Mastodynia due to large breasts. Mastodynia: what is it, symptoms and treatment. Methods for diagnosing breast mastalgia: how to distinguish it from severe breast disease
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Mastalgia affects the quality of life, as it is manifested by pain in the mammary glands. Pathology occurs in girls who are regularly exposed to stress. Sometimes mastalgia is associated with hormonal failure, a malignant tumor, and medication. The disease is quite insidious: the main symptom, chest discomfort, can become chronic.
Cyclic mastalgia occurs against the background of hormonal failure. The development of acyclic is related to the anatomy of the mammary gland. Acyclic mastalgia is often associated with chest trauma. The possible reason is surgery. Discomfort in the mammary glands associated with cyclic mastalgia appears as a result of taking oral contraceptives. This type of disease can occur in girls who have taken drugs for the treatment of infertility. Medications that cause mastalgia contain estrogen and progesterone. An excess of these hormones leads to disease.
Other causes of mastalgia:
- period of pregnancy and lactation;
- thrombophlebitis disease;
- damage to the chest ligaments;
- taking antidepressants.
If you experience chest pain, you should consult a doctor. If during the complex diagnostics the exact cause was established, for example, any pathology, the specialist excludes the possibility of a tumor. There are cases when the doctor cannot determine the cause of the pain syndrome. Then carry out differential diagnosis. A malignant tumor does not make itself felt for a long time. Breast pain occurs in advanced stages of cancer.
Clinical picture
The patient feels pain in the mammary gland. Discomfort differs in intensity and is localized at different points. Some women have mild pain, while others have severe pain. One or both glands are involved in the pathological process. In the initial stages, a seal is formed that is not associated with the cycle. That is what causes discomfort in the chest. Mastalgia of the mammary gland requires timely treatment, as the tumor can become malignant. The disease is often compared with mastopathy.
Mastalgia affects girls from 15 to 30 years old, as well as women from 40 to 55 years old. If the pain appears during the menstrual period, then it disappears after 5-7 days. In some situations, mastalgia indicates a hormonal failure, in others - a malignant tumor. In this regard, it is necessary to diagnose the disease in time and begin professional therapy.
Types of pain in mastalgia
Chest pain has different origins.
- Cyclic. It is associated with menstruation. Cyclic pain is usually dull but intense. A woman feels discomfort in the middle of her chest. Sometimes discomfort is given to the armpit. Cyclic pain is often related to hormones.
- Acyclic pain. In this case, the discomfort is not associated with menstruation. Acyclic pain is diagnosed in patients who have crossed the forty-year milestone. Discomfort appears in the center of the chest. It differs in type, that is, it can be constant and variable. Acyclic pain is usually sharp, unilateral. The factor is the presence of fibroadenoma. In some patients, acyclic pain is associated with a cyst.
- Pain syndrome with mastitis. Discomfort is accompanied by weakness, malaise, fever. Mastitis, like other gynecological pathologies, requires treatment, otherwise mastalgia occurs with chronic pain.
- Malignant tumor of the breast. To identify breast cancer, a differential diagnosis should be made. Without a comprehensive examination, the tumor can be mistaken for mastalgia. Malignant formation is characterized by pain in the upper part of the gland. The patient should examine the breast herself, then consult a doctor. If a seal is found, it is necessary to visit a gynecologist.
Diagnostics
The patient should report the symptoms that bother her, as well as concomitant ailments. The doctor performs a physical examination. To confirm the disease, instrumental diagnostics is required. The following procedures are assigned.
- ultrasound. Ultrasound examination is safe. The procedure can be performed during pregnancy and lactation. Ultrasound can detect a tumor, but in some cases it is necessary to apply additional techniques.
- X-ray and mammography. Procedures help to identify pathological changes in the structures of the mammary gland. Mammography is prescribed for patients older than 35 years.
- aspiration biopsy. Manipulation is carried out in order to determine the tumor. Aspiration biopsy involves the puncture of tissue structures and further sending for cytological examination.
- Microwave radiotherapy. This method of examination allows you to identify anomalies characteristic of oncological disease.
- Microwave radiothermometry. The procedure is carried out in a specialized office and strictly according to indications.
- Analysis of sex hormones. Thanks to this study, the doctor detects the level of hormones in the body.
Treatment of mastalgia should be comprehensive. It is important to treat comorbidities.
Treatment
If the disease is not associated with a malignant tumor, the doctor prescribes non-steroidal anti-inflammatory drugs (Ibuprofen, Aspirin). Treatment may require oral contraceptives. However, they often lead to pain and cause mastalgia. The doctor recommends medicines containing magnesium. They are taken 15 days before the menstrual cycle. Preparations with a microelement eliminate pain and reduce the severity of inflammation. The patient is recommended a diet. Fat intake should be reduced. To overcome the disease, you must follow all the prescriptions of the doctor.
Description of drugs
Before prescribing a medicine, the doctor identifies the characteristics of the body. If the patient has hypersensitivity to the components of the drug, a safer analogue is recommended. The following medicines are used to treat mastalgia.
Bromocriptine
The medicine is prescribed for gynecological diseases. It inhibits the secretion of prolactin and stimulates dopamine receptors. Bromocriptine can be prescribed for the treatment of neurological pathology, diseases of the endocrine system. The drug restores menstruation and ovulation. It is used to prevent tumors. Bromocriptine normalizes estrogen levels and also eliminates pain. Possible side effects: nausea, vomiting, malaise. Some patients experience headache. Bromocriptine should be taken with caution to avoid adverse reactions. Overdose is characterized by a violation of visual functions. The drug is not prescribed to pregnant women, as well as to patients suffering from hypertension. Bromocriptine is not recommended for nursing mothers.
Aspirin
The medicine is prescribed for gynecological pathologies accompanied by pain. Aspirin has an analgesic and antipyretic effect. The drug relieves mild and severe pain. Provides prevention of thrombosis. Dosages are strictly individual. In rare cases, the drug leads to intoxication. To avoid side effects, you should adhere to the dosage prescribed by your doctor. Some patients experience such side symptoms: nausea, confusion, profuse sweating, acidosis. In case of poisoning, symptomatic therapy is carried out. The goal of therapeutic measures is also to restore the acid-base balance. If severe intoxication is diagnosed, the doctor prescribes hemodialysis. The drug can give side effects from the gastrointestinal tract and the hematopoietic system. If the patient is allergic to the components of aspirin, you should stop taking it.
Naproxen
The medicine is available in the form of tablets and rectal suppositories. With mastalgia, tablets are recommended. The drug has an analgesic and antipyretic effect. It inhibits the migration of leukocytes, and also inhibits the activity of lysosomes. Active substances are excreted naturally. The maximum plasma concentration is observed 2 hours after ingestion. Naproxen is prescribed for inflammatory diseases, pathologies associated with the musculoskeletal system. Indication for use is also an oncological disease. Dosages are individual. Naproxen with mastalgia can cause side effects: nausea, vomiting, migraine, tinnitus, malaise, gastrointestinal upset. The drug is not prescribed to women who have bronchial asthma or nasal polyposis. Naproxen is prohibited during pregnancy and lactation. Pills are also not prescribed for girls under 16 years of age.
Progestin-KR
The medicine is prescribed for tumors. Indications for admission: benign mastopathy, mastalgia. Progestin-KR is a gel. When using the product, you must follow the dosage. It is applied in a thin layer to cleansed skin. If the patient has hypersensitivity to the components of the drug, it is worth refusing to use it.
ibuprofen
The drug has an analgesic and antipyretic effect. Active components inhibit the synthesis of prostaglandins. Ibuprofen is rapidly absorbed by the digestive tract and excreted naturally. The maximum concentration in the blood is observed 100 minutes after ingestion. Metabolism is carried out in the liver. The elimination half-life is observed after 2 hours. Ibuprofen is prescribed for pathologies accompanied by pain.
If mastalgia occurs against the background of tissue inflammation, due to which the patient feels severe discomfort, the doctor prescribes this medication. Ibuprofen helps to overcome headaches. Despite the effectiveness, it can give side effects: nausea, diarrhea, allergies, impaired visual function. Rare, severe complications - bronchospasm and internal bleeding of the gastrointestinal tract. Ibuprofen has contraindications. It is not prescribed for ulcers, erosions of the gastrointestinal tract.
Contraindications are diseases of the hematopoietic system, as well as pathologies affecting the optic nerve. If a woman has hypersensitivity to one of the components of the drug, it is worth refusing to take it. Ibuprofen may be prescribed during pregnancy. Self-medication is strictly prohibited.
If you take Ibuprofen and Furosemide at the same time, the effect of the latter will decrease. Ibuprofen enhances the effect of anticoagulant drugs. An overdose is characterized by impaired consciousness. Nausea, vomiting, migraine or tachycardia occur, blood pressure decreases. In case of poisoning, you should take activated charcoal and consult a doctor.
Pregnant women and women over 40 should pay special attention to their health. If there is discomfort in the chest, you should immediately contact a mammologist. The specialist will conduct a comprehensive examination, establish a diagnosis and prescribe competent therapy.
Folk remedies
These funds are effective in the initial stages of the disease.
- Recipe number 1. Make a vegetable compress. Take fresh beets and chop, add a tablespoon of honey, mix, spread the resulting mass on cabbage leaves. The mixture should absorb the vegetable juice. The medicine is applied to the surface of the chest and kept for 12 hours. It is recommended to carry out the procedure at night. Most patients believe that such a compress is uncomfortable, but it helps to eliminate the symptoms of mastalgia. Beetroot in combination with honey and cabbage juice promotes the resorption of seals.
- Recipe number 2. Dishormonal mastalgia is treated with burdock juice. It is recommended to use it in spring or summer. You should tear the plant, grind it in a blender, strain and take 10 g twice a day.
- Recipe number 3. Take 200 g of black elderberry and mix with 100 g of sugar. Means take 10 - 20 g 3 times a day. It, in combination with other medicines, relieves pain.
Comprehensive prevention
To avoid mastalgia and other gynecological diseases, you need to lead a healthy lifestyle. It is worth giving up bad habits. Women are shown moderate physical activity. Physical inactivity often leads to pathologies. You should avoid stress, take a good rest from work. Sleep must be sound. It is important to normalize the diet. It is recommended to limit fats, smoked meats, sweets. Dishes should be moderately salty. Include foods that are rich in vitamins and valuable trace elements in your diet. If the body receives enough iodine, magnesium and zinc, the organs function better, the immune system becomes strong.
It is worth fighting overweight. Women who suffer from this problem are recommended vegetables and fruits. It is forbidden to oversalt dishes. The fact is that salt slows down the metabolism, which causes the mammary glands to swell. You need to adjust your lifestyle. It is necessary to fight excess weight, as it predisposes to mastalgia. Adipose tissue stores estrogen. If there is a lot of this hormone in the body, the mammary glands swell, pain appears.
Physical education recommended. Sports exercises contribute to the normalization of blood flow. They improve well-being with mastalgia and reduce the severity of pain. You need to take care of your liver. The health of other internal organs depends on its condition. It is not recommended to wear tight underwear. Sports bras with padded straps are ideal.
The patient should not self-medicate. Before using drugs, you should consult your doctor. It is important to establish the exact cause of mastalgia. If the patient follows preventive measures and undergoes a timely examination by a mammologist, she will be able to avoid breast disease.
Mastalgia has a favorable prognosis. However, the cyclic form requires urgent treatment, otherwise malignancy occurs (tumor cells become malignant). Signs of mastalgia are pain in the mammary glands, swelling and redness of the skin. Proper treatment will help eliminate pain and other manifestations of a purely female disease.
Most of the fair sex at least once, but faced with various female diseases that are unknown to men. Such ailments include ovarian cysts, in the uterus, endometrial growth and pathology in the mammary glands. It is worth saying that the causes of chest pain can be different. One of them is mastalgia (mastodynia).
Mastodynia: what is it?
This diagnosis is made to women who go to the doctor with complaints of chest pain. This disease can be of two types: cyclic and non-cyclic. Let's take a closer look at how these two forms of the disease differ.
The cyclic form of the disease
Quite often, patients who are diagnosed with "cyclic mastodynia" do not even know what it is. In most cases, this subspecies of mastalgia does not require treatment. However, if a woman experiences severe symptoms of the disease, from which her quality of life worsens, then a correction can be made.
The cyclic form is completely dependent on the female hormones that are released during the menstrual cycle. Mastodynia shows its symptoms in this case a few days before the expected menstruation. In most cases, this type of breast disease affects women of reproductive age.
Also, this ailment can occur during pregnancy, when the hormonal background of a woman changes greatly. In this case, everything goes away on its own after childbirth. In most cases, a woman does not need any correction. However, be sure to report your feelings to the specialist who is monitoring your pregnancy.
In the case of treatment, the doctor must first find out what level of excreted substances is present in the woman's body.
Non-cyclic form of the disease
If you have been diagnosed with this, then you should definitely ask your doctor about how mastodynia is treated, what it is.
This type of disease in its manifestations does not depend on the day of the woman's menstrual cycle. Such an ailment can manifest its symptoms at any time. The symptoms of the disease sometimes subside, then grow with renewed vigor. Very often, this type of disease occurs in women before menopause or during it.
This form of mastodynia must be corrected. Otherwise, over time, the woman will experience more and more discomfort, which will not allow her to live normally.
Symptoms of the disease
Depending on what form of the disease a woman has, she may complain of various symptoms that prevent her from living a normal life.
Cyclic form
As mentioned above, the reasons in this case lie in the production of hormones. Such mastodynia manifests itself with the following symptoms:
- An increase in the size of the mammary glands.
- Increasing the sensitivity of the tissues of the breast and nipple.
- Heaviness and discomfort in the female breast when moving.
non-cyclic form
This species has the following manifestations:
- Breast pain that comes and goes no matter what day of a woman's cycle.
- Fluid may come out of the nipple when pressed.
- Unpleasant sensations are localized mainly in the same place.
Mastodynia: treatment
How to cope with symptoms that interfere with life and get rid of unpleasant manifestations forever? Now that you know about the diagnosis of "mastodynia" (what it is and how to detect it), let's talk about the treatment. It is worth saying that the therapy of cyclic and non-cyclic forms is different. When contacting a doctor with complaints, be sure to tell if your discomfort in the chest depends on the day of the menstrual cycle. Only based on this information, the doctor will be able to choose the right correction for you.
Cyclic form
In this case, treatment is carried out quite rarely. In most cases, a woman does not experience severe discomfort from her condition, and she is able to cope with the discomfort herself.
If the disease is very pronounced, and you went to the doctor, then first you will be recommended to take a blood test to determine the amount of the following hormones in it: testosterone.
With a strong deviation from the norm, the doctor will prescribe you some hormonal drugs that will help get rid of unpleasant monthly sensations. It is worth remembering that the above hormones must be examined on certain days of the female cycle.
non-cyclic form
With this pathology, a woman is first offered to undergo a series of examinations: a manual examination by a doctor, an ultrasound examination, a blood test, and others. If a woman has a neoplasm, which is the cause of discomfort, then the doctor makes a biopsy. During the procedure, material is taken, which is carefully examined. After the results, appropriate treatment is prescribed.
If the tumor needs to be removed, then surgery is performed followed by a restorative course of drugs.
In the event that a neoplasm is not detected, the patient is prescribed anti-inflammatory therapy, drugs that increase immunity, and sedatives. Also, if necessary, the doctor may prescribe oral contraceptives, which will restore raging hormones and normalize the menstrual cycle.
In addition to all of the above, the patient may be prescribed a decoction of herbs that soothe and bring the body back to normal. On the recommendation of a doctor, various compresses can be applied to the affected area.
Conclusion
The article was told about such a disease as mastodynia. Photos of the development of the disease are also presented. If you find yourself with primary symptoms, contact your doctor immediately. Only in this case you will be guaranteed a favorable prognosis. Quite often, women start their disease by constantly postponing a visit to the doctor. As a result, they have to lie down on the operating table. Do not pull and go for a consultation with a specialist. Take care of your well-being and the health of the mammary glands! Do not be ill!
There is such a disease of mastodynia - that not every person knows it. A whole stream of questions arises for any woman who first encounters this medical term. In medical practice, mastodynia is a pain syndrome in the area of the mammary gland, which is not natural for a woman. Therefore, at the first manifestations of discomfort in the chest, a woman needs to contact a mammologist.
More than half of the female population of our planet faces mastodynia itself, although not all women pay due attention to this syndrome. In order to understand what mastodynia is, it is necessary to understand in detail the reasons that cause its occurrence.
Most often, mammologists, among the probable causes of the development of mastodynia, call the notorious premenstrual syndrome. That is the last, most difficult phase of the menstrual cycle. This phenomenon is explained by changes in hormone levels. The fact is that in the last phase of the female cycle, the amount of estrogen produced increases significantly. In turn, this affects the increased work of the mammary glands. That is why women notice during this period pain in the chest, its swelling.
Another cause of mastodynia can be called the development of benign dysplasia of the mammary glands.
In addition, mammologists, after a long study of mastodynia, came to the conclusion that there are still a lot of reasons for its occurrence. Among the most common reasons they note:
- the period of a woman's pregnancy;
- inflammatory processes affecting the osteochondral joints of the spinal column;
- intercostal neuralgia;
- manifestations of reactive sclerosis of the connective tissues of the breast;
- the formation of a malignant neoplasm;
- mammary gland injuries;
- violation of the liver or kidneys, which entails a hormonal imbalance in the body;
- hormonal disorders caused by abortion or miscarriage (especially during the first pregnancy);
- prolonged stress and being in a nervous state.
There are signs of mastodynia and during the period when a woman starts taking oral contraceptives. This time is called the "adjustment period". After a couple of months of taking them, the pain usually disappears.
In order for the treatment of mastodynia to be correct, it is necessary to reliably find out the true cause of its occurrence.
How to recognize mastodynia?
Mastodynia can manifest as single symptoms, or all at once. The first thing a woman pays attention to is soreness in her chest. With mastodynia, there is a feeling of heaviness in the area of \u200b\u200bthe mammary glands, which is also accompanied by dull aching pain. It increases significantly with the onset of menstrual flow. Usually, pain is felt in the chest, but there are cases when it radiates to the shoulder blade, which can confuse a woman a little. The nature of the pain is constant, but sometimes the pain subsides and may soon return again.
Palpation of the breast may help detect some lumps with indistinct and elusive contours. In addition, a woman's breasts swell and increase in size due to the fact that the outflow of venous blood is disturbed. This is the most common cause of chest pain.
Mastodynia, the symptoms of which can be detected not only when examining the chest, also manifests itself in the form of compaction of the lymph nodes in the armpit.
Often, women suffering from mastodynia experience severe headaches, migraines. This phenomenon can, by the way, respond with painful sensations in the stomach. Frequent symptoms of mastodynia are manifestations of flatulence, dysbacteriosis, constipation.
The general well-being of a woman is also disturbed, first of all, the emotional sphere suffers. A woman with signs of mastodynia becomes easily excitable, depressed, or overly anxious.
Particular attention should be paid to discharge from the nipples or clear seals in the breast area. The appearance of any suspicious liquid from the nipples, especially blood, or clear, easily palpable lumps should be a reason for immediate medical attention, as they may indicate more serious diseases. All other described symptoms, as a rule, disappear, or noticeably decrease with the onset of the next menstruation.
How to treat mastodynia?
Mastodynia, the treatment of which initially involves a complete examination of the mammary glands of a woman, can be carried out both within the framework of traditional medicine and traditional medicine. As for traditional methods of treatment, it should be noted that the type of therapy is selected by a mammologist. But first of all, he prescribes a complete diagnosis of the female breast. As part of the diagnostic examination, the following methods are used:
- examination of the mammary glands (breast);
- Ultrasound of the mammary glands;
- x-ray of the mammary glands (mammography);
- MRI of the mammary glands.
Therapy for mastodynia, as a rule, is aimed at reducing pain in the mammary glands or completely eliminating it. Often a woman suffering from mastodynia is recommended to follow simple, but at the same time very important rules:
- Eliminate foods that contain caffeine from your menu. These are coffee, chocolate, tea, cocoa and Cola. All these not the most useful foods contribute to the development of fibrous tissue. It is worth giving up fatty foods and alcoholic products.
- Enrich the diet with foods high in fiber, vitamins B, A, C, and E. These changes not only have a positive effect on liver function, but also help get rid of "excess" estrogen in a woman's body.
- Choose the right underwear. The bra must match the anatomical shape of the breast, be matched to its size. Under no circumstances should you wear underwear or corsets that compress your breasts.
If it is reliably established that premenstrual syndrome is the cause of mastodynia, then all treatment can be reduced to preventing the formation of breast swelling. In other words, a couple of days before the onset of menstrual flow, you can start taking diuretics, which the doctor will prescribe. In the same period, the salt content in dishes should be minimized.
But before the woman and the specialist involved in her treatment, nevertheless, the question remains whether to get rid of only the clinical manifestations of the disease, or try to find out the true causes of its development and build a further therapeutic path on these data. In special cases, for example, serious hormonal therapy is prescribed.
Traditional medicine as a way to treat mastodynia
If cyclic pains are associated with menstruation, then in anticipation of their onset, a woman can start using some traditional medicine recipes. For example, often before the imminent manifestation of symptoms of mastodynia, you can use the means, which are based on the extract of the common or "wild pepper" rod. Thanks to the extractive substances of this plant, the production of prolactin in the woman's body is significantly reduced, and, accordingly, the hormonal background returns to normal. You can buy preparations with prutnyak extract in pharmacy chains. They should be used in strict accordance with the instructions. Among the special contraindications are the pregnancy of a woman and the period of breastfeeding.
You can treat mastodynia in another way, for example, by brewing a special tea based on herbal collection, which includes St. John's wort, dandelion root, nettle leaves. This tea can be prepared by hand or bought at a pharmacy. Tea should be prepared according to the following scheme: a mixture of herbs (1 tsp) is poured with a glass of boiling water and infused for about 10-15 minutes. You need to drink a decoction three times a day. You need to start treatment in advance, some time before menstruation.
In the event that mastodynia is caused by pregnancy or the production of breast milk, then almost all folk methods of treatment fall under the strictest ban. The only possible way is a cabbage leaf compress, but it is better to consult a doctor about this.
When the first symptoms appear, do not self-medicate, but be sure to make an appointment with a classified mammologist.
Cyclical or persistent pain in the mammary glands caused by fluctuations in hormone levels or pathological processes in the chest and other organs. It is manifested by pain, hypersensitivity, discomfort in the area of the mammary glands and their engorgement. With symptomatic mastalgia, the symptoms of the underlying disease are determined. Ultrasound, mammography, laboratory methods are used to make a diagnosis. Treatment of functional mastodynia involves the appointment of hormonal and hormone-like drugs, sedatives, analgesics, diuretics. With acyclic mastalgia, the choice of tactics depends on the leading pathology.
ICD-10
N64.4
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General information
Soreness of the mammary glands (mastodynia, mastalgia) is one of the most common complaints of patients of reproductive age. At least once in a lifetime, all women experience it, and every second pain, leading to psychological and physical discomfort, occurs monthly. The term "mastodynia" for cyclic pain and breast engorgement was first proposed by the German surgeon T. Billroth in 1880. Most often, the disorder occurs in patients 20-40 years old who have not yet given birth or have had one birth, have an irregular sex life, and suffer from gynecological diseases. The appearance of complaints of chest pain in patients older than 40 years usually indicates diseases of the mammary glands or other pathology.
Causes of mastodynia
Mastalgia occurs both during physiological changes in the female body, and in the presence of various diseases of the reproductive organs, mammary glands, and other body systems. During puberty, pain is usually observed during the maturation of the mammary glands under the influence of estrogens. In most women of reproductive age, mastodynia is not associated with the development of pathological changes in the breast and is the result of hormonal influences. It is caused by:
- Ovulation. Under the influence of female sex hormones, cyclic changes occur in the mammary gland, preparing it for the possible conception, bearing and feeding of a child. Such sensations are physiological, although they may be one of the manifestations of premenstrual tension syndrome.
- Hormonal disorders. In some patients, the appearance of mastodynia or a change in its nature is a sign of a violation of the secretion of sex hormones. This occurs with diseases of the ovaries (oophoritis, cysts, endometriosis, cancer), pathology of the hypothalamic-pituitary region or endocrinopathies.
- Taking oral contraceptives. Mastalgia is one of the side effects of hormonal drugs that regulate the menstrual cycle. When they are taken in the mammary gland, the same cyclic changes are observed as during ovulation. Usually in 2-3 months the body adapts, the pain disappears or weakens.
Pain syndrome is possible with a large size of the mammary glands, their squeezing with uncomfortable underwear, bruising. Pain is also one of the signs of inflammatory and neoplastic diseases of the mammary glands - mastitis, mastopathy and other benign tumors, sclerosing adenosis, cancer. The pain radiates to the chest with osteochondrosis, intercostal neuralgia, myalgia, Tietze's syndrome, heart disease, liver. In the absence of a hormonal or organic basis for pain, mastodynia can be a manifestation of psychogeny, neurotic and mental disorders (hysteria, hypochondria, depression).
Pathogenesis
The mechanism of the appearance of pain in physiological or dishormonal mastodynia is associated with changes in the mammary gland tissue under the action of sex hormones, especially progesterone. In the luteal phase of the ovarian cycle, active proliferation of breast epithelial cells is observed, and fluid is retained in the stroma. This leads to swelling of the mammary glands, compression of nerve endings and pain. In the presence of organic changes in tissues, pain is caused by irritation of nociceptive receptors by metabolic products that are formed during inflammatory and necrotic processes, or by the pressure of a growing volumetric formation on surrounding tissues.
Classification
When determining the variant of mastodynia, the frequency of occurrence of pain and the causes that led to its appearance are taken into account. The choice of optimal medical tactics depends on the correctness of establishing the form of mastalgia. In addition, the distinction between individual categories increases oncological alertness when the patient complains of breast tenderness. Specialists in the field of mammology distinguish the following types of mastodynia:
- Cyclic (functional, true) occurring in the second phase of the menstrual cycle. It is observed with physiological ovulation, premenstrual syndrome, hormone-sensitive dysplastic processes in the chest (diffuse mastopathy, etc.), taking oral contraceptives.
- Acyclic (symptomatic) associated with various diseases of the mammary glands. The pain syndrome manifests itself regardless of the monthly cycle and indicates damage to the breast tissues due to trauma or surgery, inflammatory, tumor processes, sclerotic changes, and developmental anomalies.
- False (reflected, radiating) caused not by functional or pathological changes in the mammary glands, but by disturbances in the work of other organs and systems. It often develops with metabolic-dystrophic diseases of the spine, joints, heart disease, radicular and myalgic syndromes.
Symptoms of mastodynia
The main manifestations of cyclic mastalgia are pain and discomfort in the area of the mammary glands. Typically, patients characterize such sensations as pulling, pressing, aching. Sometimes they become sharper, stabbing and acquire a girdle character. The breasts increase in size (swell), which can make the usual underwear feel tight and squeezing. Increased tactile sensitivity of the nipple, areola, breast skin. When touched, a woman experiences severe discomfort. A characteristic feature of true mastodynia is the occurrence of pathological sensations simultaneously in both mammary glands, and in the presence of an additional breast lobule, in the armpit. The pain syndrome is clearly associated with the menstrual cycle, develops a few days before menstruation and disappears within one day after the onset of spotting.
Acyclic mastalgia is characterized by the appearance of periodic or constant pains of varying intensity, usually occurring in one breast and not associated with the phases of the ovulatory cycle. The severity of pain depends on the type of underlying pathology. Pain is usually combined with other clinical manifestations - palpable masses, discharge from the nipple, changes in the shape and contour of the gland, color and structure of the skin, hyperthermia, lethargy, enlarged axillary lymph nodes. With false mastodynia, there are signs of damage to other organs: an increase in the tone of the back muscles, pain along the intercostal space with a vertebrogenic origin of the pain syndrome, a change in pressure and heart rate in cardiac pathology, etc.
Complications
Physiological mastodynia does not pose a threat to a woman's health, however, it can lead to a deterioration in the quality of her life - increased fatigue, the appearance of irritability, tearfulness, bad mood, anxiety and other emotional disorders on the eve of menstruation. In women with a hypochondriacal type of response, cancerophobia may occur. More serious are the consequences of untimely detection of an organic pathology that caused breast tenderness. In such cases, treatment is longer, and the prognosis of the disease worsens.
Diagnostics
The main task of the diagnostic stage for suspected mastodynia is the exclusion of organic causes of chest pain. For this purpose, a full range of laboratory and instrumental studies and consultations are prescribed to detect diseases of the mammary glands and other pathologies. The survey plan usually includes methods such as:
- Ultrasound of the mammary glands. Sonography makes it possible to quickly assess the structure of breast tissues, identify volumetric formations, clarify their shape, size, localization, and determine an increase in lymph nodes.
- Mammography. The most sensitive way to detect even small volumetric formations. It is performed in two or three projections. If necessary, a targeted photograph is taken.
- Lab tests. Discharge from the nipple and a biopsy obtained by puncture or trephine biopsy are sent for cytological examination. The level of the oncomarker CA 15-3 in the blood is determined.
If the appropriate equipment is available, radiothermometry of the mammary glands is used as a screening method. In complex diagnostic cases, CT, MRI, electrical impedance mammography, breast scintigraphy, hormonal profile assessment (estradiol, progesterone, free and bound testosterone, FSH, LH, thyroid hormones, etc.) are indicated. Differential diagnosis of physiological mastodynia is carried out with fibrocystic mastopathy and other benign tumors, various forms of breast cancer, mastitis, involutive changes, extramammary pathology. If necessary, the patient is examined by an oncologist-mammologist, gynecologist, endocrinologist, neuropathologist, cardiologist, internist, psychiatrist.
Treatment of mastodynia
Special therapy for mastalgia begins only after the exclusion of diseases of the mammary glands. With a slight pain syndrome and the absence of other disorders, women with true mastodynia are recommended to be observed in dynamics with a periodic examination by a mammologist and ultrasound or mammography. Medical tactics for severe pain and emotional disorders is aimed at reducing or eliminating subjectively unpleasant sensations in the chest that occur during hormonal fluctuations. The combination of pathogenetic hormonal, non-hormonal drug and non-drug methods of treatment is considered the most effective. Such patients are shown:
- hormone therapy. The choice of drug is made taking into account the level of secretion of hormones and the severity of symptoms. For treatment, combined oral contraceptives of a monophasic type or releasing form, gestagens, antiestrogen, gonadotropin-releasing factor agonists are used.
- Herbal medicines and homeopathic remedies. To correct dyshormonal disorders, plant derivatives with an estrogen-like effect (evening primrose, sage, oregano, cimifugi) and homeopathic preparations that contain them are used. They are recommended when a woman refuses hormone therapy.
- Sedative drugs. In the presence of significant mood swings, a tendency to anxiety and hypochondria, selective inhibitors of the reuptake of norepinephrine and serotonin are indicated. In milder clinical cases, magnesium preparations, sedative preparations and herbs (valerian, motherwort, peony) are effective.
- Analgesics. Women with severe pain syndrome are prescribed medications from the group of non-steroidal anti-inflammatory drugs. NSAIDs stabilize cell membranes and inhibit the synthesis of prostaglandins, which lower the pain threshold by sensitizing pain receptors to mechanical stress.
- Diuretics. Since one of the links in the pathogenesis of mastodynia is fluid retention in the tissues of the mammary glands, the use of diuretics can reduce the severity of the pain syndrome. Usually, potassium-sparing diuretics, which also have antiandrogenic properties, and herbal remedies are used.
Complex therapy of mastalgia can be supplemented with vitamin and mineral complexes and physiotherapeutic methods (electrophoresis, magnetotherapy, galvanization, balneotherapy). With acyclic mastodynia, the underlying disease is treated with the use of appropriate drug therapy and surgical interventions (opening and drainage of mastitis, tumor enucleation, sectoral resection, mastectomy, etc.).
Forecast and prevention
With cyclic mastodynia, the prognosis is favorable, with acyclic and false it depends on the disease that provoked the onset of pain. For the prevention of pain associated with cyclic fluctuations in hormone levels, it is recommended to normalize the sleep and rest regimen, reduce workloads, correct the diet with a decrease in the amount of salt and limit foods that retain fluid in the body (smoked meats, pickles, fried foods, alcohol). An important role is played by the prevention and timely treatment of gynecological diseases accompanied by hormonal disorders.
Pain in the mammary glands are among the symptoms that every woman has experienced at least once. The pain is associated with menstruation, but in general, all deviations are individual. Therefore, the examination scheme for identifying the disease should be individual.
Mastalgia of the mammary gland is the general name for a number of pathologies characterized by pain and discomfort in one or both breasts.
These pains are symptoms of organ dysfunction. In some cases, pain is felt constantly, in others periodically, and sometimes sensations arise spontaneously. Pain is accompanied by engorgement of the nipples and breasts around them, swelling of the surrounding tissues.
Often mastalgia has a negative impact on a woman's daily condition, her sexual life and family relationships. More often this disease occurs in young women, or on the eve of menopause.
Discomfort is felt before or during menstruation, as well as with neurosis, stress, hormonal disorders. This disease has another name - mastodynia. It is diagnosed as an independent disease only when there are no other reasons for its occurrence.
Types of mastodynia
When determining the type of mastalgia, the cyclical appearance of pain and the causes that led to the development of pathology are taken into account. The choice of diagnostic methods and course of treatment depends on the definition of the type of violation.
There are such types of pathology:
- Cyclic pathology develops every time in the second part of the monthly cycle.
- Acyclic, which is not associated with cyclic changes. Does not depend on menstruation.
- False, not associated at all with pathologies of the glands. It is more often caused by diseases of other organs.
Cyclic mastalgia
This type of pathology is also called functional or true.
It is observed during the days of ovulation, premenstrual syndrome, during dysplastic type processes, after the use of oral contraceptives.
Soreness manifests itself in the second part of the cycle and is the cause of physiological changes in the level of estrogen and progesterone in the body.
An excess of hormones retains fluid in the cells of the gland, activates substances that irritate nerve cells and cause discomfort and pain.
Also, the causes of this type of pathology are:
- Benign dysplasia within glandular tissues.
- Violation of the water-mineral balance.
- Long-term use of combined contraceptives.
Acyclic pathology
Such mastalgia is also called symptomatic. This type of mastalgia is associated with various deviations in the functioning of the mammary glands. Soreness occurs without apparent dependence on cyclic monthly changes.
She talks about disorders in the mammary gland after injury or surgical treatment, inflammation, the presence of tumors and other anomalies that disrupt the functioning of the glands. With this form of the disease, there are changes in the color of the skin around the nipples, general lethargy and migraine attacks.
false mastalgia
This pathology is also called reflected, irradiating. It is not caused by dysfunctional changes in the breast, but by dysfunctions of other organs. Often the disease occurs with disorders in the spine and articular tissues, pathologies of the heart, myalgia, etc.
Symptoms of the disease
The main symptoms of mastalgia of the cyclic type are soreness, discomfort in the mammary gland. As a rule, women describe their sensations as follows: pulling, pressing or aching pain.
Sometimes the pain becomes sharp or girdle. The chest swells, increasing. For this reason, the laundry can become tight. The sensitivity of the halo, nipples, breast skin increases. The patient experiences discomfort when touching the nipples.
A characteristic feature of the pathology is the manifestation of unpleasant sensations in the tissues of both glands and armpits. If the pain is clearly associated with menstruation, they disappear after the appearance of "blood".
Acyclic mastodynia is characterized by periodic or persistent pain of varying strength, appearing in the chest and not associated with ovulation.
Symptoms of false-type breast mastalgia are the symptoms of the disease, which caused it. The pain is accompanied by other manifestations - an increase in formations, a violation of the shape of the gland, a change in the skin surface, lethargy. With the development of false mastalgia, damage to other organs is observed:
- Increased tension in the muscles of the back and chest
- Pain under the intercostal line
- Nipple asymmetry
- Increased tissue temperature around the nipples
- High sensitivity of the nipples and the area around them
- Eruptions of a burning herpes character on the chest
- Feeling of fullness in the gland
- Lack of appetite
- Changes in pressure and heart rate, etc.
Causes of pathology
Mastodynia occurs during the period of changes in the body, as well as in various diseases of the reproductive organs, glands. In most women of reproductive age, the pathology is not associated with pathological changes, it refers to hormonal disorders. The appearance of mastalgia can lead to:
- Ovulation acting on the mammary gland through sex hormones and cyclic changes.
- Puberty, post-abortion, miscarriage or childbirth.
- Diseases of the "thyroid gland", liver or kidneys.
- The presence of fibroadenomas, cysts, and other neoplasms in the breast.
- Hormonal disorders that are a sign of hormone secretion disorders in ovarian disease or endocrinopathy.
- Taking oral contraceptives. In this case, this is a temporary side effect.
- Lack of essential acids in the body.
- Abuse of certain products, such as chocolate, drinks containing coffee or tea.
- Mammary cancer.
Soreness is possible with large glands, the use of uncomfortable underwear, bruises. Pain is a sign of inflammation and neoplastic pathology of the glands, for example, mastitis or other benign tumor growths, adenosis. Painful sensations are given to the chest, radiate with osteochondrosis, neuralgia, myalgia, and other diseases.
Diagnostic measures
The main goal of diagnostic measures in case of suspected mastalgia is to exclude the causes of the organic nature of pain syndromes in the glands. At the same time, a complete instrumental and laboratory study is prescribed, which allows to identify abnormalities in the mammary glands. For testing use:
- Palpation of the chest by a doctor and questioning of the patient. They are carried out during the initial visit to the doctor. The gynecologist must find out what other signs the patient feels that preceded the appearance of mastalgia. The size of the nipples, the boundaries of the site of inflammation are measured, the skin and its structure are examined.
- Ultrasound allows you to evaluate the structure of the glands, see tumor formations, clarify their parameters, and determine the state of the lymph nodes.
- Mammography can detect even small tumor formations.
- Cytological examination of fluid secreted from the nipples, biopsy. This study determines the level of the CA-15-3 marker for oncology.
- Puncture biopsy for the detection of tumor growths.
- In the presence of discharge from the nipples, smears are taken.
If appropriate equipment is available, microwave radiometry is used. Sometimes CT, MRI and other diagnostic methods are performed.
Treatment of the disease
Treatment of mastodynia begins only at the end of the examination and diagnosis.
If the pain is minor and there are no other disorders, patients with mastodynia are recommended to be monitored by a mammologist with regular examinations using mammography and ultrasound.
With cyclic mastodynia, treatment is not needed. It is only necessary to establish what caused such sensations. Therapy is needed only for severe pain. With periodically expressed pain, it is recommended to treat the disease with medication. Therapy is aimed at reducing unpleasant uncomfortable sensations, soreness inside the chest, which occur when hormonal balance is disturbed.
A combination of several methods is effective: the use of a hormonal course of therapy, non-hormonal medication, as well as non-drug treatment options. With this disease are shown:
- Hormone therapy, in which the doctor chooses the remedy after determining the level of hormonal levels, the severity of symptoms. Endocrine disorders are being corrected. For treatment, the gynecologist prescribes different types of oral contraceptives.
- Preparations from medicinal herbs are prescribed for the case of correction of non-hormonal disorders. For this, homeopathic medicines are used, tablets, for the manufacture of which plants are used that are included in the composition of any folk drug with an estrogen-like effect (primrose with sage, oregano with cimicifuga). They are recommended for use when the patient refuses hormone therapy.
- Sedative medicines, if there are strong fluctuations in the patient's mood. In certain cases, herbal-based anti-anxiety medications or medications containing magnesium can help.
- Non-steroidal analgesics are prescribed in case of severe pain.
- Anti-inflammatory drugs are also used. They stabilize cell membranes, lower the pain threshold.
- Universal anti-inflammatory and analgesic drugs of the NSAID class.
- Diuretics are prescribed if mastalgia is a consequence of excess fluid in the glands. Medicines help reduce pain. Potassium-sparing diuretics are used.
- Among folk remedies, cabbage helps well, the leaves of which can be applied at night to a sore chest. The sheet must first be washed and dried. An oilcloth is applied on top of the sheet and secured with a bandage. You can use decoctions of herbs that relieve itching and irritation.
It is possible to add vitamin and mineral preparations and physiotherapy to the complex of treatment. If pathologies in other organs are found during mastalgia, treatment should be carried out in conjunction with the specialist who treats this organ.
Forecast, prevention
When diagnosing cyclic mastadonia, the prognosis is usually favorable.
With pathology of acyclic, false types, treatment depends on what kind of pathology provoked painful sensations.
To prevent the disease, which is associated with hormonal imbalance, it is recommended to normalize sleep, reduce physical activity.
You need to adjust the diet with a decrease in the daily allowance of salt, dishes from foods that retain fluid. These are smoked, salty, fried foods, alcohol.
Equally important are the treatment and preventive measures for gynecological diseases that accompany hormonal disorders.
The problem of prevention and early detection, adequate treatment of such a disease of the glands is becoming more and more urgent every year, the prevalence of mastalgia is constantly increasing. According to statistics, more than 30% of women of all ages suffer from non-cancerous disorders of the mammary glands. And the most common reasons for going to the clinic are various forms of mastalgia.