopathies the complete removal of the breast glandular tissue may be necessary.

  • Disease in obstetrics and gynecology
  • Breast
Anaplasia Mastodynia
555562
de