Mastopathy is the benign change of glandular tissue in the female breast. Symptoms include swelling and tightness in the breast, often associated with menstruation, or palpable lumps and cysts in the breast.
What is mastopathy?
Palpate mastopathy in the breast. Mastopathy – also called mammary dysplasia – describes changes in the glandular body of the female breast that are benign. More than half of all women who are between 35 and 50 years old suffer from mastopathy, making this disease one of the most common diseases of the mammary glands in women. Women under 25 years of age and menopausal women are affected only in a few exceptional cases. Depending on the type of change in the glandular tissue, different forms of mastopathy are distinguished:
Fibrous mastopathy: glassy connective tissue replaces the layer of tissue lining glandular ducts on the inside
Fibrocystic mastopathy: connective tissue proliferates and glandular ducts dilate
Fibroadenomatous mastopathy: glandular tissue cells proliferate in a tumor-like manner and may be filled with pus, blood or secretion
In addition, mastopathy is divided into three groups with varying degrees of severity of tissue changes, which medical professionals use to assess breast cancer risk.
Causes
The causes of mastopathy are not yet fully understood. It is likely that affected individuals have an imbalance between the hormones estrogen and progesterone, which are involved in the menstrual cycle. Women with proven mastopathy have too much estrogen, this excess is the cause of the changes in the mammary gland tissue. As a rule, sexually mature women develop mastopathy. The symptoms usually subside automatically when women reach menopause, with the accompanying hormonal changes. Several possible causes can be named for the excess of estrogen, such as other hormonal disorders of the thyroid gland, which can also be causative for mastopathy.
Typical symptoms and signs
- Chest pain
- Tightness in the chest
- Lump in the breast
- Pathological mammary gland secretion
Diagnosis and course
If mastopathy is suspected to be present, a medical history must first be taken. The general practitioner will refer affected women to the gynecologist, who will palpate the breasts. If mastopathy is present, the physician will feel irregularities on the glandular body during palpation, and possible lumps in the breast can be easily felt. Usually, this finding is more pronounced before the onset of menstruation than after. To confirm the diagnosis, an ultrasound examination of the breast is usually performed. A mammogram can provide further information as to whether mastopathy is present, as it can also reveal small tissue calcifications. If calcifications are found during the mammography, they are removed and the tissue is examined microscopically. If cysts have formed in the breast, they are punctured and the contents are examined for changes in the cells. In cases where fluid leaks from the nipple, the secretion is examined in more detail to clarify the causes.
Complications
Mastopathy can cause pain and severe swelling of the breast tissue. During breastfeeding, mastopathy can cause the milk ducts to become blocked. This may result in milk engorgement and subsequent febrile inflammation. Occasionally, mastopathy can also lead to uncontrolled secretion from the nipple. This can be a psychological burden for affected women and can sometimes lead to social stigmatization. Mastopathy itself can also be emotionally stressful. Thus, even a harmless lump in the breast can cause anxiety and depression. This can be accompanied by pain and a permanent feeling of pressure, which can add to the psychological stress. Rarely, mastopathy develops into breast cancer. Cancer is associated with other physical and psychological complications that require long-term treatment. Mastopathy drug therapy can cause problems if the prescribed painkillers lead to side effects and allergic reactions.The active ingredients most commonly used (paracetamol, ketoprofen, ibuprofen, diclofenac, among others) can cause headaches, dizziness and visual disturbances, for example. Rarely, severe allergic reactions such as skin rashes and breathing difficulties occur.
When should you see a doctor?
If changes in the glandular tissue in the breast can be felt, a comparison with the female cycle should be made. If symptoms occur just before the onset of menstrual bleeding, a repeat breast palpation should be performed after menstrual bleeding has subsided. If the swellings have completely disappeared within a few days, no doctor is needed. In these cases, it is a natural development of the female organism and there is no need for treatment. However, if there are uncertainties or fears, a visit to the doctor is advisable. Other complaints shortly before the period may include pain in the breasts or a feeling of tension. If the symptoms persist after menstruation, a check-up with a doctor should be initiated immediately. If swelling persists or becomes larger, palpable lumps or other irregularities occur, a clarification of the symptoms is necessary. Although mastopathy is a benign change of the tissue and therefore not a potentially life-threatening disease of the breast, the abnormalities of the glandular tissue occur exclusively in connection with the menstrual cycle. Persistent irregularities are signs of another health condition. Medical tests are necessary for diagnosis and should be used. It is advisable to see a doctor as soon as possible so that the cause can be clarified at an early stage.
Treatment and therapy
Treatment of mastopathy is aimed first and foremost at relieving the symptoms associated with mastopathy. Because excess estrogen – an imbalance in hormone balance – is often the cause, this excess is balanced by the administration of progestin. Depending on the menstrual cycle, the progestin is taken starting on the 16th day of the cycle and ending on the 25th day. Prolactin inhibitors are used to counteract any tension that may occur and the cystic changes in the breast. If the symptoms are more severe, the doctor may also prescribe a drug containing the active substance danazol, which causes less estrogen to be released. In very rare exceptional cases, if mastopathy is present, the affected person’s breast is removed if the risk of developing breast cancer is particularly high, the affected woman has third-degree mastopathy, and is not older than 40 years.
Outlook and prognosis
The prognosis of mastopathy is tied to the causative disorder. If the symptoms occur during pregnancy or following childbirth while breastfeeding, complete recovery can be expected once the period of breastfeeding is over. If the health irregularities are due to the monthly menstrual bleeding, complete freedom from symptoms occurs at the latest when menopause sets in and menstruation naturally stops on its own. Therefore, even without treatment or therapy, recovery occurs in the long term. Nevertheless, there are risk factors that must be taken into account when making a prognosis. If the pain in the breast or the feelings of tension are very pronounced, depending on the personality of the affected patients, emotional stress states may occur. These can lead to the development of a mental illness if the course is unfavorable. In addition, cysts or lumps in the breast can trigger mastopathy. Often, surgical intervention is necessary to achieve freedom from symptoms. Any intervention in the organism is associated with an increased risk of complications. Nevertheless, in most cases it is a routine intervention that proceeds without any problems. If the course of the disease is very unfavorable, the risk of cancer is increased. If left untreated, this can lead to premature death.
Prevention
Unfortunately, there are no preventive measures for mastopathy. It is not known that women can do anything with which the changes in the mammary gland tissue can be prevented.Nevertheless, all women are recommended to regularly feel their breasts themselves once a month, on the one hand to quickly detect changes and on the other hand to immediately seek medical help when abnormalities appear and the first pains are present.
Aftercare
Mastopathy itself can be treated well in many cases if it is detected early. Follow-up care focuses on early detection of renewed symptoms. If these occur unexpectedly, this should be clarified with the treating physician to make sure that there is no serious reason behind it. If the pain is severe, the person concerned should consult a doctor and possibly have painkillers prescribed. Also, in case of unusual symptoms and complaints that persist longer than usual, mastopathy should be seen by a gynecologist. In general, affected individuals should focus on a healthy lifestyle with sufficient exercise in the fresh air and a balanced diet that includes plenty of fresh foods. Yoga and other relaxation exercises can help to increase long-lasting well-being.
What you can do yourself
To rule out a serious condition, mastopathy should definitely be examined by a gynecologist. The individual symptoms can be alleviated by self-help measures. Cooling compresses, which are best placed on the breasts for ten to fifteen minutes at a time, help with pain. The feeling of tightness in the breasts is relieved with the help of herbal teas, for example, hibiscus or sage tea and other varieties that have a draining or analgesic effect. Some women find a visit to the sauna beneficial – but the draining effect does not last long. A well-fitting bra supports the breasts and relieves both pain and the uncomfortable tension. Dietary measures help on the bad days. Coffee, black tea, sweet drinks and chocolate are best avoided, because their ingredients can aggravate the discomfort. Better are healthy foods such as fruits, vegetables and whole grains. From the herbal medicine monk’s pepper preparations offer themselves. Homeopathy also recommends the preparations Aristolochia, Conium and Sabal serrulata.
