I. Definition
This disease is one of the common and frequent diseases in women, mostly seen in women aged 25 to 45 years old, which is essentially a disorder of the normal structure of the breast caused by physiological hyperplasia and incomplete restoration. In China, cystic changes are rare, but mostly glandular hyperplasia is the main cause.
In China, cystic changes are rare, and most of them are glandular hyperplasia, so it is mostly called “mastopexy”. The World Health Organization (WHO) collectively calls it “benign breast dysplasia”. The risk of malignancy is two to four times higher than that of normal women, and clinical symptoms and signs are sometimes confused with breast cancer.
Etiology
The etiology of this disease is not well understood. Currently, it is thought to be related to endocrine disorders and psychological factors. The decrease of luteinizing hormone secretion and the relative increase of estrogen are the important causes of this disease. It is mainly a benign hyperplasia of the interstitial mammary glands, which can occur around the ducts and be accompanied by cysts of various sizes; it can also occur in the ducts and manifest as papillary hyperplasia of the epithelium with cystic dilatation of the milk ducts. In addition, there is also a type of lobular parenchymal hyperplasia.
III. Main clinical symptoms
The prominent manifestations are breast swelling and pain and intramammary lumps.
1. Breast distension and pain: unilateral or bilateral breast distension and pain or tenderness are common. The duration of the disease varies from 2 months to several years, and most patients are characterized by cyclic pain, which occurs or worsens in the premenstrual period and decreases or disappears after menstruation. It must be noted that although the periodicity of breast pain is typical of the disease, the lack of this feature does not negate the existence of the lesion.
2, breast lumps: often multiple, unilateral or bilateral, more common in the upper outer quadrant; and the size and texture are often cyclical with menstruation.
The size and texture often change cyclically with menstruation, with the lumps increasing in size and hardness in the premenstrual period and shrinking in size and hardness after menstruation. On examination, the lump can be palpated as a nodal structure, varying in size, with unclear boundaries with the surrounding tissues, mostly painful to the touch, without adhesions to the skin and deep tissues, and can be pushed, and the axillary lymph nodes are not enlarged.
In addition, there is also a long course of disease, slow development, and sometimes nipple overflow and other manifestations. The nodules in the breast are essentially large and small cystic dilated milk ducts, and nipple discharge comes from these cysts, which are yellow-green, brown or bloody, or occasionally colorless and plasma.
Auxiliary examination
According to the above clinical manifestations and signs, it is not difficult to diagnose this disease. However, it should be noted that malignancy can occur in a small number of patients (about 2-3%), therefore, attention should be paid to the follow-up observation of suspected patients, usually every three months for review. Unilateral and limited lesions should be especially vigilant.
V. Treatment principles
Since there is no exact understanding of the mechanism and cause of this disease, the current treatment is basically symptomatic. For patients with more obvious symptoms and extensive lesions, a bra can be used to support the breast; oral administration of Xiaojin Dan or Xieyao San, or
5 % potassium iodide can relieve the symptoms. In recent years, there are more similar drug products, such as breast lump elimination, breast fetish elimination, asparagine tablets, flat elimination tablets, cystic fetish spirit, triamcinolone, etc. The treatment effect varies.
Care measures
1.Reducing pain
(1) Psychological care: explain the reasons for the occurrence of pain, eliminate the patient’s ideological concerns, and maintain a relaxed mood.
(2) Use loose bra to hold up the breast.
(3) Take Chinese medicine or other allopathic medicines as prescribed by the doctor.
(2) Regular review and breast self-examination for timely detection of malignant lesions.
VII. Preventive care
1. Maintain emotional stability and reduce mental stimulation. According to statistics, 85% of patients have adverse emotional changes before the disease, mental stimulation can lead to increased estrogen levels in the body, endocrine disruption.
2, pay attention to the combination of work and rest. According to this, women with knowledge should pay special attention to the combination of work and rest. In addition, insisting on breastfeeding can reduce the incidence of breast enlargement because breastfeeding can reduce the incidence of breast enlargement, and also reduce the number of abortions, which can also reduce the incidence.
3, drug treatment. Chinese medicine is currently the main means of treatment, clinical evidence that the effect of Chinese medicine treatment is very good.
4.Surgery. For breast growth disease, local excision surgery cannot achieve the therapeutic purpose, but more on the exclusion of malignant lesions in the breast. For hard lumps and difficult to distinguish from breast cancer, surgery is necessary to make a clear diagnosis.