The causes of pain in the breast , diagnosis and treatment of pathological changes

Pain in the breast more or less concerned about more than half of all women.It ranges from mild discomfort to excruciating burning and weight, reduce quality of life.Therefore it is very important to find the cause of pain, and then choose an effective treatment.

How are your breasts?

The female breast is composed of glands, ducts divided into lobules, connective tissue and fat.The predominance of glandular and fibrous (connective) tissue depends on the age, hormonal levels, weight and characteristics of the organism.But the breast of every woman - a body which is constantly changing along with the menstrual cycle (see the reasons for irregular menstruation.).Hormonal transformations are as follows:

first 14 days (28-day cycle) in the ovaries of mature follicles active.By mid-cycle follicle ruptures and releases the egg.This is combined with a peak emission of estrogen.After the release of the egg in place of the follicle forms the corpus luteum.This phase is characterized by the production of progesterone.If conception does not occur, the corpus luteum gradually fades, and the level of both hormones by the end of the cycle is reduced.There is menstruating.

great influence on the mammary gland has a female hormone - estrogen.It causes an increase in the number of glandular cells, connective tissue cells.These cells line all the ducts in the breast.Excess estrogen can turn a group of glands in the cyst.In most cases they are safe and require no treatment.

Progesterone, rising in the second half of the cycle, causing swelling, improves blood circulation and leads to painful feelings during the premenstrual period.This is due to the preparation of glandular breast cells to the eventual release of milk after pregnancy.

Cyclic pain (mammalgia) - pain before menstruation

Most of all complaints of chest pain is associated with the cyclical changes in the female body.For such a condition characterized by:

  • beginning of pain for a few days before menstruation
  • subsidence of pain with the onset of menses, they disappear after a month
  • significant reduction or disappearance of pain during pregnancy and after menopause

Such complaints are found mostly in womenfrom 17 to 40 years, with middle and large size breasts.Pain in the breast, which is the cause of ovulation, usually bilateral, most pronounced in the upper outer quadrant of breast

pain as a symptom of PMS

cyclic pain, recurring every month, may be part of premenstrual syndrome.Other signs of this unpleasant condition include:

  • Irritability and sudden mood swings
  • Worry and anxiety
  • Increased appetite
  • Abdominal pain, bloating

main feature of premenstrual breast pain is a complete lack of symptoms prior to ovulation.The first half of the menstrual cycle is painless, and after 14 days gradually increase the above-mentioned complaints.Peak pain accounts for 2-3 days before menstruation.

Those or other symptoms of PMS say at up to 80% of women.Almost all of them are breast tenderness - one of the main symptoms.This condition is not dangerous for life and health.Some people believe that women with monthly breast pain and seals are at risk of cancer.Currently, there are no data on the relationship of cyclic pain in the breast and breast cancer.

Most often pain occurs on the background of existing diffuse fibrocystic mastopathy.This is not a disease but a special condition of the female breast, in which there is a uniform growth of glandular and fibrous tissue.No effects besides discomfort, it does not.


non-cyclic

  • with cysts in the breast
  • in benign and malignant tumors
  • with injuries and after
  • operations of medication (hormones, antidepressants)

In rare cases, the pain is not associated with the menstrual cycle.Usually unpleasant sensations occur when cysts, tumors, traumas and other pathologies in the breast.Non-cyclic pain is often unilateral and localized.That is, a woman can clearly show the place in which there is discomfort (eg, localization of pain in the right breast around the nipple).

  • nodules
  • Cysts breast
  • fibroadenoma
  • Inflammatory processes
  • reaction to the implant
  • Acute mastitis
  • Laktotsele
  • Malignant tumors
  • Paget's disease

cyst breast

breast cyst - a cavity filled with fluid.It is believed that almost every woman has one or more small cysts.They arise normally during the menstrual cycle.But sometimes cysts grow large and cause pain and discomfort possessor.

If a careful examination and ultrasonography revealed no cancer threat, the small cysts usually do not touch, and the treatment prescribed is the same as in diffuse mastopathy.If cysts suspicious (with parietal component is very large, inflamed) and cause severe pain, it carried out an operation to remove them.

fibroadenoma fibroadenoma - a benign tumor in the breast.It is a rounded education in the chest, usually painless, and smooth moving.But depending on the location and size of the site can experience pain and discomfort, which lead a woman to the doctor.

fibroadenoma arise on the background of hormonal fluctuations, often - in young women of childbearing age.Unlike diffuse fibrocystic mastopathy, fibroadenoma require biopsy.To eliminate the cancer in the host introduced a special needle and pumped out of the cells, which are examined under a microscope.After confirming the diagnosis fibroadenoma removed.Along with her leaving pain and anxiety about cancer.

Laktotsele

Laktotsele - a cyst in the breast, filled with breast milk.As a result of trauma, congenital abnormalities or inflammation occurs in the chest scar, preventing normal lactation.Milk stagnates accumulates, forming a cyst.It grows, causing a feeling of fullness and pain in the chest.In some cases it may occur nagnaivanie - abscess.

Laktotsele is a soft, mobile education.When milk puncture released therefrom.To relieve pain puncture is not enough, need a small operation to remove the cyst.

lactostasis

main reason laktastaza, unlike laktotsele is unsteady rhythm of feeding.Increased milk production and its consumption small child leads to stagnation in the chest.Symptoms usually manifest themselves very quickly:

  • seal in the chest
  • tension and bloating
  • aching chest

In rare cases, the pain can join a small increase in temperature.All these are symptoms in the first 3-4 months after birth, when the mother and baby are not included in the rate of a single lactation.

main treatment lactostasis considered active feeding.A first portion of milk can express to facilitate sucking.In the first few months it is recommended to feed the baby on demand, regardless of the time of day.If lactostasis stop feeding the affected breast, the amount of such a valuable milk therein can be reduced, leading to further problems.

Mastitis Mastitis - inflammation in the mammary gland.The most common variant of the disease lactation arising on a background of breastfeeding.And in most cases, mastitis is preceded lactostasis.The stagnation of milk in combination with cracked nipples allow bacteria actively proliferate.As a result, the breast swells, becomes red and hot to the touch, causing severe pain.The general feeling is usually characterized by weakness against the backdrop of increasing the temperature to 39 degrees.

diagnosis of mastitis is easy.It is much harder to cure it, while maintaining the normal lactation.The drugs are considered first-line antibiotics.They are appointed by a doctor after the examination.When a serious condition and there is no effect from the drug may require incision to drain the pus.In any case, it is important to maintain lactation at the recommended level.

Trauma Breast

Injury to the breast is rare.Commonly found bruises and abrasions after falling, accidents and other mishaps.If the injury occurs in the chest hematoma (accumulation of blood, bruise), then after a considerable amount of time can appear the pain and discomfort.Therefore all mammary hematoma puncture and require removal to prevent inflammation.

Pain in

implants after surgery for reconstruction or breast augmentation pain - is the norm.It will take time to heal scars and "addiction" to the new size.But sometimes the implant causes chronic or acute inflammatory reaction or compresses the nerve endings.In this case, you need to consult with a plastic surgeon about reoperation.

Cracked nipples

Almost all women after childbirth experience unpleasant sensations in the nipples.Constantly hungry baby requires hourly feeding, and the milk is still very small.Friction leads to skin itching, burning and pain in the nipples.In the most unpleasant sensations arise with the appearance of cracks.Dry skin on the breast leads to cracking of the nipple - painful condition.Sores and wounds do not have time to heal between feedings, which delays healing.In such cases, we recommend frequent lubrication nipples Bepantenom, Depantenolom and other similar creams (see. The treatment of cracked nipples).They do not harm the baby, but quickly heal cracked.In severe infected wounds is sometimes necessary to restrict the stay of the child "on his chest" to subside the symptoms.


Pain not associated with breasts

  • intercostal neuralgia spread is not very wide (in rheumatoid diseases, SARS)
  • syndrome Tietze
  • postherpetic neuralgia

syndrome Tietze

disease Tietze, but still sometimesoccurs.The symptom is that the state of pain and swelling in the area of ​​the cartilage of the ribs.The causes of disease are not known, the condition may worsen inadequate physical activity and stress.In women, this syndrome is often disguised as breast pain.Delete the disease is fairly easy: hold enough chest X-ray and to pay special attention to the costal cartilages.What is a specific treatment of Tietze syndrome yet, with severe pain using standard NSAIDs.Quite often, after the syndrome disappears by itself change physical activity.

Shingles

virus Herpes zoster, causes at the first ingestion of chickenpox leads to shingles (cm. Cold sores on the body).It's pretty painful condition associated with blisters, burning pain and itching.Most often affects the skin and nerves in the lumbar area (hence the name of the disease).If the rash has appeared in the chest area, it is possible to confuse this itch and pain under the breast with signs of mastitis.Therefore it is very important to inspect the chest for bubbles and redness.Soreness rash disappears after 2-3 weeks, the condition much easier antiviral therapy (acyclovir, and other drugs, see. ointments for herpes).

Breast Cancer

most formidable of all the causes of breast pain is considered to be breast cancer.This tumor, which occupies the first place among oncological processes in women.In addition to the high prevalence of this cancer is still dangerous and high mortality, as many women are putting off going to the doctor until the last.

cancer risk factors of breast

  • early menstruation, late menopause, lack of childbirth and pregnancy
  • Obesity
  • Age over 60 years
  • Transferred earlier breast cancer, ovarian or bowel
  • Oncological processes above bodies and the nearest relatives (mother, sister, grandmother)

Among all these factors, one predominates: the impact of estrogens on mammary gland.It must be remembered that the usual diffuse breast, cyclic breast pain before menstruation are not risk factors and causes of cancer.

heredity, burdened with cases of cancer, requires careful attention to health.Up to 10% of cancer in the breast is considered the result of genetic damage.The presence of specific genes BRCA1 and BRCA2 increase the risk of cancer in tens of times.So chest pain in women whose relatives suffered from breast cancer, demands special treatment and special studies.

Symptoms of breast cancer

small tumors without metastases often do not cause any discomfort.Pain will only appear if "failed" the location next to the nerve endings.Therefore, an important step in the early diagnosis of breast self-examination is a woman.

particular form of cancer is considered to be a cancer Paget.It is localized in the area of ​​the nipple, causing its deformation and retraction, as well as pain on the left or right of it.

Treatment of breast cancer

In the initial stages of the disease, when the cancer has not spread beyond the breast or nearby lymph nodes, usually used a complex treatment.It includes surgery to remove the cancer, chemotherapy and radiation.Depending on the type of tumor may be applied hormones.Sometimes too much of the tumor is reduced by chemotherapy and then removed.The volume in our country surgery usually great: clean the breast, lymph nodes, and the underlying muscles.In European countries, women detect the disease at a much earlier, so they used a partial resection of the breast with cosmetic sutures.

methods of breast examination

When the pain in the breast need to undergo a series of trials.They will help determine the cause of discomfort, to eliminate life-threatening condition and choose the appropriate treatment.

BSE

Lying - to examine the right breast under the right shoulder pad is placed, and give birth to his right hand behind his head.Use your fingertips to examine the entire breast in a circle, from the periphery to the nipple.
Standing - survey conducted in two positions: with the lowered and raised his hands.

What to look for when examining:

  • seal any shape and size.Particularly: with irregular contours, stationary, large size.
  • Indrawing nipple
  • Discharge from the nipple of any color (except milk during pregnancy and lactation)
  • Changing breast size (asymmetric)
  • Changing the breast skin by the type of "lemon peel»
  • Change skin color (redness, blue)and its temperature
  • Tenderness to palpation
  • presence of ulcerations in the skin of the breast

All these features - it is an occasion to refer to a specialist.So your doctor may be mammolog, gynecologist or therapist.If doctors have any concerns about the health of the woman, but he sends it to further examination and consultation with an oncologist.Inspection and palpation of the breasts of women helps to detect breast cancer in its early stages.But in fairness it should be noted that most of the tumors found the woman alone.They are benign and do not require treatment.

Breast examination at pains appearance

Mammography - an X-ray examination of the breast.The method is the standard diagnostic pathology of the breast in women over 40 years.It allows you to assess the condition of the tissues of the mammary glands, the prevalence of disease, the nature of the growth of the tumor process.But if the dense glandular component predominates in the breast, mammography becomes uninformative.Therefore young women holding ultrasound instead of X-ray is recommended.