Definition
Mastopathy is a remodelling reaction of the breast. In the process, more connective tissue is formed. Cell proliferation occurs in the milk ducts and the milk ducts are widened.
More than half of all women are affected by conversion reactions of this mastopathy. However, only about 20% of the affected women suffer from pain, which leads them to see a doctor. The age of the disease is between 35 and 55 years and occurs exclusively during sexual maturity.
The cause of mastopathy has not been fully explained to date. There is no doubt that it is related to hormonal factors. An imbalance between progesterone and estrogen plays a special role, with estrogens predominant. Both psychological factors and a genetic predisposition appear to be responsible for this hormonal dysregulation. In addition to these hormonal causes, hyperprolactinemia and thyroid dysfunction have also been observed, which are thus seen in connection with mastopathy.
Classification
The mastopathies can be divided into 3 classes depending on the extent of the remodelling reactions.
- Degree of masthopathy: Occurs in 70% of cases. There is no increased cell proliferation and no risk of degeneration.
- Degree of masthopathy: exists in 20% of cases and cell proliferation occurs. However, there is hardly any increased risk of cancer, there are no atypes and it is not a precancerous stage.
- Degree of masthopathy: In 10% of the affected patients, cell proliferations with distinct atypical features are found. This increases the risk of breast cancer by a factor of 3.
Symptoms
Women with a mastopathy often experience pain and feelings of tension shortly before the onset of menstruation. There may also be secretion from the nipple (nipple) and spontaneous milky secretions from the mammary gland. In addition, the lump may be enlarged shortly before menstruation.
A fibroadenoma causes no symptoms and is usually not painful. Large fibroadenomas can cause an unevenness in the form of a bulge on the breast. Diffuse compression of the tissue can be detected in mammography.
If there are calcifications of the mammary ducts, these can be recognized as so-called “pellet chest“. Bumpy changes of the glandular body are palpable, which are movable in relation to the skin. However, the palpable changes can be very different and therefore difficult to differentiate.
A therapy for mastopathy consists mainly of alleviating the symptoms. A complete cure is hardly possible. In mastopathy grade 1 or 2, progesterone is applied as a gel or progestin-emphasized ovulation inhibitors are given to balance the progesterone mane.
In the case of a grade 3 mastopathy, the entire glandular body should be removed while preserving the nipple. This is particularly indicated if there is a corresponding family history, i.e. breast cancer in close relatives. In any case, tissue should be removed in order to determine the exact degree of the disease and to exclude the possibility of a carcinoma (malignant tumor).
