Cystic hyperplasia of the breast (generalized), referred to as slow breast disease, is an endocrine-related, non-inflammatory, non-tumorigenic, proliferative disease of the glandular tissue. The main clinical manifestations are breast swelling and pain, breast lumps and nipple overflow. The symptoms increase before menstruation and decrease after menstruation. This disease accounts for the majority of breast lumps in young and middle-aged women, exceeding the incidence of tumors, and its occurrence is chronic. Foreign medical experts believe that there is no specific drug for the treatment of this disease. Patients with mild symptoms do not need to be treated and should be regularly observed for changes in their condition. Since the disease has the potential for malignant transformation, the number of people seeking medical attention is increasing.
Symptoms.
1. pain in the affected breast with the menstrual cycle.
2. palpable striated or nodular masses in one or both breasts, with bready texture and unclear borders.
3, yellow-green, brown or bloody overflow from the nipples.
Diagnosis based on.
1. breast pain, lumps, and nipple discharge.
2, Needle aspiration cytology or biopsy for a definitive diagnosis.
3. infrared scan of the breast, ultrasound, mammogram or dry plate x-ray may assist in the diagnosis, but only for reference value
4. The size, texture, smoothness of the border and the presence of adhesions with the surrounding tissues of breast lumps are of great significance in determining the nature of the tumor. The hand feeling of skilled surgeon is more valuable to assist diagnosis than infrared scan, ultrasound, X-ray, etc.
Classification of symptoms.
According to clinical manifestations: it can be divided into qi stagnation (liver depression), qi depression, yin deficiency (dysregulation of flushing), blood stasis, etc. Rarely, there are evidence types such as dampness and heat.
Differential diagnosis and treatment principles.
1. neoadjuvant chemotherapy, surgical treatment, radiotherapy, postoperative chemotherapy and endocrine therapy are the mainstays of breast cancer.
2.Intraductal papillary adenoma: surgical treatment
3. Surgical treatment of breast fibroids.
Treatment.
Treatment principles
1, endocrine therapy.
2.Regular follow-up and observation of its changes.
3, symptomatic treatment.
4.Chinese herbal medicine treatment.
5.Surgical excision when malignancy is suspected.
Methods.
1.If the symptoms are mild, they can be left untreated, and regular follow-ups should be made to observe the changes.
2.For those with heavy symptoms and severe pain, endocrine therapy, or compound iodine solution, along with vitamin E and lactic nodules, can be used.
3.Chinese herbal treatment has definite efficacy. The basic formula is often called “prolotherapy”, which is added and subtracted at the end of the day. Adding endocrine treatment will be more effective.
4, breast fibroids and slow breast disease are two different diseases, individual herbalists treat these two diseases according to the same evidence, often delaying the disease. To prevent malignancy, fibroids should be treated with surgery as soon as possible, and breast cancer should not be treated with Chinese herbal medicine alone.
5. Surgical excision is feasible for those with limited lesions.
Caution.
Teach patients to conduct their own examination and pay attention to the growth rate and hardness of the lump. Once a fast growing and hardening lump appears, the possibility of malignant change should be highly suspected.
Some of the disease can heal spontaneously, but malignancy may occur in a small number of patients (about 5%). Therefore, prevention of malignancy is the key. Patients are advised to review the disease every 3-6 months. Usually, at the initial diagnosis, mass aspiration for cytological examination and tissue biopsy is required. It is especially important to be alert for unilateral, hard masses with unsmooth edges.
Chronic breast disease is treated with Chinese herbal medicine, which has definite efficacy, and with endocrine therapy, which can receive unexpected results. Breast fibroids should be surgically removed if medication is not effective.
A lot of Chinese medicine practitioners of the master school, classical school, and jianghu school are prone to misdiagnosis, and quite a few Chinese medicine practitioners of the academy school who have not learned modern medicine well, even the so-called breast Chinese medicine practitioners, are not able to handle such diseases well. Some “Western” physicians mistakenly believe that this disease does not require treatment.
The Chinese medicine treatment of chronic breast disease is one of the more important pieces of the few remaining positions squeezed by modern medicine. I hope that colleagues must take advantage of this position, not because of too many misdiagnosis, and the loss of this piece of treasure.