Mammary dysplasia in the practice of a gynecologist

• Tatiana S. Kononenko
• Lyudmila Yu. Karakhalis
• Grigoriy A. Penzhoyan

Abstract

The prevalence of benign mammary dysplasia (BMD) is unprecedented in our time. According to some authors, its frequency is 50% or higher. Mastopathy is based on hormonal disorders, often combined with diseases of the pelvic organs (uterine fibroids, genital endometriosis, endometrial hyperplasia). The pathogenesis is based on absolute or relative hyperestrogenism, insufficiency of the luteal phase of the cycle, hyperprolactinemia, impaired receptivity of mammary gland tissues (MG), increased prostaglandin levels, and the launch of insulin-like growth factors. Such a diverse pathogenetic mechanism forms the clinical picture of hyperplastic syndrome in the reproductive system.

The aim of the study was to determine the severity of mammary dysplasia in proliferative diseases of the reproductive system.

Material and methods. Thirty-seven women with BMD were examined. A comprehensive examination was carried out: collection of general and gynecological anamnesis, physical examination, ultrasound examination of the breast, an overview mammography. The presented data were processed using Microsoft Excel (2010), Statistica 13.3 (USA, Tibco).

Results. 45.9% of patients with mastopathy had an increased mammographic density, which indicates a high degree of dysplasia and characterized by increased risks of breast cancer. The cystic type of mastopathy prevailed over the fibrous and glandular types, which is typical for all gynecological diseases. 81.1% of patients with mastopathy did not use hormonal contraception. There was a short duration of breastfeeding. The article presents four profiles of patients with a long course of mastopathy, the same type of mammary gland density and aggravated/not aggravated gynecological history, using hormonal contraception and barrier methods. It was found that hormonal contraception does not have a negative effect on the course of mastopathy and reduces the severity of mastodynia.

Conclusion. Proliferative diseases of the reproductive system were accompanied by increased mammographic density in 45.9% and cystic type of mastopathy in 67.6% of patients.

Keywords: benign mammary dysplasia; proliferative diseases; mammographic density; hormonal contraception

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