Female mammary gland and disease. Diseases of the mammary glands in women

A woman’s mammary glands, which form the beauty of her body, glorified by artists of all times and peoples, perform the important function of lactation when feeding a baby. For him, mother's milk is the most complete and sometimes difficult to replace food. Being an external organ, the mammary glands are easily accessible to visual observation and control. In this regard, every woman herself can easily notice changes or initial symptoms of breast diseases. There are several most common diseases that every woman should know about in order to detect them in a timely manner, as well as to behave wisely in relation to these diseases.

First of all, it is necessary to distinguish the norm from pathology (diseases). In biology and physiology, the norm is not some clear standard or rigid parameters. The diversity of nature is based precisely on the extreme variability of the biological norm. The norm is usually more diverse than the pathology. Thus, in women, as a rule, there is great variability in the size and configuration of the breasts. Often women consult a doctor about asymmetry in the size of the mammary glands. This is also a variant of the physiological norm. In nature, there is no absolute symmetry and paired organs differ slightly from each other, and sometimes these differences, in particular in the size of the mammary glands, can be more pronounced and noticeable. The shape and degree of protrusion of the nipples can also vary. A healthy woman's nipples may be flat or even inverted. And this can only interfere with breastfeeding. In this case, you can use special breast pumps or breast shields that replace the baby's nipple.

The shape of the nipple can also be corrected or restored using simple plastic surgery. The size, shape, consistency (density to the touch) of the mammary glands can change significantly with age, as well as during pregnancy, breastfeeding and after them.

The most pronounced changes in the female breast occur during pregnancy, when, under the influence of certain hormonal changes in the woman’s body, glandular tissue grows in the mammary glands, the latter increase in size and become denser. In this case, pronounced pigmentation of the nipples and areolas (a circle around the breast nipple) is noted. To a lesser extent, regular changes occur in women during the menstrual cycle. These monthly changes also occur differently in women. Some do not feel them at all or do not notice them, others may experience a feeling of heaviness, engorgement or even pain in the glands. These sensations are usually short-lived (1-3 days). They occur more often before menstruation or in the middle of the menstrual cycle and are caused by cyclic hormonal reactions in a woman’s body. All of the above changes and sensations in the mammary glands are normal, physiological and should not cause concern or anxiety in women.

Along with this, diseases can develop in the mammary glands, varying in causes and nature of the course. Moreover, they often have very similar symptoms, and their differentiation and establishment of the correct diagnosis often require medical qualifications and the use of certain laboratory and instrumental research methods. Nevertheless, it is useful for every woman to have certain ideas about some diseases of the mammary glands and their most characteristic symptoms, so that, if necessary, they can correctly navigate the situation and promptly seek help from a medical institution. Let's look at the main, most common diseases.

Mastitis is an acute inflammation of the mammary glands. In most cases, mastitis develops in the postpartum period while breastfeeding. The cause of the disease is the penetration of microbes through dilated milk ducts or cracks (skin damage) of the nipples into the breast tissue. Subsequently developing edema in the glandular tissue impedes the outflow of milk, thereby promoting stagnation and progression of the inflammatory process. In this case, the glands become painful, swell, the skin over them sometimes turns red, and the body temperature rises.

Treatment of mastitis is simple and effective, but requires medical qualifications and urgency. There are serous and purulent mastitis of varying degrees of development. All this leads to certain differences in treatment tactics. Only a doctor can figure this out, so attempts to self-medicate on the advice of friends and acquaintances in the form of various compresses or applying various objects can lead to serious complications. But preventing the development of mastitis is entirely within the competence and capabilities of women themselves. This requires compliance with simple hygiene rules for breast care. In particular, in the postpartum period, daily washing of the mammary glands with warm water and soap, followed by gentle rubbing with a towel, is recommended.

To prevent milk stagnation, it is also important to follow a breastfeeding regimen and express the remaining milk in a timely manner.

Breast abscess usually develops as a complication of untreated or advanced mastitis. A limited purulent infiltrate is formed, which gradually increases in size, softens in consistency, and becomes sharply painful. An abscess can also develop in women who have never given birth or breastfed, when infection penetrates into the breast tissue from various skin and subcutaneous inflammatory foci, such as eczematous changes, boils, small ulcers, cracked nipples, and traumatic injuries. Abscesses usually require surgical treatment.

Plasmatic inflammation of the glands is a special type of inflammatory changes, characterized by general pain, swelling, redness of the skin and periodic purulent or brownish discharge from the nipple. Individual symptoms may be expressed to varying degrees in different patients. Acute plasmatic inflammation can become chronic, in which individual symptoms weaken or disappear, but discharge from the nipple remains. To establish the correct diagnosis and effective treatment in these cases, consultation with a medical specialist, surgeon, gynecologist, or oncologist is necessary.

Tuberculosis of the mammary glands - usually multiple or single nodular formations appear - “abscesses” in the gland tissue, which can ulcerate, break out, forming fistulas. Tuberculosis requires immediate treatment with certain chemotherapy drugs under the supervision of a phthisiatrician.

Traumatic injuries to the chest are associated with various mechanical impacts: bruises, blows from various objects, compression, wearing tight or chafing bras. These effects can cause prolonged pain, inflammation and subcutaneous hemorrhages in the mammary glands. Moreover, in some cases there is no need for any treatment, in others certain therapy is indicated. However, in all cases, if certain changes and symptoms do not go away within a few days, you should consult a doctor in order to relieve your own anxiety and, if necessary, receive appropriate treatment to prevent the transition of certain acute traumatic injuries into chronic ones.

Cyclic mastodynia. As already mentioned, a healthy woman may experience minor pain in the breasts in the middle of the menstrual cycle or a few days before the onset of menstruation. However, such cyclical pain in the mammary glands can intensify and disturb no longer 1-3 days, but for 1-2 weeks or longer. Such symptoms are caused by certain disturbances in hormonal and water metabolism in the body, tissue swelling and, of course, require medical advice. In some cases, it is possible to relieve or reduce chest pain simply by limiting the daily intake of salt and liquid in the premenstrual period (salt - no more than 3 g and liquid - no more than 1 liter). In addition, adherence to such a water-salt regime in the last week before menstruation is a preventive measure for a number of pathological changes not only in the mammary glands, but also in the uterus and appendages. In the treatment of cyclic mastodynia, various types of vitamin and hormonal therapy are also effectively used, aimed at normalizing hormonal metabolism in a woman’s body.

Galactorrhea is the release of milk or colostrum outside of breastfeeding. Small discharge may remain for a long period (up to several years) after the child has stopped breastfeeding or after an abortion. This discharge usually goes away over time without any treatment. But doctor's supervision is necessary. In some cases, a cytological examination of nipple discharge is necessary (taking smears on a glass slide and examining them under a microscope). For heavy and long-lasting discharge, certain drug therapy is indicated to suppress the hypersecretion of prolactin, a hormone that stimulates secretion in the mammary glands.

Mastopathy is one of the most common diseases of the female breast, although the impression of widespread mastopathy somewhat exceeds its true frequency among women. The reason is that some forms of mastopathy are difficult to distinguish from possible variants of the normal state of the glandular tissue of the mammary gland. Therefore, sometimes healthy women are diagnosed with mastopathy until additional studies and follow-up examinations allow the doctor to remove it. The diagnosis of mastopathy usually combines a whole group of pathological conditions in the mammary glands that are different from each other in certain respects. These are fibrosis (overgrowth of connective tissue), cysts, mixed fibrocystic changes of both diffuse and focal nature. All these changes are a consequence of certain shifts in the hormonal balance in a woman’s body, which in turn can occur under the influence of a wide variety of reasons: termination of pregnancy (after abortions and miscarriages), disturbances in sexual activity, disturbances in breastfeeding, overdose of solar radiation ( even healthy women should avoid long hours of sunbathing), repeated mechanical trauma to the breast, severe mental trauma, etc. Hormonal abnormalities and mastopathy caused by them can also occur secondarily as a consequence of diseases and dysfunctions of the ovaries, thyroid gland and liver.

Manifestations of mastopathy can be different. The disease is characterized by the appearance in the mammary glands of formations of various sizes and densities, fine-grained to the touch, and often painful. Inflammatory phenomena may be absent.

Based on the nature of the lesion, diffuse and nodular (focal) forms are distinguished.

With the so-called focal form of mastopathy, single compactions of larger sizes may be observed with unchanged surrounding breast tissue. The seals are usually round or plaque-shaped, relatively mobile, and have an elastic consistency. With mastopathy, there may be pain and other unpleasant sensations in the mammary glands, both associated and unrelated to the menstrual cycle. Mastopathy can also be asymptomatic, unnoticed by the patient. These cases of mastopathy are usually detected only during preventive examinations.

Treatment tactics for mastopathy vary depending on the causes of its development, the form and severity of the changes. In some cases, with minor changes, observation by a doctor without treatment with periodic follow-up examinations is sufficient, since self-healing is possible, that is, the reverse development of pathological changes in the mammary glands. In other cases, successful treatment of such underlying diseases as inflammation of the appendages, diseases of the liver, thyroid gland, vegetative neurosis, simultaneously leads to the disappearance of pathological changes in the female breast.

Drug treatment methods for mastopathy are aimed at normalizing the hormonal balance in a woman’s body. In case of focal forms of mastopathy, in addition, surgical removal of nodular seals is indicated, since they rarely respond to therapeutic treatment, and, most importantly, these seals can mask pre-tumor changes, and therefore their timely removal is the prevention of tumors. The operation consists of removing only one lump or a limited area (sector) of the gland with the lump. Nodular formations in mastopathy often tend to gradually increase in size, so it is advisable to remove them in a timely manner while they are relatively small in size. Postponement of the operation is associated with the possibility of growth of the compaction and, accordingly, an increase in the volume of partial resection of the mammary gland.

Fibroadenoma is a benign formation representing a nodular proliferation of fibrous connective tissue. Fibroadenoma is often the result of a chronic course of untreated mastopathy, but can also occur without previous diseases of the mammary glands. Unlike malignant tumors, fibroadenomas develop in predominantly young women, up to 40 years of age. There are cases of the development of these formations in girls during adolescence. Usually the formation has a very dense consistency, round or oval shape and clear, even contours. The size of fibroadenomas can vary greatly: from the size of a pinhead to a chicken egg and larger. Fibroadenomas are insensitive to drugs, and therefore require surgical treatment - sectoral (partial) resection of the mammary gland.

In girls aged 11-16 years, with the development of the body, with the onset of regular menstruation, spontaneous (without treatment) regression of fibroadenomas is possible. However, in these cases, a doctor’s supervision with periodic control examinations of the breast is necessary.

Lipoma is a benign tumor arising from adipose tissue. It can develop in various parts of the body, including the mammary gland. The neoplasm has a characteristic soft elastic consistency and a spherical, smooth surface. Usually these are harmless formations that do not cause complaints from patients or concerns from doctors. In most cases, when they are relatively small in size, they do not require treatment. However, to differentiate lipoma from other, more serious pathologies, consultation with a doctor is necessary.

Intraductal papilloma is a benign formation, similar to known skin papillomas, that grows in the ducts of the mammary gland. The most characteristic symptom is nipple discharge. The discharge can be very scanty (1-2 drops per day) or copious. They can appear when pressing on the breasts or randomly when a woman notices them from marks left on the inside of the bra. The discharge can have different colors: yellow, greenish or brown, and bloody. Other symptoms: pain or discomfort in the chest, small lumps behind the areola of the mammary gland may be present, but may not be present. Treatment of papillomas is their surgical removal.

Paget's disease is a peculiar disease named after the English surgeon and pathologist F. Paget, who described this disease in the last century. The disease is characterized by eczema-like lesions of the nipple and areola of the mammary gland. The skin over the nipple and areola becomes inflamed, becomes crimson, ulcers form, which either get wet or dry out, becoming covered with crusts. In all cases, an urgent visit to a medical specialist is necessary to clarify the diagnosis by taking smears from the surface of the ulcers, their cytological examination under a microscope and determining the type of treatment. Inattention to such changes and postponing a visit to the doctor is dangerous due to the possibility of developing tumor changes.

The changes and diseases of the female breast listed above are the most common, although they do not cover the entire variety of possible abnormalities and pathological processes in the mammary glands. It should also be noted that often different diseases have the same symptoms and a similar picture of external manifestations. On the other hand, each individual case of the same disease occurs in different patients to a certain extent differently. Doctors even have a postulate that no two patients are alike. All this often complicates an objective assessment and final diagnosis of changes, requiring qualified specialist consultation and the use of instrumental and laboratory diagnostic methods. An accurate and timely diagnosis allows you to determine the correct tactics in the behavior of the patient and the doctor and carry out effective treatment. The latter is important for any disease, both mild and severe, if only because a mild, “trifling” disease can lead to serious complications if not properly behaved and treated. The wait-and-see attitude is especially dangerous: “I’ll see what happens next,” “If it doesn’t go away on its own, then I’ll go to the doctor.” This position often leads to the fact that time for easy and simple therapeutic measures is missed, and severe complications develop that require complex, sometimes traumatic, treatment methods. Treatment of breast cancer in Israel

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The female mammary glands are a unique organ. It is they who are entrusted with the most important function of producing breast milk - the main food of a newborn baby. Breast diseases can interfere with this task and cause serious harm to the health of the woman herself. The structure and functioning of the female mammary glands is studied by an independent medical branch - mammology. This science is developing in close relationship with gynecology, endocrinology and other disciplines.

Female mammary glands are normal

To identify the symptoms of pathology, it is necessary to distinguish them from the norm. There is a huge variety of norm options that are not limited to a rigid standard. Variations in the size and configuration of the mammary glands in women are enormous; they can also be asymmetrical, which is not a pathology.

Normal changes in the mammary glands

The glands do not have to directly perform their lactation function so often, however, it cannot be said that the rest of the time they are completely at rest. These organs are distinguished by significant hormone dependence and respond to all processes occurring in the body of women. The breast responds with structural and physiological changes to the events of the menstrual cycle and the onset of menopause, pregnancy and lactation, and stress. In most cases, these changes are within normal limits.

Cyclic changes in the mammary glands in women:

The size and shape of the breast changes slightly.
At different periods of the cycle, the consistency of the mammary glands may be denser or softer.
In some cases, before menstruation, the breasts become coarser and painful sensations appear. Such reactions are individual and manifest themselves differently both in different women and in one woman in different cycles.

Changes in the mammary glands in pregnant women:

The glandular tissue grows significantly, leading to a noticeable enlargement and thickening of the breast.
The pigmentation of the areola (areola) becomes more pronounced.

Pathologies of the mammary glands

The mammary glands in women are quite accessible for visual observation and self-examination. Most often, women notice pathological changes on their own, however, they do not attach due importance to them and do not consult a doctor. The earlier the disease is detected and identified, the easier and faster it will be to fight it. Therefore, if any alarming symptoms appear, it is recommended to contact a mammologist.

Alarming symptoms

Most often, diseases have local (local) manifestations:

chest pain that gets worse with movement or pressure;
feeling of heaviness, tension;
increased density of gland tissue;
change in breast size or shape;
burning sensation in the mammary gland;
pain or burning in the nipples;
changes in the skin of the nipples and areolas, cracks, abrasions, wounds;
nipple discharge;
the appearance of hair on the skin of the chest;
enlarged axillary lymph nodes, indicating an inflammatory process.

Some of these signs may indicate the onset of menstruation. However, if they appear in another phase of the cycle and do not go away for a long time, this should alert the woman and become a reason to consult a doctor.

Common breast diseases

Diseases are most often caused by hormonal imbalance caused by various factors. The development of pathology is facilitated by microbial infection of the mammary gland, general weakening of the immune system and traumatic injuries.

Chest injuries

The cause of injury may be:

hit with a heavy object;
chest bruise;
poorly chosen underwear that squeezes the mammary glands or rubs the skin.

The injured breast hurts, and the injury may be accompanied by internal hemorrhage. In addition, the disturbed structure of the gland contributes to the development of inflammatory processes and is a favorable environment for microbial infection. Against the background of traumatic injuries, an oncological process can develop. If pain after an injury does not go away within a few days, you should consult a doctor.

Separately, it should be said about cracked nipples, the cause of which is most often the incorrect attachment of the child to the breast. The wounds manifest themselves as sharp painful sensations that intensify with feeding. In fact, such an abrasion is an open gate for infection, which will not be slow to penetrate the mammary gland. Together with postpartum lactostasis, microbial infection leads to the development of severe inflammation of the gland - mastitis. Local healing and softening agents (bepanten, sea buckthorn oil, vitamin E oil solution) help get rid of cracks.

Mastopathy

Mastopathy (literally: disease, pathology of the breast) is one of the most common female diseases. In a broad sense, mastopathy even includes some variants of the normal functional state of mammary gland tissue. The disease combines several pathological conditions that differ from each other:

proliferation of the connective tissue framework of the gland (fibrosis);
cystic degeneration of secretory tissue;
diffuse and focal mixed fibrocystic changes.

Dense neoplasms of varying sizes appear in the chest, often painful. These can be small grains scattered throughout the structure of the gland (diffuse form), or large formed nodes (nodular form). Mastopathy is not always accompanied by inflammatory processes. The disease is especially often diagnosed against the background of injuries to the mammary glands, after abortions and miscarriages, accompanied by powerful hormonal changes. Pathologies can be caused by diseases of the endocrine organs (ovaries, adrenal glands, thyroid gland, hypothalamic-pituitary system).

Treatment of the disease depends on its etiology and progress. With minor changes in the structure of the mammary gland, self-healing is possible, so treatment consists only of careful observation and control. Drug therapy consists of taking medications that affect the hormonal balance of the body and normalize it. Large nodular seals are difficult to treat with drugs. In such cases, surgical removal of tumors is indicated, since there is a high probability of their malignant degeneration. The operation is carried out with the maximum possible preservation of healthy gland tissue, however, in advanced cases, partial resection is possible.

Cyclic mastodynia

Absolutely healthy women may experience minor pain in the mammary glands before menstruation. However, if the hormonal balance and water metabolism in the female body are disturbed, such cyclic changes can last up to two weeks or longer, intensifying at the same time, which is a pathology.

The cause of cyclic mastodynia is most often a violation of the water-salt regime and the resulting swelling of the mammary glands. Symptoms can be relieved by limiting fluid and salt intake (no more than 3 g per day) for several days before menstruation.

Plasma inflammation

The plasmatic inflammatory process covers the entire mammary gland. The disease manifests itself as general pain, the breasts swell, and the skin turns red. Often there is a brownish discharge from the nipples, resembling pus. Without treatment, the acute process becomes chronic, which is accompanied by a decrease in pain. The allocations continue. Diagnosis and treatment are carried out under the supervision of a mammologist; a gynecologist, oncologist and surgeon may also be involved.

Tuberculosis

Mycobacterial infection of the mammary glands is extremely rare. Breast tuberculosis is mainly secondary to the pulmonary form of the disease. It is extremely rarely diagnosed in men. Favorable conditions for the development of the disease arise against the background of diabetes mellitus, weakened immunity, chest injuries, and immunodeficiency.

With tuberculosis, the affected gland enlarges and becomes denser, the skin turns red, and the axillary lymph nodes enlarge. In the structure of the gland, multiple or single nodes form and develop, which can ulcerate and break out with the formation of fistulas. The patient loses weight, weakens, loses appetite, and signs of intoxication of the body are expressed.

Galactorrhea

The disease is manifested by the release of milk secretion from the nipple outside the period of breastfeeding. It is often a residual phenomenon after cessation of feeding or abortion, can last several months (and even years) and goes away without treatment, however, medical supervision and laboratory analysis of the discharge are necessary. In some cases, drug therapy is used to suppress the secretion of the hormone prolactin.

Breast diseases during lactation

During lactation, the mammary glands actively produce their secretion, intended for feeding the baby. Diseases during this period can be caused by stagnation of milk inside the gland, as well as infection of the organ.

Lactostasis

Stagnation of milk in the segments of the gland (lactostasis) is a common phenomenon in the first days of lactation, when the body has already begun to actively produce nutritious secretions, but the child is still too weak to eat so much. Later, lactostasis develops against the background of improper feeding and expressing milk. When the disease occurs, the breasts become red, painful, and body temperature may rise.

You should not stop breastfeeding your baby, as this is a natural way to normalize the condition of the mammary glands. An adequate feeding regimen and proper pumping, if necessary, contributes to the rapid formation of a relationship between the child’s appetite and the amount of milk produced.

Mastitis

Lactostasis without taking the necessary measures leads to serious inflammation of the mammary gland - mastitis. The cause of the disease is a microbial (usually bacterial) infection against the background of congestion in the chest. Pathogenic microorganisms enter the mammary gland through the enlarged lumen of the milk ducts, nipple cracks, or through the bloodstream.

The glands affected by mastitis swell, the disease is accompanied by severe pain and febrile body temperature. The disease progresses rapidly, foci of infiltration appear in the tissues of the gland, then purulent abscesses form. Self-medication in this situation is very dangerous; urgent consultation with a doctor is necessary. Spontaneous breakthrough of an abscess is accompanied by the outpouring of its purulent contents and the development of sepsis.

Benign neoplasms of the mammary glands

Tumors and cysts occur due to hormonal imbalance.

The cause of the appearance of a cyst is blockage of the excretory ducts of the gland and the accumulation of secretions inside the organ. A cystic bladder filled with fluid is formed.
Fibroadenoma is a painless growth of the connective tissue of the gland, often a consequence of mastopathy. The size of the tumor can vary, and it is usually not sensitive to drugs, so surgical removal is required. Spontaneous regression can occur in young girls during puberty or in women during menopause.
Lipoma comes from adipose tissue, does not cause discomfort to a woman and usually does not require treatment. When diagnosing, it is important not to mistake a more dangerous tumor for a lipoma.
Papilloma forms inside the milk ducts and is accompanied by pathological discharge from the nipples, sometimes pain. The tumor is small and cannot be palpated. If there is a possibility of malignant degeneration, the papilloma must be removed.

Mammary cancer

The likelihood of developing cancer increases with age. Women over 40 years of age are recommended to undergo an annual breast examination by a specialist. Favorable conditions for cancer: trauma, hormonal imbalances, inflammatory diseases, late age of first pregnancy, bad habits, bad heredity, negative environmental conditions. A malignant tumor grows quickly and actively spreads throughout the body, so every minute counts in the fight against it.

Paget's cancer

Eczema-like damage to the nipple and areola, accompanied by inflammation and itching of the skin, the formation of weeping ulcers, and discharge from the nipple. The disease is diagnosed not only in women, but also in men after 50-60 years of age, in whom the course is more aggressive. The exact causes of the disease are unknown; treatment consists of mastectomy and subsequent drug therapy, and even after surgery there is a high probability of relapse.

If any alarming symptoms appear regarding the structure and functioning of the mammary glands in women, it is recommended to consult a mammologist. Such attentiveness will help to detect potentially dangerous diseases in the early stages and prevent them.

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Hello dear readers. The female breast is a delicate organ that can be injured, “cold”, or suffer from hormonal disturbances. Knowledge of possible pathologies of the mammary glands and their symptoms is important for every girl and woman. Having discovered the first signs of an illness in yourself, you can contact a specialist in a timely manner and quickly heal the illness at the very beginning of the development of the pathological process.

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Main pathologies of the female breast: types and forms

Symptoms of breast diseases in women depend on the specific disease. The international classifier identifies several categories of breast pathology:

a group of benign dysplasias (adenosis and its sclerosing form, fibrous and cystic, a mixed version of the disease);
hypertrophy of glandular tissue;
malignant neoplasms;
unrefined neoplasms and other pathologies;
anomalies (absence of the pectoral muscle or gland/accessory gland, absence of the nipple/accessory nipple, unrefined and other anomalies).

This classification is convenient in that it allows us to identify the leading symptoms for each group. But it is not informative for patients. Because the diagnosis written by the doctor on the card will be more precise. For example:

adenoma;
atrophy;
papillary tumor;
(outside childbirth);
nodular/diffuse;
fat necrosis;
invasive ductal;
mammalgia;
mycoses (actino-, candidomycosis);
hereditary cancer;
anomalies;
cancer tumor;
disease ;
fistula;
syphilis of the mammary glands;
cracked nipples;
injuries;
mammary tuberculosis;
fibroma, including.

These are the main diseases that affect the female bust. The reasons for the development of many pathologies have not been fully determined. Exceptions are infectious and inflammatory pathologies for which the causative agent is known (for example, actinomycosis, candidiasis, tuberculosis, herpes virus or), trauma to the mammary glands, fistulas and cracked nipples.

The causes of other pathologies may be a genetic predisposition stimulated by unfavorable factors:

disturbances in the production of hormones, associated diseases of the female sphere (including STDs) or pituitary disorders;
bad habits;
inactive/hyperactive sex life;
frequent termination of pregnancies or lack thereof;
neglect of breastfeeding;
late pregnancy and childbirth;
environmental problems in the place of residence;
industrial hazards;
poor diet;
consumption of milk from cattle affected by viral leukemia.

And there are many more known and unknown factors that can cause the transformation of normal bust cells into pathological ones.

Signs of benign dysplasia

This is a whole group of pathological processes in the glandular tissue of the breast, which are characterized by:

proliferation;
regression of glands;
tissue imbalance: epithelial/connective.

The main symptom for this group of pathologies is pain, which intensifies before or during menstruation and decreases until it completely disappears after bleeding. Pain syndrome can be:

intense;
medium-intensive;
unbearable.

The pain is localized most often in both glands, less often in one gland, sometimes radiating to the armpit, shoulder, under the scapula, simulating signs of a heart attack. When palpated in the tissues of the gland, compactions may be felt.

Changes in the size of the mammary glands or their shape occur only in the advanced stage of the disease. At the same time, during menstruation, the nipples become hard, the breasts increase in volume (fill out). Light, translucent ones may appear.

At the initial stage of the disease, treatment is conservative; at later stages, surgery may be suggested.

Signs of hypertrophy

Hypertrophy or excessive growth of glandular tissue, in some cases together with the growth of fat cells, can be congenital or acquired. There are three stages of hypertrophy from a slight increase in the bust to a change in volume by 8-10 sizes with the development of pronounced mastoptosis. Main symptoms of the pathology:

noticeable change in bust size;
back pain, development of osteochondrosis, in the case of unilateral hypertrophy - scoliosis;
discomfort during active exercise;
increased fatigue;
difficulty breathing;
discomfort during sleep.

Treatment is mainly surgical:

restoration of the position of the nipple and areola.

When diagnosing the disease in teenage girls, mammologists try to resolve the issue using conservative methods. And only after reaching 18 years of age can such patients be offered a surgical solution.

Signs of malignant neoplasms

The symptom that usually sends us to the hospital is pain. With these diseases, pain begins only in the later stages of the disease, sometimes at the time of tumor disintegration. That is, when any treatment gives a minimum of results and causes maximum harm to the body. Therefore, it is important to regularly conduct self-examinations and palpation of the breast, paying attention to the following symptoms:

appearance ;
immobility of the node/adhesion with surrounding tissues;
change in shape/size of the areola;
disturbances in the nipple area (its retraction, formation of cracks, ulcers, wounds, scabs);
changes in the skin over the seal (hyperemia, peeling, ulceration, formation of lemon peel and other disorders);
enlargement of the gland, deformation;
discharge from the nipple (from clear to bloody);
rapid growth of formations without clear boundaries.

Even if painless lumps appear that are not prone to growth, you should visit a mammologist. As you age, your likelihood of developing cancer increases. After 60 years, malignant oncology in the breast area in women is as much as 400 times more common, compared to the number of sick girls aged 20 years.

With this pathology, the surgeon’s scalpel comes to the aid of patients, and a mastectomy is performed.

Mastitis: main signs

Inflammation in the area of the mammary glands is often associated with postpartum lactostasis; less often, it can develop after injury, hypothermia of the gland, or penetration of an infectious agent. Characteristic symptoms for this disease are:

local temperature;
tissue hyperemia;
fever;
pain;
the breast becomes dense and may increase in size.

If you consult a doctor in a timely manner, treatment will be conservative, including antibiotic therapy, physical therapy, etc. methods. If abscess formation occurs, conservative therapy is ineffective and surgery will be required.

Other diseases

This is a large group of ailments, including mastodynia (pain in the gland area). Galactorrhea, the main symptom of which is the release of milk or a similar fluid outside of lactation. and fistulas are distinguished by: pain, the appearance of ichor (and in the case of a fistula, purulent discharge) and an increase in temperature.

This group also includes fat necrosis. The following symptoms are characteristic of this disease:

regional lymphadenitis;
change in nipple shape;
cyanotic skin of the affected breast;
the appearance of a specific formation of a round shape.

Atrophy or a sharp decrease in the volume of glandular tissue is accompanied by mastoptosis. The pathology is congenital; malnutrition can be acquired. Corrective therapy is possible for this disease (

The mammary glands are part of the woman’s reproductive system; breast tissue is a target for ovarian steroid hormones, prolactin, placental hormones and, indirectly, hormones from other endocrine glands of the body.

According to established tradition, oncologists are involved in the diagnosis and treatment of breast diseases. However, recently, obstetricians and gynecologists have begun to deal more deeply with the problem of benign diseases of the mammary glands.

Risk factors for developing breast diseases

Currently, conditions that contribute to the occurrence and development of breast diseases have been identified, which makes it possible to identify a contingent of women with an increased risk of the disease.

Since benign diseases and breast cancer have much in common in etiological factors and pathogenetic mechanisms, the risk factors for their development are largely identical.

The hereditary factor is of primary importance - the presence of benign and malignant diseases in maternal relatives.

One of the most common unfavorable factors is chronic salpingoophoritis, since inflammation disrupts the production of sex hormones.

In most patients with various forms of mastopathy, pathology of the thyroid gland is detected. Hypofunction of the thyroid gland increases the risk of mastopathy by 3.8 times.

An important reason contributing to the occurrence of mastopathy are various diseases of the liver, bile ducts and gall bladder. The liver plays a large role in the metabolism of excess endogenous estrogens. With her illnesses, this ability is reduced and even lost, as a result of which the hormone content increases.

Among other risk factors, obesity, especially when combined with diabetes and arterial hypertension, may play a role. It is known that in the presence of the entire triad, the risk of mastopathy, as well as breast cancer, increases threefold.

Another risk factor for the development of dishormonal changes in the mammary glands is iodine deficiency, which contributes to disturbances in the hypothalamus-mammary gland system.

A woman is at greater risk of getting sick when she is stressed, neurotic, or depressed, so chronic stress is one of the factors in the occurrence of mastopathy.

Disturbances in the hormonal status of the female body are also caused by irregular sex life, which can contribute to the development of pathological processes in the mammary gland.

Indirect risk factors include addiction to alcohol and smoking.

The risk of developing breast disease may increase exposure to ionizing radiation.

Injuries and microtraumas can have serious consequences for the development of breast diseases.

Artificial termination of pregnancy significantly increases the risk of developing breast pathology. After an abortion, the proliferative processes in the mammary glands stop and the tissue undergoes reverse development. These regressive changes occur unevenly, so the structure of the glands can become pathological.

The risk of mastopathy and breast cancer increases under the influence of such unfavorable factors as lack of pregnancy or late first pregnancy, lack of breastfeeding.

Women who gave birth to two children before the age of 25. have a three times lower risk of developing breast diseases compared to those who have had only one child. Age is also an important risk factor for cancer: the incidence of breast cancer increases with age and reaches, according to some authors. by age 75 up to 30%.

An increased risk of the disease was found to be associated with the early onset of menstruation and its late cessation.

Factors that have a protective effect include early birth (20-25 years), breastfeeding, and the number of births (more than two) with full lactation.

Often, causal factors are interrelated, forming a common unfavorable background. The complexity of assessing the totality of causative factors dictates the need for regular comprehensive examination (breast self-examination, mammography, consultation with a mammologist) for each woman.

Diagnosis of breast diseases

Clinical examination

The examination begins with an analysis of the medical history. Of great importance in understanding the causes of breast diseases are data on risk factors for their occurrence.

An objective examination includes examination and manual examination, which determines the degree of gland formation, shape, size, condition of the skin, and nipple.

Superficial and deep palpation of glands and lymph nodes is carried out; The presence of compactions and their nature are revealed. Particular attention is paid to existing nodular formations.

Palpation is performed in a vertical and horizontal position of the subject. Palpation allows you to determine the location of the tumor, its size, boundaries, consistency, and relationship with the underlying tissues. It is first carried out with light touches of the pads of 2, 3, 4 fingers placed flat on the palpable mammary gland. Then they move on to deeper palpation, but this should also be painless. Palpation of the breast in a horizontal position can greatly facilitate the diagnosis of minimal tumors, as well as their differentiation from dyshormonal hyperplasia. In this position, the entire mammary gland becomes softer, which makes it possible to identify small areas of compaction in it. In addition, when the examined woman is in a horizontal position, areas of dishormonal hyperplasia become softer to the touch or are not detectable at all, while the tumor node does not change its consistency compared to the examination while standing.

Scale for assessing changes detected in the mammary glands

	Characteristics of palpated areas	Clinical conclusion
	In one or both mammary glands, localized areas of compaction are clearly defined against a background of diffuse	Localized fibroadenomatosis against the background of diffuse
	In one or both uterine glands, compacted areas without clear contours are detected against the background of diffuse fibroadenomatosis	Localized fibroadenomatosis against a background of diffuse
	Fine-grained areas of diffuse compaction are detected in one or both mammary glands	Diffuse cystic or fibrous fibroadenomatosis
	Palpation of the structure of the glands is homogeneous	Absence of physical signs of a pathological process

An objective assessment of the condition of the glands consists of examination and palpation data, as well as mammography, ultrasound and other special studies of mammary gland tissue.

Laboratory and instrumental methods for studying breast diseases

Laboratory methods

An obligatory component in a comprehensive examination of patients with diseases of the mammary glands is the determination of the individual hormonal status of a woman; primarily, the level of prolactin and estrogen.

For examination to determine the likelihood of developing pathological processes in the mammary glands, the determination of tumor markers has been proposed in the last two decades. Literature data indicate an increased level of tumor markers in groups of women with severe diffuse forms of mastopathy. It is more rational to determine the role of markers in predicting the occurrence of mammary gland pathology in patients who have genetic or anamnestic factors of predisposition to a malignant process or with proliferative forms of mastopathy.

Tumor markers such as carcinoembryonic antigen (CEA), high-molecular antigens CA-125 and CA19-9, mucin-like cancer-associated antigen (MRA) allow monitoring the effectiveness of treatment.

Radiation methods

Mammography. The accuracy of mammographic diagnosis ranges from 75-95%. The high percentage of false negative results is due to the fact that in young women, especially during lactation, nodes and tumors are difficult to distinguish against a dense background of the gland. On this basis, it is considered inappropriate to perform mammography in women under 30 years of age. It is very difficult to detect a tumor against the background of mastopathy. Under these conditions, a tumor node is detected in no more than 50% of cases. The minimum tumor size detected by mammography is 0.5-1.0 cm.

It is advisable to conduct this study on days 5-12 of the menstrual cycle.

X-ray mammography should be performed in women over 35 years of age, in cases where the tumor is not clearly palpable; when the formation is localized directly behind the nipple; with developed premammary adipose tissue; pronounced involutive changes in breast tissue; as a screening research method (Fig. 15.2).

Currently, women over 40 years of age are recommended to undergo mammography every 2 years, and after 50 years of age - annually. When local lumps are detected by palpation, mammography is performed on women at any age.

Pneumomammography is used to improve the contouring of a node located deep in the breast tissue, as well as for tumors located on the periphery of the gland (at the edge of the sternum, in the projection of the subclavian and axillary processes), obtaining an X-ray image of which is difficult. An X-ray examination is performed after introducing 200-500 ml of nitrous oxide through several needles located in different quadrants of the mammary glands.

Pneumocystography is an additional differential diagnostic method for cystic forms of fibroadenomatosis and cystadenopapillomas. After puncture of the cyst and evacuation of its contents, 10 ml of air is injected into the cavity. An x-ray allows you to trace the structure of the walls of the cyst and the relief of its internal surface.

Ductography or galactography is a method used to diagnose non-palpable ductal tumors. The information content of this method is 80-90%.

Electroradiography (xerography) is an informative method, but its disadvantage is the high dose of radiation exposure, which is 3 times higher than the dose for conventional mammography.

Echography. Preference should be given to this diagnostic method: when examining patients under 30 years of age, when localizing the lesion in parts of the mammary gland that are difficult to access for mammography (subclavian process, submammary fold, retromammary space, axillary process), when performing differential diagnosis of solid and cavitary formations, when performing targeted puncture biopsy. The information content of the method is 87-98%.

Mammography and ultrasound are complementary methods.

CT scan. A highly informative method for examining patients with unclear data from conventional tomography and “dense” mammary glands. Computed tomography allows you to detect tumors up to 2 mm, assess their spread, and also carry out differential diagnosis of mastopathy and malignant neoplasms.

Magnetic resonance imaging (MRI). The harmlessness of the procedure, combined with good execution of cuts in any direction, allows us to believe that it will become one of the leading techniques. However, an early sign of cancer such as microcalcifications is not visible with MTP.

Transillumination (diaphanoscopy). The method is based on assessing the structures of the mammary gland in transmitted light. The study is carried out in a darkened room. A light source will be placed under the mammary gland and the structure of the organ will be visually examined. Modern diaphanoscopy devices use a television camera and monitor to enhance image contrast. The undoubted advantages of the diaphanoscopy method include non-invasiveness, absence of ionizing radiation, cost-effectiveness, and ease of research. However, the method is not sensitive enough. Its further development is expected through computer evaluation of the results and the use of low-energy lasers.

Histological methods

A puncture biopsy is the insertion of a needle into the thickness of the compaction and aspiration of tissue particles through it. In 80-85% of cases, cytological examination of punctates makes it possible to make a diagnosis. In dyshormonal hyperplasias, a puncture biopsy allows one to determine the degree of proliferation and atypia of the epithelium and to identify the presence of a cystic cavity.

An excisional biopsy involves excision of the detected lump along with a section of surrounding tissue. If benign changes in the mammary gland are detected, such an intervention is therapeutic and prophylactic.

BREAST DISEASES

Mammary (breast) gland(MF) in a biological sense is an organ that produces milk for feeding young and is a unique feature of the class of mammals, in particular the species Homo sapiens. However, in the human environment, as culture developed, the female breast became not only a biological object, but acquired social and aesthetic significance. Since prehistoric times it has inspired sculptors, writers, painters and poets.

Item mammology as a science, it is the study of the anatomy, physiology and pathology of the breast, the scientific basis for diagnosis, treatment and rehabilitation for its various diseases.

Scientific origins This specialty is associated primarily with the name of the French anatomist and surgeon Alfred Velpeau (1795 - 1867), who published the first scientific manual on the treatment of breast diseases: “Traite des maladies du sein” (1856). Since then, the term mammology has had a synonymous term - senology, which is still used by French-speaking surgeons in our time. By the way, the International Association of Mammologists is called “Senologic International Society”.

First of all, let's remember anatomical features MJ. The breast is a paired organ. It develops from the ectoderm and is a modified cutaneous apocrine sweat gland. They are located on the anterior surface of the chest at the level from III to U1 of the rib between the anterior axillary and parasternal lines. Each gland consists of 15–20 lobes, located in a radial direction and surrounded by loose fatty and connective tissue. Each lobe is an alveolar tubular gland with a milk duct. The gland tissue also extends to the axillary region – the so-called. axillary growth of Spence. The ducts are 2 mm thick and in the area of the areola form sinuses up to 5-8 mm in diameter. There are 5-10 main milk ducts opening around the nipple, although some argue that the correct number is 15-20. Sartorius discovered that many of the visible ducts at the nipple end blindly. The nipple, located in nulliparous women above the 1st intercostal space, contains many nerve endings, including Ruffini-like bodies and terminal bulbs of Krause. There are also sebaceous and sweat glands, but no hair follicles. The areola is round in shape, pigmented, from 15 to 60 mm in diameter. The Morgagni tubercles, located along the perimeter of the areola, are raised by the ducts of the Montgomery glands opening in them. These glands are large, sebaceous, capable of secreting milk, and are a cross between the sebaceous and mammary glands. The mammary gland is enclosed in a connective capsule formed by the superficial pectoral fascia on the outside, which connects to the superficial abdominal fascia of Camper. The deep part of the gland lies on the deep pectoral fascia covering the pectoral muscles and the serratus muscle. The superficial and deep fascia of the chest above the gland are connected by fibrous cords - Cooper suspensory ligaments, which, attached to the collarbone, constitute a natural means of maintaining the shape of the breast. The main blood supply to the breast comes from the internal mammary and lateral mammary arteries. About 60% of the gland, mainly its medial and central parts, receive blood from the anterior perforating branches of the internal mammary artery. The study of the lymphatic system of the breast is very important for surgical treatment. It has been established that lymph flows centrifugally towards the axillary and internal mammary lymph nodes. 97% of lymph flows to the axillary nodes and only 3% to the intrathoracic lymphatic chain. The lymphatic system of the mammary gland itself consists of the superficial and deep plexuses; the subareolar plexus of Sappey is also distinguished.

Growth, development and function Breast cancer is determined by the function of endocrine organs. Under the influence of FSH and LH, premordial follicles in girls 10-12 years old are transformed into mature ones that secrete estrogens. Under the influence of estrogens, the growth and maturation of the genital organs and breast tissue begins. With the onset of the menstrual cycle, progesterone, the hormone of the corpus luteum, also turns on. During pregnancy, the condition of the breast is influenced by hormones produced by the placenta - human chorionic gonadotropin, prolactin and hormones of the true corpus luteum, which prepare the breast for lactation. After childbirth and expulsion of the placenta, the function of the adenohypophysis is reactivated. Under the influence of prolactin and the posterior pituitary hormone oxytocin, lactation begins.

Survey Women with breast diseases begin with the collection of complaints and anamnesis. Complaints may be about the presence of tumor-like formations in the breast, identified by the patient herself. Pain in the breast, which may depend on the menstrual cycle, the presence of discharge from the nipple, which can be of a different nature - bloody, purulent, milky. In the anamnesis, it is necessary to find out issues of puberty, the nature of the menstrual cycle, the course of pregnancy, childbirth, the nature of lactation, gynecological diseases, the number of abortions, and previous mastitis.

Breast examination produced in a bright room. Inspection of both glands must be mandatory: the woman must be undressed to the waist. There are several techniques for palpation of the breast. At the beginning, the mammary gland is palpated while standing with arms down, then they are asked to slowly raise both arms from the sides, paying attention to the synchronicity of raising the breast, after which the examination is continued with the hands placed behind the head. After this, inspection and palpation are continued in the supine position. There is a traditional direction of palpation: start from the upper-outer quadrant, then the upper-inner, lower-inner and finally the lower-outer. After carrying out superficial and deep palpation of the breast, the axillary hollows, supra- and subclavian fossae are carefully examined.

All breast diseases can be classify By clinical and morphological principle.

FUNCTIONAL DISORDERS

DISORDERS OF LACTATION FUNCTION.
1. Disorders of lactopoiesis (poly-, hypo- and agalactia)
  Milk flow disorders (galactorrhea, lactostasis).

AESTHETIC FUNCTION DISORDERS

Micro or hypermastia
Involutional or post-lactation ptosis
Other volume or shape disorders, incl. Iatrogenic (keloid scars, cicatricial deformities, defects of the areolar-nipple complex, absence of a gland)

UNSPECIFIED CONDITIONS.

Mammalgia

ORGANIC LESIONS.

CONGENAL DEFECTS (ANOMALIES).
1. Hypo- or aplasia
  Ectopic or aberrant localization (polythelia, polymastia, accessory breast)
  Hemartoma.

DAMAGE

Cracked nipple, incl. in nursing
Bruise, hematoma, wound
Burns and frostbite
Fat necrosis

INFLAMMATORY PROCESSES

Acute banal mastitis, incl. in newborns, adolescents, pregnant women and men
Lactation mastitis
Plasma cell mastitis
Chronic mastitis, incl. recurrent subareolar abscess with or without maillary fistula
Specific mastitis (tuberculosis, syphilis, actinomycosis)
Rare inflammatory processes (erysipelas, phlebitis of the saphenous veins - Mondor's disease)

BENIGN DYSPLASIA

Simple or papillary cyst
Regular typical proliferation of ductal or lobular epithelium
Ductal ectasia
Fibrosclerosis focal or diffuse
Gynecomastia
Other non-neoplastic proliferations

BENIGN TUMORS

Adenoma of the gland or nipple
Ductal papilloma single or multiple
Fibroadenoma
Benign soft tissue tumors

MALIGNANT TUMORS

Breast cancer (ductal or lobular, infiltrating carcinoma, special histological variants, Paget’s cancer)
Breast cancer in men
Sarcomas, carcinosarcoma or unspecified tumors

The most common benign neoplasm of the breast is fibroadenoma. The etiology of FA is unknown, but its prevalence among adolescents and young women suggests a dependence on hormonal changes. Similarly, there are observations that pregnancy stimulates the growth of FA that is already present. FA is common mainly among women under 25 years of age. The disease can develop even when breast cancer begins to develop. The typical history of FA involves the incidental discovery of a painless breast mass. The average size of FAs that attract attention is 2-2.5 cm in diameter. It is not typical for them to grow larger than this size, although massive and multiple FAs are not uncommon (10-20%). FA is a well-defined tumor, usually spherical in outline, but often divided into lobules or with constrictions. It is usually of a soft consistency and is never described as hard. Hardening is possible with calcification. Such FAs are detected in the elderly and may represent a tumor of stony density. For this reason, and also because of their age, they can be mistaken for breast cancer. FA may have the same clinical picture as a breast cyst and only aspiration can help in diagnosis. Cysts mainly occur in people over 25 years of age, but there is a fair amount of overlap. Therefore, as soon as a woman reaches 20 years of age, an aspiration biopsy is indicated, even if the tumor is definitely determined to be FA.

Treatment FA is surgical only. Attempts at hormonal intervention are unsuccessful and controversial due to the side effects of hormones in these young women. As stated earlier, despite the accuracy of the clinical diagnosis, attempting aspiration is mandatory for women over 20 years of age and should not be neglected at any age since the risk of aspiration is zero. If a cyst is found and aspiration is successful, then surgery is not necessary. But if the formation turns out to be hard, then it must be operated on, regardless of age. Age can only determine the urgency of the operation. Thus, in adolescents, FA should be removed before starting the use of oral contraceptives and before pregnancy. However, you should not rush and operate before the growth of the breast is completed, because the experience will be extreme. The operation may consist of either sectoral resection of the breast or simple enucleation of the tumor. However, in any case, a prerequisite for such operations is the study of the removed drug using the express method. The prognosis is favorable.

Breast cancer (BC).

Despite the high incidence of breast cancer, which has especially increased in recent years, the causes of this terrible disease are not fully understood. Numerous studies have revealed that the occurrence of a cancerous tumor can be caused by certain individual characteristics of the body, genetic and metabolic factors, which are commonly called risk factors. Therefore, when interviewing the patient, you need to find out these factors. These include primarily gender, age and family history. The risk of breast cancer doubles if the disease is present in close relatives - mother, grandmother, sisters, especially if there are 2 or more such relatives. These factors are called hereditary predisposition factors. They can be confirmed by modern genetic studies. Thus, if the BrCa-1 and BrCA-2 genes are detected, the probability of developing breast cancer is 85%, which gives grounds for such patients to even undergo a preventive mastectomy.

The presence of a benign breast tumor is also an unfavorable factor. An early age at menarche, a late onset of menopause, taking exogenous estrogens or hormone replacement therapy, infertility and late age at first birth, a history of abortion - all this indicates the presence of risk factors in the subject.

Diagnostics Breast cancer is based on clinical data, as well as data from additional examination methods. What can speak in favor of a diagnosis of breast cancer? 1. Consistency - usually rocky density. 2. Tumor borders – in breast cancer they are uneven. 3. Contours are unclear. 4. Size - all tumors are over 2.5 cm. 5. Mobility - when growing into surrounding tissues, breast cancer will be weakly mobile, 6. Connection with the skin or nipple. 7. The presence of lesions of regional lymph nodes - firstly the lymph nodes of Sorgius (along the outer edge of the pectoralis major muscle) and then the submuscular ones.

Here are some symptoms determined during physical examination of the breast:

Benzadone– retraction of the nipple when squeezing it with two fingers and simultaneously pulling the tumor inward with the fingers of the other hand.

Krause– thickening of the nipple and areola due to breast tumor.

Koenig– the palm is placed flat on the breast above the tumor. When lying down, the tumor “disappears.” For breast cancer it is negative.

Moshkovich– when the skin of the breast is vigorously rubbed with ether and alcohol, the subsequent hyperemia of the skin is interrupted in the area where the cancerous tumor is located by a belt of anemia (pallor), the intensity of which is less pronounced towards the periphery of the tumor (spots).

Payra– The breast is grabbed with two fingers on the right and left above the tumor while moving the tumor with the other hand. With breast cancer, small transverse folds form on the skin.

Pribram– when you pull on the nipple, the cancerous tumor moves along with it.

Ri– when the arm is abducted on the affected side, the tumor remains in place (a sign of growth into the chest).

Simon– polyuria in patients with advanced breast cancer. Develops in connection with Mt in the pituitary gland.

Snow- protrusion in the sternum area. Determined at Mt.

RMJ at present classify according to the international TNM system. T 0 – the tumor in the breast is not detected. T1 – up to 2 cm, T2 – from 2 to 5 cm, T3 – from 5 to 10, T4 – more than 10 cm or skin lesions exceeding the size of the tumor.

N0 – axillary lymph nodes on the affected side are not palpable.

N1 – dense ones are palpated.

N2 – p\m l\u on the affected side are large, connected to each other, limited mobility

N3 – lymph above or below the collarbone or there is swelling of the arm on the affected side

M0 – no signs of distant MTs

M1 – there are distant MTs, skin lesions outside the MF, MTs in the opposite MF, the presence of Troisier’s node, which is located in the medial part of the supraclavicular vein at the confluence of the internal jugular and subclavian veins. The defeat of this node indicates a previous lesion of the parasternal or mediastinal lymph nodes.

Choice treatment method Breast cancer depends on the prevalence of the process, the morphological structure of the tumor, the patient’s age, the state of menstrual and ovarian functions, general condition, and concomitant pathology. Treatment methods: surgical, combined (combination of surgery with radiation therapy or chemotherapy) and complex (combination of surgery with radiation, drug and hormonal therapy). The radical mastectomy operation is performed according to 2 main methods: according to V. Halsted - with removal of the pectoralis major and minor muscles and according to Petit - with preservation of the pectoralis major muscle. Urban's operation, which includes thoracotomy and removal of the cellular space along the internal mammary artery, is not currently used.

Recently, for T0 N0 M0 u T1 N0 M0, localized in the upper outer quadrants of the breast, extended sectoral resection of the breast with lymphadenectomy has become widespread.

With breast cancer in young women, it is often necessary to perform a 2-sided oophorectomy to reduce the estrogenemia factor.

The prognosis of breast cancer depends on the stage of the disease and the histological characteristics of the tumor. In early stages, the five-year survival rate reaches 95%, in stage III - 50-55%, in stage 1U the prognosis is usually unfavorable.