Mammary gland hyperplasia is the most common breast disease in women, and its incidence accounts for the first place in breast diseases. In recent years, the incidence of the disease has been increasing year by year, and the age is getting younger and younger. Mastocytosis is a physiological hyperplasia of the normal breast lobules with incomplete replenishment, a disruption of the normal structure of the breast, a pathological hyperplasia, which is neither an inflammatory nor a tumor. It is a type of disease that is neither inflammatory nor neoplastic. It mostly occurs in women aged 30-50 years old, with a peak incidence of 35-40 years old.
1.Disease introduction
Many patients visit the doctor because of breast discomfort and pain, some of them have run to many hospitals and have taken all kinds of drugs for breast enlargement, but they still do not get better or get better and worse, in today’s high prevalence of breast cancer, more and more women are worried that they are unfortunately “hit” and any discomfort of their breasts makes them panic!
In adolescent or young women, breast pain before menstruation, sometimes spread to the back of the shoulder, after menstruation, breast pain gradually relieves itself, only some thickening of the breast can be touched, no obvious nodules, these are physiological changes, not disease, and do not need treatment, belong to the physiological hyperplasia. Mastocytosis is a physiological hyperplasia of the normal breast lobules with incomplete replenishment and disruption of the normal structure of the breast, which is pathological hyperplasia.
2.Cause of pathogenesis
The real cause of pathogenesis is still unclear. At present, it is mostly thought to be related to endocrine disorders and mental and environmental factors.
1, endocrine disorders. The decrease of luteinizing hormone secretion and the relative increase of estrogen are the important reasons for the development of breast hyperplasia. Such as ovarian dysplasia, menstrual disorders, thyroid disease and liver dysfunction.
2, the influence of emotional and other mental factors. Mental tension, emotional excitement and other adverse mental factors tend to form mastocytosis, often stay up late, lack of sleep, etc. can also cause mastocytosis, and these adverse factors will also aggravate the existing symptoms of mastocytosis.
3, human factors or bad habits: women of advanced age, sexual dysfunction, abortion, marital discord, not breastfeeding and other reasons, resulting in the mammary glands can not have a normal, cyclical physiological activity. Wearing too tight bras or tight underwear, etc.
4. unreasonable diet structure, such as high-fat, high-energy diet leading to excessive fat intake, drinking alcohol and smoking and other bad habits can induce mastopathy. In addition, now that people have a better diet, there are many people with hypertension and hyperglycemia, and these also tend to make women have endocrine disorders, leading to mastopathy.
5, long-term use of estrogen-containing health products, birth control pills. Long-term excessive intake of estrogen will lead to endocrine imbalance, and some fast food, artificially raised aquatic products and poultry feeds also contain hormone ingredients, which can also lead to the occurrence of mammary gland diseases.
3.Clinical manifestations
Disease symptoms
1, breast pain: often swelling or stabbing pain, can involve one or both breasts, with one side is more common, the pain is severe can not be touched, and even affect daily life and work. The pain can be radiated to the ipsilateral armpit or back of the shoulder; part of it can be manifested as nipple pain or itching. Breast pain often appears or worsens a few days before menstruation and decreases or disappears after menstruation; pain can also fluctuate with emotional changes, exertion and weather changes. This kind of pain related to menstrual cycle and emotional changes is the main feature of the clinical manifestation of mastopathy.
2, breast lumps: lumps can occur in the unilateral or bilateral breast, single or multiple, generally in the upper outer quadrant of the breast. They may appear as lamellae, nodules, or cords of different sizes, with lamellae being the most common. The borders are not obvious, the texture is medium or slightly hard, and there is no adhesion to the surrounding tissues, often with tenderness. Most breast lumps also have the characteristic of changing with the menstrual cycle, with the lumps increasing in size and hardening before menstruation and shrinking and softening after menstruation.
3, nipple overflow: a few patients may have nipple overflow, spontaneous overflow, mostly pale yellow or pale milky white, there are also a few by squeezing the nipple visible overflow. If there is bloody or coffee-colored overflow, you need to come to the hospital immediately.
Physical signs of disease
1.Self-examination.
Self-examination plays a decisive role in the detection of breast diseases, and it is especially important for women to know some knowledge of breast self-examination. Self-examination should be done a week to two weeks after menstruation. Mammary gland hyperplasia self-examination methods are as follows.
Visual: Stand in front of a mirror with your hands down or with your arms crossed, and carefully observe whether the bilateral breast is symmetrical in size, whether the skin and nipples are sunken or eczema, whether there is redness or swelling, and whether there are abnormal protrusions.
Touch: With the left hand raised or crossed, check the left breast with the right hand, lightly press the breast with the belly of the finger to touch whether there is a hard lump, starting from the nipple to make a circular clockwise check, touching with the palm of the hand flat, four fingers together, using the end of the index finger, middle finger, ring finger to lightly touch the outer upper, outer lower, inner lower, inner upper area of the breast in order, and finally the nipple and areola area in the middle of the breast. Do not use your fingers to grasp and pinch the breast tissue during the examination, otherwise the grasped breast tissue may be mistaken for a lump. If you find a swelling in the breast or a nipple overflow, you should seek medical attention in a timely manner to avoid delaying your condition.
2, professional breast examination: should be done regularly every year. Ask a breast specialist for an examination. The examination time also avoids the pre-menstrual period and menstrual period as much as possible, usually 10-12 days after the end of menstruation.
4.Diagnosis and differentiation
Auxiliary examination
With the development of ultrasound imaging, the application of high-frequency ultrasound has greatly improved the resolution of ultrasound, which can detect microscopic lesions in the breast, especially for the identification of cystic and solid tumors, which is difficult to be replaced by other imaging.
2.Mammography: Mammography is an important means to detect early cancer and microscopic cancer, but it is unnecessary to repeatedly examine them within a short period of time, especially the breast during puberty and pregnancy and lactation is sensitive to X-rays, and excessive exposure will increase the incidence of breast cancer. Generally, mammography is not necessary before the age of 30, except for those with special circumstances, and is performed every 2-3 years between the ages of 30 and 40, and once every 1-2 years after the age of 40. The examination of microcalcifications is incomparable to other imaging examinations.
3, breast MRI: breast MRI has high sensitivity and medium specificity. Because of its relatively high price, long examination time and relatively small and confined space, it is not popular at present. It has great advantages for microscopic breast cancer that is negative by mammography plus ultrasound, post-operative review, examination of breast implants or breast augmentation by injection, nipple overflow, and screening of high-risk groups.
4.At present, for clinical examination of breast diseases, mammography + ultrasound is the golden combination. When the combined application of mammography and ultrasound is negative, the possibility of malignancy is less than 3%.
5.Disease treatment
Since there is no exact understanding of the mechanism and cause of mastocytosis, the current treatment is basically symptomatic. Some patients often go into remission on their own after a few months to one to two years after the onset of the disease and do not need treatment. There are many types of mammary gland hyperplasia. Physiological mammary gland hyperplasia, such as simple mammary gland hyperplasia, does not require special treatment and can subside on its own. Mammary gland hyperplasia caused by mental, emotional and human factors will also subside or be relieved through adjustments (such as timely diagnosis and treatment of other organ diseases related to the occurrence of breast diseases, regulation of emotions, alleviation of mental stress, changing unhealthy eating habits, quitting smoking and alcohol, etc.).
Pathological breast enlargement needs to be treated actively, especially the cystic enlargement type, which cannot be taken lightly because of the possibility of cancer. Most of the drugs commonly used in clinical practice are Chinese patent medicines, such as Prosperity Pills and Gui Zhi Fu Ling Capsules, which have the functions of activating blood stasis, dredging liver and Qi, softening and dispersing nodules, and tonifying Qi and blood. In addition, there are still hormone therapy, some people use androgens to treat this disease, but this treatment may aggravate the imbalance between human hormones, and should not be routinely applied. It should only be considered when the symptoms are serious and affect normal work and life. For severe pain, methyltestosterone or tamoxifen can be tried and started orally within one week before menstruation to avoid further disturbance of the fine balance between human hormones. Chinese herbal medicine or formula can also be used for treatment under the guidance of Chinese medicine diagnosis.
6.Disease prevention
1.Keep a relaxed mood and optimistic emotion.
2, change the diet structure, prevent obesity, eat less fried food, animal fat, sweets and too much food, to eat more vegetables and fruits, eat more coarse grains. Black soy beans is the best, eat more walnuts, black sesame, black fungus, mushrooms.
3, regular life, work and rest, maintain a harmonious sex life. Regulation of endocrine can play a role in the prevention of breast enlargement.
4, more exercise, to prevent obesity to improve immunity.
5, prohibit the abuse of contraceptives and estrogen-containing beauty products or food.
6, avoid abortion, adhere to breastfeeding, can prevent the problem before it happens.
7, self-examination and regular re-examination.
8, clear diagnosis, according to the condition to develop a reasonable treatment plan.
9, psychological treatment is very important, mammary gland hyperplasia is more harmful to people than psychological damage, due to the lack of proper understanding of the disease, excessive tension stimulates worry and sadness, resulting in neurasthenia, will aggravate the endocrine disorders, prompting the aggravation of hyperplasia, so you should lift all kinds of adverse psychological stimulation. People with poor psychological tolerance should pay more attention to less anger, to maintain emotional stability, lively and cheerful mood, to promote the remission or remission of mastocytosis.