Mammalogy: diseases — симптомы, диагностика и лечение

Breast cancer is the most common malignant tumor in women. And at the same time, one of those where early treatment changes the outcome the most: a tumor found up to 2 cm in size without affecting the lymph nodes is treated fundamentally differently and with a fundamentally different prognosis than an advanced one. The main problem is not that the disease is difficult to treat, but that at an early stage it shows almost nothing: it does not hurt, does not interfere, does not raise the temperature. This is why self-examination and routine ultrasound or mammography are crucial, rather than waiting for symptoms.

Fibroadenoma is a benign tumor of the breast and the most common reason why a young woman finds a “ball in her breast.” It is not cancer and practically does not turn into cancer. But it is fibroadenoma that most often becomes a cause for alarm, because it is palpable as a distinct dense node. The key question in this diagnosis is not “is it dangerous”, but “is it really a fibroadenoma” - and the answer to this is given not by palpation, but by examination.

Mastitis is inflammation of the breast tissue. Most often it develops in nursing women in the first weeks after childbirth, but it also occurs outside of lactation. The disease is unpleasant because it develops quickly: from the first compaction and increase in temperature to the formation of an abscess, it can take only two to three days. That is why in case of mastitis, it is not the choice of medicine that decides, but the speed of treatment - at the infiltrate stage, conservative treatment helps, but with an abscess formed, surgery is needed.

Galactorrhea is the discharge of milk or colostrum-like fluid from the nipple in a woman who is not pregnant or breastfeeding, and sometimes in men. Most often, the reason lies not in the mammary gland itself, but in hormones: milk production is stimulated by prolactin, and its excess triggers secretion. Prolactin levels are increased by a pituitary tumor (prolactinoma), decreased thyroid function, a number of medications, and frequent breast stimulation. Galactorrhea is often combined with cycle disorders, difficulties with conception, and decreased libido. The condition itself is not dangerous, but its cause is important to find. Bloody or one-sided discharge is another signal that requires examination by a mammologist.

A breast cyst is a round formation filled with fluid. This is one of the most common findings during breast ultrasound in women 35–50 years old: cysts are formed due to dilation of the ducts under the influence of fluctuations in hormone levels. They can be single or multiple, ranging in size from a few millimeters to several centimeters, sometimes enlarge and become painful before menstruation, and often disappear after menopause. Simple cysts are benign and do not turn into cancer. However, any new lump in the breast should be shown to a doctor: only an ultrasound can distinguish a cyst from a solid tumor and determine whether additional diagnostics are needed.

Lactostasis is stagnation of milk in the breast area of ​​a nursing woman. It occurs when milk is removed from part of the lobules worse than it is produced: due to improper attachment, missed feedings, pressure from tight underwear or excess milk production. The tissue around the ducts swells, painful compaction appears, and sometimes redness. The state of health usually does not suffer much, and if the temperature rises, it does not last long. Without the right measures, stagnation can turn into mastitis and abscess. The main thing is to continue to feed, gently relieve the swelling and do not knead the breast with force. In most cases, lactostasis goes away in 1–2 days.

Mastalgia is pain, heaviness or painful sensitivity of the mammary glands. This is one of the most common reasons for visiting a mammologist. Most often, the pain is cyclical: it increases in the second half of the cycle under the influence of sex hormones and disappears with the onset of menstruation. Non-cyclical pain does not depend on the cycle and can be associated with cysts, inflammation, sprains or taking hormonal drugs. Sometimes it’s not the gland that hurts, but the chest wall—the muscles, ribs, cartilage. Isolated pain is rarely a sign of cancer, but persistent local pain, thickening or skin changes require evaluation. A correct diagnosis allows you to calm down and find relief.

Mastopathy is the collective name for benign changes in breast tissue: proliferation of connective tissue, formation of small cysts, engorgement and pain. This is a very common condition, and the main thing you need to know is that mastopathy itself is not a precancer and does not turn into cancer. However, it makes the breasts “uneven” to the touch, and against this background it is easier to miss a truly significant formation - so regular examination is important.