Mammary gland hyperplasia is the most common breast disease with complex etiology and many types, mostly seen in middle-aged women aged 30 to 50. It accounts for about 40% of women of childbearing age and 75% of all breast diseases. Its essence is neither inflammation nor tumor, but physiological hyperplasia and incomplete restoration resulting in disruption of the normal structure of the breast, but because a few, especially those with high risk factors for breast cancer, may become cancerous in the course of continuous and gradual evolution (about 2~3%), it undoubtedly forms a threat to the physical and mental health of the majority of women, and in the last decade or so In recent decades, the incidence of breast hyperplasia has been increasing year by year in the world and in China with the changes in living environment, lifestyle and living conditions, and tends to be younger, and the corresponding incidence of breast cancer also tends to increase. This has aroused widespread concern and attention in the medical field.
Causes and classification of mammary gland hyperplasia
The mammary gland is the target organ of hormones in the pituitary-ovarian axis. Numerous Chinese and Western medical studies have shown that the pathogenesis of mammary gland hyperplasia is multifactorial, and although the mechanism is not completely clear, it is mainly related to ovarian endocrine dysfunction, with a decrease in luteinizing hormone secretion and a relative increase in estrogen, causing different degrees of hyperplasia of the ductal epithelium and fibrous tissue of the breast, and the formation of terminal glandular ducts or follicular cysts. According to traditional Chinese medicine, mammary gland hyperplasia belongs to the category of “breast fetish”, and the etiology of the disease is due to liver qi stagnation and dysregulation of punching and blood stasis, resulting in obstruction of the meridians. Most of the clinical breast enlargement is closely related to emotional communication, mood suppression, excessive sadness, long-term depression is the cause of breast enlargement, usually can be divided into three types. The first is the breast pain type: short duration, often accompanied by menstrual disorders, characterized by periodic pain in the breasts, mostly in women aged 20-40 years, the pain is obvious before menstruation and relieved after menstruation, generally in the breast can not feel the lump, only local glandular thickening or with a mild granular feeling, which mostly belongs to physiological changes; second is the breast adenopathy type: more than 35 years old, the duration of the disease is about 2 years. It is often a limited lump or pain in one or both breasts, associated with menstrual cycle, with unclear boundaries with the surrounding tissues, which are mostly lobular hyperplasia-like changes in the breast. The breast can appear a single large lump, garden spherical, smooth surface, cystic in the solid sense, can also be manifested as multiple cystic nodules of varying sizes in the breast or with nipple overflow, about 1/3 of patients have pain and tenderness in the early stage, the occurrence of cancer rate is slightly higher, mostly on the basis of epithelial hyperplasia of the milk ducts to atypical hyperplasia, should pay great attention to.
Reasons for the increased incidence of mastopexy
According to the literature, breast hyperplasia is increasing at the rate of 3% per year, while breast cancer has jumped to the first place of female malignant tumors, with the incidence rate of 18.4/100,000 in 1982, 24.3/100,000 in 1991, 36.3/100,000 in 2001, 52/100,000 in 2003, 56.2/10 in 2004; medical research shows that the increase of cancer rate is closely related to the high protein and high fat diet. The medical research shows that the increase of cancer rate is closely related to high protein and high fat diet, and the incidence rate increases in both rural and urban areas. Experts analyze that this is related to bad lifestyle habits, endocrine disorders, hormone disorders in the body, lower immune function and genetic factors.
1.Dietary structure is not appropriate
Prefer to eat barbecue, smoked products and high-fat diet, etc.
2, endocrine disorders
Early menarche, late marriage, more abortions, no nursing after childbirth, insufficient nursing, thyroid insufficiency, etc., easily cause ovarian dysfunction.
3, “sex” environment expansion
The “sexual” environment, which has been enlarged by hearing and hearing, has led to the secretion of “kinesin”, resulting in a relative decrease in progesterone and an increase in estrogen.
4.Exogenous hormone intake
In order to prevent aging and skin beauty, long-term use of estrogen drugs or estrogen-containing cosmetics can cause the estrogen level in the body to lose balance.
5.Mental stimulation
Due to the high competition and fast-paced stress in modern life, some women become emotionally unstable, depressed or paranoid due to work pressure, family marriage, etc., and their estrogen and progesterone levels and glandular structure become disrupted, leading to a decrease in immunity.
6.Other
Genetic factors, especially a family history of breast cancer, increase the relative risk of developing this disease.
Diagnosis of mastocytosis
In addition to medical history and clinical examination, the following diagnostic methods are commonly used for the diagnosis of mastocytosis, which can be used in different cases.
1.Near infrared scan of the breast is one of the auxiliary methods for the initial screening of breast diseases, mainly using the different intensity of infrared light through the breast to visually distinguish the changes of gray shadows and vascular shadows of breast nodules or lumps.
2.Molybdenum-rhodium targeting of breast soft tissues or mammography of breast ducts is the best way to diagnose benign and malignant breast diseases, which can show soft tissue shadows of different microdensities in the breast, lesions in the ducts and small calcified foci.
3.B-type ultrasound tomography can clearly determine the cystic, substantial or mixed lesions in the breast, identify whether isolated or diffuse lesions, and follow up the treatment effect.
4, fine needle aspiration cytology or nipple overflow smear cytology This method has the advantages of easy operation, rapid diagnosis, less damage than excision and coarse needle biopsy, etc. For those with nipple overflow, smear cytology, endoscopic observation of the breast duct or bite biopsy can help to understand the nature of the lesion.
5.Suspicious lesion excision or frozen section pathological examination of the breast Lesion excision not only achieves the purpose of biopsy, but also is a treatment method, if the frozen diagnosis is malignant, you can choose radical surgery.
Among the above examinations, various methods should be selected as far as possible without damage or with less damage, which is the trend of future development.
Treatment of mastocytosis
Simple mastopathy with mild symptoms can be treated without treatment, and lobular hyperplasia lesions of breast pain can also be observed and are generally not cancerous. Some patients can recover with ovarian dysfunction, and the symptoms can be relieved and disappear after a few months to 1-2 years, or after pregnancy or breastfeeding, which all belong to the physiological category and do not need to be treated. For those with severe symptoms, diffuse breast hyperplasia with pain should start with endocrine regulation under the guidance of a doctor. At present, the commonly used drugs are progesterone (5-10mg/1 time/day, discontinued one week before menstruation), bromocriptine (5mg/day for three months), triamcinolone (20mg/day for 2-3 months), danazol (100-400mg/day for 3-6 months), which have certain effects and can reduce the local pain of the breast, reduce the size of the lump and reduce the density of the gland. If combined with estrogen measurement of breast tissue, it can improve the efficacy. In addition, methyltestosterone, small amounts of iodine (5% potassium iodide 5ml/3 times/day), sedatives and vitamins E, B1, B6 and A can achieve the purpose of adjuvant therapy and have a certain effect of lowering estrogen in the body.
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Self-care of mastopathy
Through a lot of epidemiological studies, it is now known that the disease is related to endocrine disorders and psychological factors, and it is also recognized that the disease is mostly benign and has the tendency to heal itself. In daily life, strengthening self-care, maintaining a relaxed mood, treating menstrual disorders and adjusting ovarian function are important aspects of preventing the occurrence of this disease, and it is feasible to propose some measures to reduce mastopathy for its etiology.
1, women should pay attention to breast health care during adolescence, do not bundle chest. Should wear loose cotton bras to facilitate the normal development of the breast.
2, to correctly understand themselves, establish a good outlook on life, scientific and reasonable, regular and healthy life, including women’s menstruation, pregnancy and nursing, menopause physiological health protection, in order to avoid ovarian dysfunction, progesterone reduction, estrogen increase and lead to breast hyperplasia.
3, try to avoid using estrogen creams or taking estrogen-containing drugs to reduce the loss of balance of hormones in the body induced mammary gland hyperplasia.
4, general breast self-examination once a month, 4-7 days after menstruation, breast tissue is soft and thin, lesions can be easily detected, every 3-6 months, but also regular breast examination, in order to achieve early detection, early diagnosis, early treatment. The fact that marriage and breastfeeding are a physiological regulation of the function of the breast at the right time can prevent the development of mastocytosis.
5, keep the couple’s life in harmony, the regularity of life is stable, consciously resist the “sexual” environment to expand the influence of the elimination of factors that are not conducive to health.
6, active prevention and treatment of gynecological diseases, such as menstrual disorders, adnexitis, uterine fibroids, etc., is undoubtedly an important part of reducing the triggering factors of mastocytosis.
7, advocate a reasonable diet, mainly low-fat and high vitamin diet, try to eat vegetables, cereals, fruits, soy products, kelp, fish, yogurt and intake of sufficient amounts of protein and trace elements and other substances, to help prevent breast enlargement and cancer.
8, exercise, improve immune function and resistance to disease, consciously regulate emotions, anger first, learn to relieve, maintain emotional well-being, and be content.
There is no doubt that only the correct understanding of the self, not to lose control of reason, strengths and weaknesses, to improve themselves, in order to reduce and avoid the occurrence of mastocytosis, so as to achieve the “spirit within the guard”, “the disease is safe from the” purpose.