Involutive mastopathy: causes of appearance and clinical signs

Lumps in the chest

25.04.2018

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Involutive changes in the mammary glands are a restructuring of their structure during development.

If they occur in menopausal women, the process is physiological in nature and does not require therapeutic measures.

But the occurrence of such changes in patients of reproductive age indicates a pathological condition and is an indication for a more thorough examination and treatment.

The condition of a woman’s breasts depends on her hormonal levels, which also determine reproductive function. In adult women who have entered menopause (menopause), the production of hormones decreases, which affects the condition of the mammary glands. This feature is not considered a disease and is observed mainly in women over 45-50 years of age.

There are frequent cases of involutive restructuring of mammary gland tissue in women during the reproductive period. This indicates a hormonal imbalance in the body, manifested by a decrease in estrogen levels. A negative consequence of the described changes is a low likelihood of pregnancy.

The causes of early breast involution are:

• frequent episodes of nervous tension (stress, depression);
• drinking alcohol, smoking;
• diseases of the reproductive system;
• consumption of “junk” food (fast food, smoked meats, canned and fatty foods, etc.);
• pathologies of the thyroid gland;
• hypo- and vitamin deficiencies;
• endocrine diseases;
• irregular menstrual cycle;
• obesity.

The factors described above can provoke hormonal imbalances in a woman’s body, under the influence of which involution processes begin to develop in the mammary glands. The types and characteristics of involutional changes are presented in the table.

Type of changes	Description	Image
Fat involution	This condition is characterized by the proliferation of adipose tissue and a decrease in the glandular component of the breast. In this case, the mammary glands become soft, loose, and when palpated, fatty lobules can be felt
Fibrous changes	Involution of this type implies the appearance of foci of fibrosis (connective tissue) or diffuse fibrous growth. Focal fibrosis is easily detected by mammography (MMG). In the photographs it appears as a light spot on a dark background, which indicates an increased density of the gland in these areas
Fibrocystic mastopathy (involutive mastopathy)	Mastopathy of this type is manifested by the appearance of cystic structures with serous contents. They can be single or multiple, of various sizes. They are palpated in the form of dense, smooth and round formations in various areas of the chest

A large percentage of women with the breast changes described do not report any symptoms. They learn about this condition of the mammary glands during preventive MMG or ultrasound examination of the mammary glands.

But some patients are bothered by discomfort in the chest, nagging pain or heaviness in it, which is why they come to see a doctor. Identified involutive changes in menopausal women do not require further examination. They are recommended to perform MMG in a preventive mode once every 2 years.

If a change in the structure of the breast according to the involutive type has developed in a young woman of childbearing age, then it is necessary to conduct an ultrasound of the mammary glands, thyroid gland and pelvic organs (to exclude a pathological process in them), and examine the hormonal levels.

Women over 45 years of age with an involutive process in the breast, but in the absence of symptoms, do not need specific treatment or any corrective measures.

Young patients are often prescribed hormone therapy; drugs are selected in accordance with abnormalities in the tests. Also, for treatment to be effective, it is necessary to eliminate provoking factors, namely: give up alcohol and nicotine, adjust your diet and diet, replenish vitamin deficiencies, avoid stressful situations, and follow the principles of a healthy lifestyle.

To improve breast condition, the following herbal preparations are prescribed:

• Mastodinon;
• Mastofit;
• Cyclodinone;
• Indinol.

To relieve pain in the mammary glands, Progestogel gel (with microdoses of progesterone) is used. It is applied to the chest area with a spatula up to two times a day.

Source: https://fraumed.net/mammary-gland/seals-in-chest/involyutivnye-izmeneniya.html

Involution of the mammary glands

Involution of the mammary glands is a natural process of reverse development of glandular lobules with replacement by adipose tissue cells. It manifests itself as a decrease in the volume of the mammary glands, a decrease in their elasticity, a change in contour and sagging. Sometimes the involutive process occurs pathologically: it begins prematurely and is accompanied by the proliferation of fibrous fibers and the formation of cysts. Pain and discomfort may occur in the chest, and lumps may be detected. For diagnosis, ultrasound, mammography, and hormone level testing are used. In case of pathological course, hormonal, analgesic and sedative drugs are prescribed. In some cases, surgical correction of the breast shape is performed.

Physiological involution of the mammary glands is an integral part of the aging process of the female body. Involutive changes usually begin at 35-40 years of age, intensify by 45-47 years of age and last until 58-65 years of age, when adipocytes completely replace glandular cells. In a normal course, age-related changes in the breast are practically not felt subjectively.

We can talk about the pathological course of involution when it occurs before the age of 35, develops quickly, is accompanied by uncomfortable sensations, and the development of fibrocystic structures. In some cases, active regression of the glandular lobules is observed immediately after the end of the lactation period.

The nature of the course and severity of age-related changes in the breast are largely determined by the individual characteristics of the body.

Involution of the mammary glands

Under normal conditions, the replacement of glandular breast tissue with fat cells occurs due to an age-related decrease in the level of female sex hormones.

The causes of premature fatty degeneration of the mammary glands or the atypical course of involutive processes with the formation of fibrocystic elements are various dishormonal conditions, primarily hypoestrogenism. The main factors leading to pathological involution are:

• Hereditary predisposition . Premature reverse development of mammary gland tissue occurs with congenital insufficiency of ovarian function or disturbances in the central regulation of the synthesis of sex hormones. Such patients usually exhibit other signs of hypoestrogenism: menstrual irregularities, infertility, small breasts, etc.
• Reproductive diseases . The secretion of sex hormones can be disrupted during inflammatory and volumetric processes in the pelvic organs (chronic oophoritis, plastic pelvioperitonitis, external genital endometriosis, cystadenomas, cysts and ovarian tumors). Often such diseases occur against the background of other chronic inflammations.
• Endocrine pathology . The level of secretion of estrogens and progestins is influenced by FSH and LH, adrenal and thyroid hormones. Therefore, relative or absolute hypoestrogenism is often observed in patients with hypothalamic-pituitary pathology, thyroiditis, hypothyroidism, androsteromas and some other endocrine diseases.
• Uncontrolled use of hormonal drugs . Long-term contraception using oral contraceptives without the supervision of a gynecologist increases the risk of dyshormonal disorders. The risk group includes patients who take corticosteroid drugs and drugs that affect the secretion of hormones by the adrenal glands and the thyroid gland.
• Obesity . With excess body weight, the volume of adipose tissue in the mammary glands often increases. Due to compression of the lymphatic and blood vessels, dystrophic changes in the secretory tissue occur earlier, followed by its subsequent replacement by fatty and fibrous tissue. In addition, obese patients are more likely to suffer from dyshormonal disorders.

According to the observations of specialists in the field of mammology, premature involution often occurs in women who have given birth repeatedly and who breastfed their children for a long time.

Risk factors also include poor lifestyle (physical inactivity, poor sleep and rest patterns, constant stress), smoking, alcohol and drug use, frequent medical or surgical abortions, early and late miscarriages, and ectopic pregnancies.

As reproductive function declines and estrogen production decreases, breast tissue undergoes a natural reverse development (involution). Glandular lobules of the 3rd type, into which the lactation lobules of the 4th type regressed after the end of feeding, gradually turn into lobules of the 2nd, then 1st type and subsequently atrophy.

In some areas of the glands, only ducts remain, surrounded by adipose tissue. The fibrous component of the stroma also normally decreases. The mammary glands lose their shape and begin to sag, their skin thins and becomes wrinkled.

When determining the type of involutional changes occurring in the mammary gland, the time of their visible manifestation, the ratio of elements of adipose and connective tissue, and the presence of cystic formations in the structure are taken into account. Based on these criteria, 4 main forms of involution of the mammary glands have been identified, on which the choice of treatment tactics depends:

• Natural age-related involution . The reverse development of the lobules of the mammary glands becomes noticeable when a woman reaches menopause. The breast stroma is dominated by adipose tissue; cysts are not detected.
• Premature involution . Signs of atrophy and replacement of glandular tissue are detected in women up to 35-40 years of age. The lobules can be replaced by both adipose tissue and fibrocystic formations.
• Fibro - fatty involution . Involutive changes begin on time or prematurely, but the number of fibrous fibers does not decrease. The stroma of the mammary gland contains adipose and connective tissue.
• Fibrocystic involution . _ An extremely rare form of reverse development of the mammary glands, in which in the breast, which has undergone fibrofatty degeneration, compactions in the form of hollow cysts of different sizes are detected.

At the initial stages of the reverse development of breast lobules, there are no clinical manifestations. Some women experience or intensify signs of mastodynia - subjectively unpleasant sensations of engorgement, discomfort, soreness in the mammary glands, and increased sensitivity to touch.

Such symptoms in menstruating women become more noticeable in the second half of the monthly cycle. Some patients complain of muscle tension, pain in the upper chest and back. Over time, a woman notices that her breasts decrease in size, lose their elasticity and original shape, and begin to sag.

After 50 years, the condition of the skin of the mammary glands changes, which first becomes flabby and then becomes covered with wrinkles.

During involution with the growth of connective tissue, the breast retains its shape and elasticity longer. It can identify areas of minor compactions, after the resorption of which folds form on the skin of the mammary glands.

If the reverse development follows the fibrocystic variant, a woman during self-examination may find round elastic lumps of various sizes in her breasts. To the touch, such cysts resemble nodules or balls of fluid. They are usually mobile and extremely rarely painful.

The detection of such neoplasms is a reason to contact a mammologist to rule out benign tumors or breast cancer.

The main negative consequence of age-related involution is breast sagging (mastoptosis), which is perceived by some women as a cosmetic defect. Sometimes, with significant ptosis of the mammary glands, the skin under them macerates.

There is currently no statistically reliable data on the malignant degeneration of involuting cysts, however, since the risk of malignancy cannot be completely excluded, dispensary observation is recommended for such patients.

A diagnostic search for suspected involution of the mammary glands is carried out in cases where it occurs prematurely or develops in fibrofatty or fibrocystic variants. In such cases, it is important to promptly identify the causes that provoked the pathological course of the process and exclude other breast diseases. In diagnostic terms, the most informative are:

• Ultrasound of the mammary glands . On sonography, adipose tissue appears lighter than glandular tissue. Ultrasound examination allows you to identify areas of fibrosis and cysts, assess their size and structure.
• Mammography . The diagnostic efficiency of the method reaches 97%. Allows you to differentiate cysts from other neoplasias. If necessary, supplemented with ductography.
• Laboratory diagnostics . Particularly important for premature involution. Usually the level of estradiol, progesterone, FSH, LH is assessed, and, according to indications, total and free testosterone.

In complex diagnostic cases in the presence of space-occupying formations, MRI, CT, scintigraphy of the mammary glands, biopsy with cytological examination of the biopsy, and tests to determine the function of the thyroid gland and adrenal glands are additionally prescribed. Differential diagnosis is carried out with benign and malignant breast tumors. If indicated, the patient is consulted by an oncologist, endocrinologist, and gynecologist.

CT OGK. Fatty involution of the mammary glands in a 65-year-old woman (age norm). Glandular and fibrous tissue are practically absent.

Patients with a physiological course of the involutive process do not need treatment. A woman is recommended to wear comfortable underwear to prevent excessive stretching of the skin of the mammary glands due to their sagging.

For patients with fibrofatty and fibrocystic variants of involution in the absence of discomfort in the chest, dynamic observation by a mammologist is recommended with ultrasound or mammography 1-2 times a year, taking into account age.

When the reverse development of glandular breast tissue is accompanied by pain and emotional disorders, it is possible to prescribe analgesics, mild sedatives and estrogen-like substances of plant origin.

In the case of premature involution, the main goal of treatment is to correct the disorders that caused premature regression of the milk lobules.

Since this pathological condition most often occurs when estrogen levels decrease, patients undergo hormonal correction and therapy for the underlying disease that provoked hypoestrogenism.

For hormone replacement therapy, depending on the patient’s age and research results, the following is prescribed:

• Female sex hormones . Taking into account laboratory data, estrogens, gestagens or combined hormonal drugs are used. Sometimes inhibition of androgen synthesis is necessary.
• Phytoestrogenic drugs . In situations where contraindications to replacement therapy are identified or a woman refuses it, herbal products are used.

Surgical methods of treatment for involuting changes in the breast are used in exceptional cases at the request of the patient. To correct mastoptosis, one of the options for mastopexy is usually chosen.

If involution is accompanied by a significant decrease in the volume of the mammary glands, breast lift can be combined with endoprosthetics.

More often, such operations are performed on young women with premature involution or patients with significant prolapse of the glands, causing constant maceration of the skin under the breasts.

With timely treatment of premature involution, the prognosis is favorable. Since the pathological condition is based on a physiological process, involutive changes do not pose a threat to a woman’s life. Modern methods of plastic surgery, if necessary, can eliminate a number of consequences of reverse breast development.  

To prevent the pathological course of the involutive process, regular observation by a gynecologist, planned treatment of diseases that can cause early hypoestrogenism, and the justified use of hormonal drugs are recommended.

According to the results of observations, the aging process begins later and proceeds more mildly in women who lead a healthy lifestyle.

Therefore, for preventive purposes, sufficient physical activity and proper rest, a rational diet high in plant foods, and cessation of smoking and alcohol abuse are recommended.

Source: https://www.KrasotaiMedicina.ru/diseases/zabolevanija_mammology/mammary-gland-involution

Involutive form of mastopathy

Having noticed age-related changes in the shape of the mammary glands, women immediately consult a doctor with suspicions of cancer. But most often this condition is explained by involutive changes in the gland. This is the norm for a woman in menopause and is called “involutive mastopathy.”

Symptoms of the disease

Involutive mastopathy is difficult to recognize by any external manifestations. The only thing a woman can notice is that the glands have become softer and flattened. The breast glands may also increase in size.

Sometimes the changes are accompanied by mastodynia - painful sensations and heaviness in the glandular tissue.

An accurate diagnosis can only be established by performing a mammography, which will clearly show glandular lobules, connecting cords and lymph nodes.

The most active involution process occurs in the lower and inner regions of the gland. The upper outer area remains unchanged for a long time. Since adipose tissue does not appear as a shadow on an x-ray, the affected part of the gland on mammography looks almost transparent, only the milk ducts, large arteries and vessels are visible.

With the fibrous type of involutive mastopathy, there is an accumulation in the gland of a large number of compactions formed by connective tissue. Fibrous cords in the image sometimes resemble concentric stripes that form in the lower part of the gland due to stretching of the skin.

Involutive changes can also affect the axillary lymph nodes, which will appear on the image as rounded shadows with a light center, while a healthy lymph node has only a small notch in the hilum area.

Causes of involutive mastopathy

The main cause of the development of the disease is a hormonal imbalance, in which the production of estrogen decreases, which leads to thinning of the glandular tissue and its replacement with fat. In women over forty-five years of age, such a decrease in estrogen secretion is normal.

Involutive changes can begin earlier, at 35-40 years of age and last until the onset of menopause, when the breasts significantly decrease in size. In some cases, instead of shrinking, the mammary glands become enlarged.

The final stage of the involutive process is the complete replacement of the breast lobules with fat, as well as the maximum thinning of the skin.

In women of childbearing age, a hormonal imbalance can be caused by any gynecological disease. In this case, involutive changes are considered a serious pathology requiring immediate treatment.

In addition to gynecological diseases, the following factors can provoke a violation of estrogen secretion in a woman:

• smoking, alcohol and other bad habits;
• chronic lack of sleep;
• inactive lifestyle;
• malnutrition;
• lack of walks in the fresh air;
• late pregnancy (after thirty-five years) or multiple abortions;
• lack of lactation.

Treatment of involutive changes in the mammary gland

Since this type of mastopathy is a consequence of a malfunction of the hormonal system, to solve the problem you must first find out and eliminate the cause that caused the malfunction.

Most often, the patient is prescribed hormone replacement drugs, designed to normalize the hormonal balance in the body.

If pain occurs, painkillers, sedatives and anti-inflammatory drugs can be prescribed.

Regular physical activity, healthy, full sleep and spending time outdoors have a good effect. To avoid the development of gynecological diseases, it is necessary to periodically (at least twice a year) visit a mammologist and gynecologist, who will help to identify the disease in time and eliminate it at an early stage.

To summarize, let’s say that depending on the woman’s age and the presence of concomitant diseases, involutive mastopathy can be a pathology in one case and the norm in another.

Be that as it may, you should not delay your visit to a mammologist, since it is he who will determine whether such changes are normal or require intervention, and will also select an appropriate treatment regimen.

Source: http://VashMammolog.ru/mastopatiya/involyutivnaya-mastopatiya.html

Involutive mastopathy: symptoms and treatment

Most women during menopause turn to a specialist with various questions regarding their breasts. They believe that changes in the glands occur only during cancer. But after examination, the doctor diagnoses involutive mastopathy.

• Pathology and norm
• Symptoms of the disease
• Treatment

During diagnosis, involutive changes can be detected starting from the age of 35, with each year the symptoms gradually increase. The skin begins to thin and the fat layer increases. The glandular tissue gradually decreases - first of all, fat accumulations appear between the lobes. Despite the thinning of the connective tissue cords, they begin to emerge more clearly.

The process of involution progresses in the inner and lower parts of the mammary gland, after time it begins to appear in the upper outer square along with fibrous and glandular tissue.

The appearance of the breasts directly depends on the hormones produced by the body. Her condition is influenced by more than 10 different hormones. The condition of the glands determines the hormonal background and age of the woman.

Involutive mastopathy is directly related to hormonal imbalance; it may be associated with diseases of the genital area. Therefore, it is necessary to quickly find the cause of involutive changes in order to stop tissue degeneration.

Women who are at risk include:

• They have bad habits.
• Associated with heavy physical work.
• Eating irregularly or inadequately.
• They don't get enough sleep.
• They lead a sedentary lifestyle.
• Insufficient time is spent outdoors.
• Old-timers.
• Lack of lactation after childbirth.
• History of multiple abortions.

Symptoms of the disease

Mastopathy of this form is practically invisible during visual examination - it is clearly visible during diagnostic procedures.

The photographs clearly show the structure of the involuting mammary gland - light, almost transparent tissue with milk ducts and blood vessels. It has a coarse cellular structure with preservation of dense connective tissue and fibrous changes that extend in the radial direction.

Mastopathy with involutive changes in some cases can be considered both a serious pathology and a normal condition. It all depends on the woman’s generative functions, her age and existing diseases of the reproductive system. Only taking into account all factors does the doctor determine an individual treatment regimen for breast involution.

Treatment

Involutive mastopathy is treated primarily with hormone replacement therapy. If the disease begins to be accompanied by pain, the specialist prescribes suitable painkillers, sedatives and anti-inflammatory drugs.

Preventive actions include maintaining a healthy lifestyle, sleeping at least eight hours and eating fortified foods.

If you contact a specialist in a timely manner and follow all his instructions, there is a high percentage of stopping the pathological degeneration of tissue.

Source: http://oboleznjah.ru/involyutivnaya-mastopatiya-simptomy-i-lechenie/

Involutive changes in the mammary glands: what they are, signs and causes, types and need for treatment

Structure of the mammary gland

The process of fibrofatty involution is disrupted if other organs do not function properly

To understand what happens to a woman’s breasts during this process, we need to look at anatomy. The mammary gland is a paired organ. Its base is located on the pectoralis major muscle and on the serratus anterior. The glandular part of the mammary gland is disc-shaped and located at the base of the organ.

The posterior surface is attached by connective tissue to the fascia of the pectoralis major and serratus anterior muscles. The body of the mammary gland consists of lobes with their apices facing the nipples. They are separated from each other by layers of connective tissue. Just under the skin of the gland there is a layer of fatty tissue.

If it is not developed too much, granularity is determined by palpation. These are small processes of glandular tissue.

The active stage of organ development occurs until approximately 40 years of age. During this period, new milk passages appear to maintain the basic function of the breast.

During menopause, a gradual decline in the functioning of the organ begins, their tissue is replaced by connective and fatty tissue. This process is irreversible and becomes more noticeable with age.

During the postmenopausal period, the organ cannot perform its functions, glandular tissue is completely absent. The replacement process ends by age 60-70.

Fibrofatty involution of the mammary glands in adulthood is not a disease. These are changes that sooner or later begin in the body of every woman. Only in isolated cases is this pathological.

Normal breast cycle

The female breast is a part of the body that experiences significant changes several times throughout a woman's life. Its formation, condition and health are influenced by three main hormones: estrogen, progesterone and prolactin.

It is their action and level that will become the condition for the growth of glands during puberty, as well as, together with the hereditary factor, for breast size.

Naturally, hormonal disruptions or changes in the body will affect the mammary glands.

Fibrofatty involution

Glandular tissue in the process of involution is replaced by adipose and connective tissue

Fibrofatty involution of the mammary gland is the age-related replacement of healthy glandular tissue with adipose and connective tissue, that is, fibrous (ICD-10 code No. 64). This process is two-way. The woman’s body loses its reproductive function and its gradual restructuring begins, since the organ is no longer needed to feed the child.

Reverse development of the mammary gland in old age is normal. Mammologists do not consider this condition a disease. However, periodic examination is recommended to monitor tissue structure.

If such a condition of the mammary gland is detected by ultrasound or mammography in a young nulliparous woman, this is a serious reason to consult a specialist - an endocrinologist, mammologist, gynecologist and undergo a full examination. In such cases, FGI is a serious pathology associated with hormone levels and requires treatment.

Types of involution

After 40 years, a woman needs to undergo regular mammography to monitor the process of involution.

The reproductive period of a woman is characterized by a high content of glandular tissue and a small amount of fat. Fibrous tissue forms a kind of frame that supports the breast. There are 4 types of process:

1. The replacement of glandular tissue with adipose tissue, in which the volume of connective tissue is preserved, is called fibrofatty involution. Another name is fibrous mastopathy with the phenomenon of fatty involution.
2. In the case of replacement of glandular tissue with connective tissue with the formation of cysts, they speak of fibrocystic mastopathy (FCM).
3. Natural involution, which begins at 40-45 years of age and is characterized by a predominance of adipose tissue. Sometimes this process is quite active. In this case, mammology speaks of fatty invasion.
4. A premature process occurring due to the development of certain pathologies or during the post-lactation period.

Pathological involution has certain signs and symptoms.

Complications

The main negative consequence of age-related involution is breast sagging (mastoptosis), which is perceived by some women as a cosmetic defect. Sometimes, with significant ptosis of the mammary glands, the skin under them macerates. Due to the presence of painful sensations, the patient may develop emotional disorders in the form of mood lability and irritability.

Women with fibrocystic involution who find lumps in the breast sometimes experience cancerophobia. There is currently no statistically reliable data on the malignant degeneration of involuting cysts, however, since the risk of malignancy cannot be completely excluded, dispensary observation is recommended for such patients.

Among the negative consequences of FJI:

• mastoptosis – sagging gland;
• Maceration is a violation of the structure of the skin.

Many women suffer from cancerophobia - the fear of getting cancer.

Reasons for the development of involution

The cause of early involution may be problems in the woman’s endocrine system

Experts believe that the reasons for the early development of involution are:

• genetic predisposition;
• failure of the endocrine system;
• prolonged stressful situations;
• bad habits;
• some chronic diseases of internal organs.

Recently, a similar diagnosis has often been made to young women under 35 years of age. This is associated with uncontrolled use of hormonal contraceptives and frequent abortions.

Obesity plays a huge role in the development of pathological involution. With excess body weight, adipose tissue puts pressure on the blood and lymphatic vessels, as a result of which the flow of blood and lymph is hampered. Premature dystrophic disorders occur.

Symptoms of involution and risk group

After 40-45 years, lumps may appear in the mammary gland, which indicates a violation of the involution process

At the initial stage of development of the pathology, there are no symptoms. Further, a woman may experience the following symptoms:

• reduction in breast volume;
• decreased elasticity;
• the skin becomes flabby and covered with fine wrinkles;
• burning and tingling in the chest area;
• the appearance of small seals and knots;
• pain when pressing on the chest.

If one of these signs appears, you need to consult a doctor to conduct some research and clarify the diagnosis. Symptoms and treatment of fibrofatty involution of the mammary glands depend on the patient’s age and concomitant pathologies.

The risk group includes:

• women terminating pregnancy;
• nursing mothers who have abruptly stopped breastfeeding;
• nulliparous women;
• having bad habits;
• having irregular sex life;
• with a history of certain diseases;
• lovers of a deep tan (without a swimsuit).

These women should take care of their breasts to keep them healthy and youthful.

Sometimes involution begins against the background of some concomitant pathologies. Fibroadenomatosis is a benign disease associated with changes in the mammary gland - the proliferation of connective tissue. It is a type of diffuse mastopathy.

It has various forms: lobular, ductal, fibrous, cystic, proliferative. The proliferative type of fibroadenomatosis occurs when the septa of individual cysts merge.

This creates growths that eventually fill healthy cavities.

Fibroadenoma is also a benign pathology in which several types of tissue grow - glandular and connective. The disease develops due to hormonal imbalances in the body. Most often it affects young women and girls aged 15-35 years.

Involutive changes in the ovaries: what is it?

G. Savelyeva, Academician of the Russian Academy of Medical Sciences, Professor, V. Breusenko, Doctor of Medical Sciences, Professor, Yu. Golova, Candidate of Medical Sciences, Russian State Medical University

The period of a woman's life after the cessation of menstruation is called postmenopausal. Postmenopause - absence of menstruation for more than 12 months.

Menopause, characterized by loss of cyclic ovarian function, corresponds to the last menstrual period, the date of which is determined retrospectively. In the modern population of women, there continues to be a tendency towards an increase in the average age of menopause, which is approaching 52-53 years.

Involutive changes in the ovaries are a regression of the paired gonads, which manifests itself in the post-climatic period. Occurs approximately one year after menopause, that is, when menstruation is absent for at least 12 months in a row, and the woman loses the ability to have children.

Involutive changes in the appendages occur around the age of 50, but under the influence of hormones they can begin earlier or later.

Since the functional abilities of the ovaries regress, the production of sex hormones stops. The pituitary gland, on the contrary, begins to produce hormones more actively.

A woman’s appearance also undergoes significant changes: she gains weight, her voice deepens, and excessive hair growth may occur.

Involutive changes in the pelvic organs affect the ovaries and partly the uterus. Since the production of sex hormones is reduced, the ovaries and uterus lose their volume, and connective tissue grows. Follicles are not formed, there is no ovulation, so the corpus luteum also ceases to function. Because of this, there is a sharp decrease in progesterone, and then estrogen.

Compared to the body of a patient who has not yet entered the climatic and post-climatic periods, a woman over 60 years old has an ovary that is 2 times smaller in size and weight.

Post-climate regression of the reproductive system does not happen overnight. This process is long and gradual, lasting 3-5 years. During this period, the body is influenced by the nervous system, which also does not remain unchanged. A woman experiences sudden mood swings, irritability, depression, sweating, hot flashes, and asthenic syndrome.

The severity of symptoms is different for everyone, for some they cause obvious discomfort and significantly reduce the quality of life, for others they barely feel them. In the first case, hormonal therapy is prescribed to reduce unpleasant symptoms.

Diagnosis and treatment

Ultrasound can determine the type of mastopathy and predisposition to cancer

To identify the involution process, the following diagnostic measures are used:

• Ultrasound;
• mammography;
• MRI;
• blood analysis.

The main goal of all diagnostic procedures is the early recognition of precancerous conditions and the prevention of malignant degeneration.

At the slightest deviation from the norm, consultation with an oncologist is required. Often the doctor determines lymphadenopathy, which is a preliminary, working diagnosis indicating the development of pathology.

This condition is characterized by enlarged lymph nodes.

Mammographic examination of the breast should be done after 40 years, once every 2 years. This is a fairly effective way to recognize cancer and precancerous conditions. The accepted Bi-Rads classification is used for evaluation. She divides the results into 7 options - from 0 to 6. Moreover, if we talk about breast involution:

• bi-rads 1 – normal structure of glandular tissue;
• bi-rads 2 – the norm for women who are in menopause;
• bi-rads 3 – the beginning of the transformation of glandular tissue.

The main signs of changes that specialists identify during mammography are a significant decrease in glandular tissue, a predominance of fatty and fibrous tissue.

For benign tumors, the doctor prescribes a tumor marker test

Sometimes, if necessary, the doctor prescribes a blood test for a tumor marker, which helps identify the risk of developing breast cancer. When determining involutive restructuring, such an analysis is not necessary. It makes sense for benign formations and precancerous conditions.

Physical examinations of the breast should not be neglected. An experienced doctor will use palpation to evaluate the consistency, sensitivity, soreness, and compaction of the glands. The examination allows you to assess the shape, contours, symmetry and condition of the areola and nipples.

There is no data on the degeneration of involution into a malignant tumor, however, experts insist on an annual visit to the doctor and undergoing the necessary examinations.

There is no point in treating the age-related form of FGI. After diagnosis, the doctor will prescribe a follow-up study in a year. Every woman needs to periodically self-monitor her breast condition between visits to the doctor. If desired, and after the doctor's permission, you can use traditional methods of treatment.

Therapy for young women will be comprehensive, based on diagnostic results and concomitant pathologies. Hormonal drugs that stabilize the background and vitamin complexes are often prescribed. If the disease is accompanied by pain, analgesics are recommended.

Preventive measures

To prevent mastopathy, it is recommended to move more and lead a healthy lifestyle.

Preventive measures for women who want to prolong the youth of their breasts should include an active lifestyle, moderate physical activity, a balanced diet, drinking water, and daily walks. The chest reacts very negatively to stress loads, so it is important to do everything to reduce them as much as possible. Women also need to remember the benefits of vitamins for the mammary glands and the entire body as a whole.

It is important to understand the need to independently feed a child, to realize the harm from abrupt refusal of feeding and abortion.

Prevention

Naturally, every woman wants to keep her youth and her breasts in shape for as long as possible. Despite the fact that fibrofatty involution of the mammary glands is an irreversible process, its onset can be delayed. The following methods are recommended for this:

1. Active lifestyle and frequent walks in the fresh air;
2. Stable and sufficiently long sleep;
3. Proper diet, eating healthy foods and sufficient amounts of vitamins A and C;
4. Avoiding stressful situations at work and at home.

Source: https://medlazaret.ru/ginekologiya/involyutivnye-izmeneniya-molochnyh-zhelez.html

Involutive changes in the mammary glands: what is it?

One of the diagnoses that women hear at an appointment with a mammologist is involutive changes in the mammary glands. What it is? Is the process occurring in the chest dangerous? At what age do extensive adipose tissue, areas of fibrosis and cysts most often form?

Doctors give useful recommendations for preventing age-related processes and reducing the risk of hormonal imbalances. Women should know what to do when diagnosed with fibrocystic breast involution.

What it is

Reverse development of mammary gland tissue is in most cases a physiological phenomenon; there are no dangerous consequences for the body; drug and surgical treatment is not required. Natural change (involution) of breast tissue in women occurs with age: glandular tissue is gradually replaced by fat cells.

When hormonal levels are disrupted, the process becomes pathological, not only adipose tissue, but also fibrous tissue actively grows, and cysts of different sizes are formed.

The longer a woman postpones a visit to a mammologist when pain or changes in breast shape appear, the more active the pathological process is.

In most cases, breast involution occurs due to hormonal imbalances with the approach of menopause. If a woman monitors her health, takes phytoestrogens and vitamins for preventive purposes, and reduces the impact of negative factors (stress, lack of sleep, overeating, physical inactivity), then the involution of mammary gland tissue can be slowed down.

Physiological changes in the breast also occur during hormonal imbalances in other periods of life and in special conditions: pregnancy, puberty, lactation.

With gradual involution and the absence of concomitant diseases, there is no discomfort or pain: women note only a slight increase in the size of the mammary glands; after 60 years, the breasts become less elastic, sag, and the skin becomes flabby.

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Causes

The main factor that provokes the replacement of glandular tissue is hormonal imbalance.

The ratio of the level of regulators develops both during natural processes (puberty, lactation, pregnancy, menopause), and during the development of endocrine pathologies and reproductive dysfunction.

A decrease in estrogen concentration and changes in the secretion of other regulators also occur in old age (60-65 years or more).

Many women monitor the condition of the reproductive and reproductive systems, devote a lot of time to training, proper nutrition, and reduce the frequency and severity of stress.

A balanced approach to maintaining health gives positive results.

A consistently high concentration of hormones with mental balance, the absence of severe chronic pathologies, and self-care increasingly leads to the fact that even at 55-60 years old, the condition of a mature woman’s breasts remains virtually unchanged.

Factors provoking accelerated involution of the mammary glands:

• endocrine diseases,
• life under stress,
• sleep deficit,
• chronic fatigue,
• morbid obesity,
• gynecological diseases,
• lack of attention to health,
• rare visits to the mammologist,
• unhealthy diet
• frequent hypothermia of the chest,
• uncontrolled use of hormonal pills,
• fasting or low-carb diets,
• a sharp decrease in the volume of the fat layer to critical values.

Note! If there is no desire to pay attention to health, control weight and psycho-emotional balance, then irreversible changes in the structure of the mammary glands occur much earlier: by 2540, the breasts are flaccid, flabby, cysts, fibrous foci, and areas of compaction are formed. The more hormonal balance is disturbed, the brighter the manifestations of age-related and pathological processes in the breast.

Types of pathological process

Doctors distinguish several types of reverse development of breast tissue:

• fatty involution. At the end of the lactation period and with the onset of menopause, the hormonal levels are unstable, and adipose tissue actively grows. With this type of involution, the mammary gland is lighter than usual in the images, connective tissue fibers, milk ducts and blood vessels are clearly visible. In nulliparous women and young girls, fatty involution indicates a hormonal imbalance. To exclude advanced stages of pathologies, it is necessary to be examined by an endocrinologist, stabilize hormonal levels,
• fibrocystic involution. Pathological process: not only does the total proportion of glandular tissue decrease, but also zones of fibrosis form in the breast tissue, and cystic formations appear. Benign elements are capsules filled with liquid contents. As inflammation develops, the secretion becomes inflamed, pus and blood appear. On palpation, large cysts feel like elastic balls or nodes. In advanced cases, the percentage of glandular tissue is significantly reduced, the structure of the breast is damaged,
• fibrous involution. With age, glandular tissue degenerates: extensive areas of fibrosis appear. Often the active proliferation of connective tissue is combined with the replacement of glandular cells with fat cells. For this reason, the process is called fibrofatty involution.

First signs and symptoms

In the absence of breast lesions and chronic pathologies, unpleasant sensations during the reverse development of the mammary glands are absent or mild. Some women complain of mastodynia (chest pain). Sometimes discomfort is felt in the thoracic spine and shoulder blade area.

The natural process of changes in the mammary glands occurs in several stages:

• from 25 to 40 years. Fluctuations in hormonal levels occur before menstruation, during puberty, pregnancy, and breastfeeding. The volume of glandular tissue is sufficient, there is no pain or pathological changes, the channels are normal,
• from 40 to 50 years. As the body ages, the first signs of reverse development in the breast appear: the area of ​​fibrous and adipose tissue increases, tumors, papillomas, fibrocystic mastosis, fibroadenomatosis,
• from 50 to 55 years. Age-related processes are more active; connective and adipose tissue are clearly visible on chest X-rays and ultrasound; there are much fewer glandular cells than in young women;
• age over 55 years. The glandular tissue is completely replaced with adipose tissue, the structure and appearance of the mammary glands changes. In old age, with a deficiency of sex hormones, the breasts are less elastic and often sag. In the absence of pathologies, there are no seals or knots.

Diagnostics

To clarify the condition of the breast, women are prescribed an ultrasound (the optimal method up to 3540 years old) or mammography (breast x-ray is performed after forty and in complex cases of pathologies in young women). If pathological changes are detected, the mammologist additionally prescribes thermography, MRI, and ductography.

It is necessary to donate blood for hormones: for a comprehensive diagnosis, the doctor must know the level of FSH, progesterone, LH, prolactin, testosterone. If diabetes is suspected, a woman undergoes a laboratory determination of her glucose level. If there is a suspicion that the endocrine glands are affected, then it is necessary to find out the degree of secretion of hormones from the thyroid gland, pituitary gland, and hypothalamus.

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General rules and methods of treatment

In the absence of neoplasms and pronounced discomfort, specific therapy for breast involution is not carried out. A mandatory element is periodic monitoring of the condition of the mammary glands using mammography (no more than once a year) and ultrasound (every six months or less often, as prescribed by a mammologist).

It is important to clarify the etiology of fatty and fibrocystic involution. If the process is active, a decrease in the volume of glandular tissue occurs at a young age, then the doctor prescribes specific hormonal therapy.

With active growth of cysts, laparoscopic treatment is performed to remove the contents of the cavity.

Preventive recommendations

It is impossible to completely stop breast involution, but with attention to health, women can slow down the process of reverse changes in the tissues of the mammary glands. Prevention of diseases, stabilization of hormonal levels are important points of prevention.

Doctors' recommendations:

• move more, do morning exercises, walk, visit a sports section or fitness club, regularly and to the extent possible, do swimming, yoga,
• create a comfortable environment in the family, reduce stress at work, change your occupation if you have to endure nervous overload every day,
• eat right, monitor the quality of food, eat less processed foods, fast carbohydrates, smoked foods, fried foods, strong coffee and black tea,
• get full rest at night (at least 7 hours), but do not sleep until lunchtime,
• drink less alcohol, don’t smoke,
• control your weight, remember the dangers of abdominal and visceral obesity. You cannot transfer or receive food at night. It is very difficult to combat such a problem as morbid obesity in women: it is necessary to use surgical methods of treatment,
• Have your breasts examined by a mammologist every year, and have a medical examination after forty years. If you have a genetic predisposition to diabetes mellitus or thyroid diseases, visit an endocrinologist. Examination by a gynecologist 2 times a year should become the norm.

Breast involution is a natural process. The nature of nutrition, lifestyle, level of physical activity, and psycho-emotional state of a woman determine how actively changes occur in the tissues of the mammary glands.

The less often a serious hormonal imbalance develops throughout life, the lower the risk of pathological processes in the breast.

If you follow preventive measures, you can postpone the reverse development of mammary gland structures to a later date.

Attention!

The site administration advises you not to self-medicate, and in any controversial situations, consult a doctor.

Source: https://fr-dc.ru/gormony/chto-takoe-involyutivnye-izmeneniya-molochnyh-zhelez-kak-lechit-formirovanie-obshirnogo-massiva-zhirovoj-tkani-uchastki-fibroza-i-kisty