Is it possible to install an implant for breast fibroadenoma?

The health of a woman's breasts is inseparable from the health of the body as a whole. But often, even with undisturbed general health, a woman may be bothered by discomfort in the mammary glands. This is how mastopathy manifests itself - a common pathology of the mammary glands. Why does it occur? What threats does it pose and how to deal with the problem? Mammologist-oncologist at the Women's Medical Center, a doctor of the highest category, Irina Petrova, .

What is mastopathy of the mammary glands

The pathological condition develops against the background of hormonal imbalance. It is preceded by excessive production of the hormones estrogen or prolactin, which causes the glandular tissue in the breast structure to grow and increase in volume. Increase the risk of disease:

disruption of the thyroid gland and decreased production of hormones;
obesity;
liver diseases;
gynecological diseases;
stressful situations.

In recent years, the number of women suffering from this disease has been growing rapidly. According to mammologist-oncologist Irina Petrova, pathology is detected in 97% of women who come for an appointment. The specialist attributes this to the deterioration of the environmental background, which causes gene mutations and widespread disease. And also with the changing lifestyle of a modern woman.

“Previously, women often gave birth and breastfed for a long time,” comments Petrova. — During pregnancy and breastfeeding, mastopathy does not develop. But it is impossible to speak unequivocally about reducing the risk of the disease with frequent childbirth, since a complex of reasons leads to the development of pathology: genetic failure, hormonal imbalance, stress. All this causes changes in the mammary glands.”

Breast surgery and fibrocystic disease

Every woman wants to feel beautiful and desirable, to have a full, toned bust. For some, it is not a problem to undergo breast surgery, but for others, they do not know whether they can afford the miracle of surgery. The reason for this is a health condition called mastopathy or cystic fibrosis disease.

Many conservative methods (massage and any procedures that stimulate blood flow to the gland tissues) are not available to women suffering from this disease. Is surgical breast enlargement possible for mastopathy? This question worries thousands of women. After all, every third person, according to statistics, is familiar with one of the forms of this disease.

If this topic is relevant to you, we are happy to improve your mood. In general, mastopathy is not a contraindication for mammoplasty, including augmentation.

Is it possible for you to have surgery? An accurate, reliable answer is not possible without consulting a mammologist. Only after this specialist gives the go-ahead for surgery, the plastic surgeon evaluates his skills, your condition, and says a confident “yes.”

If the cherished “yes” has been heard, remember, endoprosthetics is not a reason to stop treating mastopathy. The disease is chronic and requires constant medical supervision.

The only real inconvenience associated with prosthetics awaits you at an appointment with an ultrasound diagnostician. In some cases, the presence of an endoprosthesis reduces the reliability of the information obtained from an ultrasound examination.

Types of breast mastopathy

Pathological tissue growth in the breast structure occurs unevenly. In this case, small cavities filled with liquid contents, the so-called cysts, can form in the mammary glands. In this case, cystic mastopathy is diagnosed.

The proliferation of glandular tissue may be accompanied by its transformation into connective tissue, with the appearance of scar changes. This process is characteristic of fibrous mastopathy.

Often the processes occur simultaneously: the formation of multiple small cysts and the formation of fibrous tissue allows the doctor to diagnose fibrocystic mastopathy.

“The disease is distinguished by the component, the content of which increases in the mammary glands,” clarifies Irina Petrova. — Mastopathy can be cystic, fibrous or glandular. But, from the point of view of danger, for a woman the disease is divided into two types - diffuse and nodular.”

Mammoplasty for fibrocystic mastopathy: what patients need to know

According to the observations of doctors, pathological changes in the tissues of the mammary glands are present in almost 90% of women. In approximately half of cases, the disease first appears in adolescence or young adulthood. Does this mean that only the remaining 10% will be able to restore the former attractiveness of their bust or change its shape? Not at all.

Breast plastic surgery for fibrocystic mastopathy (FCM) is a routine operation for most surgeons. The presence of nodes, cysts and seals is no longer a strict contraindication, although sometimes it requires additional actions from both the doctor and the patient.

How will the presence of silicone implants and the fact of surgical intervention affect the course of the disease? How to prepare for plastic surgery under these conditions and what to do after it? TecRussia.ru finds out together with our regular expert, plastic surgeon Ilya Sergeev from the DoctorPlastic clinic:

↑ What is FCM and what types does it come in?

Mastopathy (fibrocystic disease) is a common pathology, which is based on an imbalance of the glandular, epithelial, fatty and connective tissue components of the breast.

Glandular tissue is responsible for milk production, epithelial tissue lines the milk ducts. Fat determines the shape and size of the bust. Fibrous cords and layers hold this entire structure on the surface of the chest.

The correct ratio of all components is determined by the woman’s hormonal background. The leading role is given to estrogens and progesterone. However, prolactin, insulin, thyroid hormones, gluco- and mineralocorticoids can also contribute to the development of pathological changes. In fact, any disruption of the endocrine system affects the condition and functioning of the breast.

There are two forms of mastopathy: diffuse, when pathological changes cover all parts of the mammary gland, and nodular, when the altered structure is localized in a separate area of tissue. Their symptoms and external manifestations are sometimes indistinguishable without instrumental studies (ultrasound, mammography, CT or MRI). At the initial stages, the disease can make itself felt by periodic nagging pain in the area of the mammary glands, then local and diffuse compactions appear in the tissues. But sometimes patients find out about the problem only during a routine examination.

↑ Is it possible to do breast surgery for nodular and diffuse forms of mastopathy?

FCM is not a contraindication for aesthetic surgery. Patients with cysts and nodes can have their bust size increased or decreased, have a lift, and correct the nipple-areolar complex. The presence of a silicone implant does not interfere with a full examination of the mammary glands and early detection of oncological pathologies.

Sergeev Ilya Vyacheslavovich Plastic surgeon, Candidate of Medical Sciences, leading specialist in breast plastic surgery at the DoctorPlastic clinic

The only contraindication is if there is dynamic growth of the node, a noticeable increase in its volume. In this case, it is necessary to monitor the situation and postpone the plastic surgery for a while. If we are talking about small cysts, slight fibrosis, then surgery can be done.

↑ Features of preparation and conduct of the operation

In addition to standard tests, patients with fibrocystic disease will need to undergo an ultrasound, MRI or CT scan to clarify the size and condition of the formations. The need for any additional studies is determined by the surgeon and the attending physician individually, taking into account the stage, form and severity of mastopathy, and the presence of concomitant diseases in the woman.

Sergeev Ilya Vyacheslavovich Plastic surgeon, Candidate of Medical Sciences, leading specialist in breast plastic surgery at the DoctorPlastic clinic

The presence of a mammologist during the operation itself is not required: the plastic surgeon is able to independently remove all cysts and fibroadenomas. In this case, nodes with a diameter of more than 1-1.5 cm are then sent for histology. Small formations (several millimeters), as a rule, are not removed, but in the future they require dynamic monitoring.

After surgery, as before, it is extremely important to undergo annual examinations and, if necessary, treatment. Left unattended, mastopathy, firstly, can reduce a woman’s quality of life, create significant discomfort, and secondly, it is associated with the risk of developing serious oncological and gynecological diseases.

↑ What else do patients with FCM need to know?

Not with all forms and stages of mastopathy development, aesthetic breast correction is possible immediately after the examination. In some cases (for example, with large, rapidly growing nodes), a mammologist may prescribe conservative treatment or recommend dynamic observation for 3-6 months.

A delay in mammoplasty should not be perceived as a disaster. A hasty breast lift or breast augmentation can solve one problem and create a whole series of new ones. It is much easier to wait time, undergo the necessary course of treatment and only after that return to the issue of aesthetics.

Sergeev Ilya Vyacheslavovich Plastic surgeon, Candidate of Medical Sciences, leading specialist in breast plastic surgery at the DoctorPlastic clinic

Almost 90% of my patients have FCM in one form or another, and this is not a clear contraindication to endoprosthetics. In fact, implants have nothing to do with the mammary gland - they are installed under the pectoralis major muscle and provide a visual image of the breast. But mastopathy “exists” on its own: it needs to be observed and calmly treated by a specialized doctor.

Features of diffuse mastopathy

With this pathology, the component is distributed evenly in the mammary gland. The breasts may become painful, and discomfort intensifies on the eve of menstruation. As the disease progresses, the discomfort becomes constant, and during self-examination of the breast, lumps that were not there before may be felt.

Diffuse mastopathy worsens a woman’s quality of life, causing discomfort and constant anxiety. But the disease itself does not pose a threat to life. Your health can be corrected with timely, comprehensive treatment. Doctors today have enough tools in their arsenal to help normalize a woman’s condition.

Contraindications for surgery

Close attention has been paid to the mammary glands for decades. These include numerous operations to correct shape and size, as well as the development of advanced technologies that make it possible to diagnose benign and malignant diseases in the early stages due to the increase in breast cancer throughout the world.

Even 10 - 15 years ago it was believed that mammoplasty should not be performed for mastopathy of any form. The material used for endoprosthetics increased the risk of malignant neoplasms, and sometimes the cancer was simply not diagnosed before the operation, although it was already at an early stage.

Today, mastopathy in 95% of cases does not in any way affect the possibilities of mammoplasty. This is due to the following:

Only high-quality and absolutely safe implants are used;
There are various methods for installing an endoprosthesis; preference is given to one method or another in a specific situation;
there is a large arsenal of diagnostic procedures that allow you to monitor the mammary glands after mammoplasty;
Histological examination methods have been improved, in which the benign nature of the process in the breast can be confirmed with 100% probability.

However, despite this, the feasibility and safety of mammoplasty is determined by the doctor in each specific case. The generally accepted practice is the following:

If formations (cysts or fibroadenomas) larger than 1 cm are found in the mammary glands, they must be removed. This can be performed during mammoplasty, then the material should be sent for urgent histological examination, and only after confirmation of benign growth can the operation be continued.
If this is not possible, or the surgeon does not have sufficient knowledge in this area, removal of the lesions occurs as a preparatory operation, and mammoplasty itself is performed a second time.
If mastopathy has a pronounced fibrous component, the likelihood of getting the expected result is less. This is due to the fact that such breast tissue is less extensible, and this creates certain difficulties when installing implants and subsequent uniform distribution of tissue on it.

In any case, the operating surgeon, when a woman who wants to perform mammoplasty comes to him, prescribes a set of examinations to clarify the presence of pathological processes in the organ.

The minimum includes the following:

Ultrasound examination of the mammary glands, and, if necessary, mammography.
A blood test for tumor markers; it is especially important to take them if any formations are detected. Most often this is SA-15-3.
Additionally, MRI or CT, ductography (examination of ducts) and others.

The danger of nodular mastopathy

With the development of this form of the disease, nodules—neoplasms—form in the mammary glands. Their size can vary: from small, about the size of a pea, to a walnut, if the woman “did not notice” the progression of the disease for a long time. The “knot” can be felt tactilely, the mammary glands become painful and enlarged, regardless of the day of the menstrual cycle. There may be enlargement of the lymph nodes in the armpits.

“The danger of nodular mastopathy is in the intensive division of cells in this area,” continues Irina Petrova. “It often occurs against the background of a cancerous process in the mammary gland, when one of the ducts is already blocked by tumor cells. Therefore, nodular mastopathy is usually removed surgically, but not because the disease itself or the lump that has formed in the mammary gland poses a danger. But because there is a high probability of a tumor process in the breast and the development of cancer at the cellular level.”

Recommendations

The most correct way to solve the problem of mammoplasty, if a woman has signs of mastopathy, can only be determined by a doctor after a detailed examination. It is he who, taking into account all the manifestations of the disease and the required volume of intervention, can advise whether it is better to perform everything in one stage or divide it into several. But it is undoubtedly useful to adhere to the following recommendations:

For minor manifestations of mastopathy, it is advisable to undergo a course of treatment, as well as try to find the cause of the development of the disease and, if possible, eliminate it. So, often the problem lies in the pathology of the thyroid gland, in dyshormonal processes, etc.
If a woman has cysts or numerous fibroadenomas, it is better to remove them some time before mammoplasty. Perhaps the volume of the operation will be so large that subsequent plastic surgery will completely change its principles.
If such tumors are removed during mammoplasty, it will be quite difficult for the surgeon to immediately navigate the necessary manipulations. This may ultimately affect the result of the plastic surgery.
In any case, a mandatory histological examination of all removed nodes, cysts and other tissues is necessary. It is rare, but it still happens that malignant tumors are hidden under benign neoplasms.
In the time before and after mammoplasty, it is useful to take medications for the treatment of mastopathy. This way you can reduce the risk of complications and also not provoke the progression of the pathology.
After mammoplasty, women with any changes in the mammary glands should undergo regular preventive examinations. The minimum volume is blood for tumor markers, ultrasound.

We recommend reading the article about complications after mammoplasty. From it you will learn about possible complications after implant installation, the development of hematomas, inflammation and scars, as well as specific consequences.

Plastic surgery is equipped with both modern equipment and safe materials that reduce the risk of the negative impact of a foreign object on tissue. If you decide to have breast surgery, you should definitely consult a doctor.

Only a specialist, after a certain examination, can say whether mammoplasty can be done for mastopathy in a given situation and which technique is preferred. There is no reliable evidence that such operations seriously aggravate the course of the pathology.

Mastopathy and breast cancer

The disease is often called a harbinger of cancer or a condition that increases the risk of breast cancer. But, according to Irina Petrova, it is wrong to interpret this disease this way. Mastopathy does not increase the risk of cancer and in itself is neither a harbinger nor a symptom of cancer.

“We are saying that mastopathy is a good background for the development of breast cancer,” the specialist notes. - Just as a smoker has a good background for the development of lung cancer, and a patient with an ulcer has a good background for the development of stomach cancer. But the presence of a background does not mean that cancer will definitely occur. It all depends on the functioning of the body’s immune system, since more than a million cancer cells are released in the human body every day. If the immune system copes with them, oncology does not develop. Therefore, mastopathy cannot be regarded as a precancerous condition.”

Does the risk of fibrocystic tumor malignancy increase with implantation?

Until recently, it was believed that silicone breasts were a giant step towards breast cancer, especially if the implantation was performed for diffuse mastopathy. Today, manufacturers of modern endoprostheses assure that there is no such danger. Silicone:

does not enter the gland tissue, while maintaining the integrity of the capsule;
does not diffuse and is not absorbed when it breaks;
does not pass into milk if a woman becomes pregnant after implantation

That is, the risk for a woman and her possible offspring when implants are introduced is minimal. But if you enlarge the breast with access through the areola, then with mastopathy the risk of fibrosis of fairly large areas of glandular tissue increases. This method of gaining access to the site of implantation of the prosthesis is traumatic for the gland, and its scarring is a fibrotic process.

It is up to you to decide whether to undergo breast surgery with endoprosthetics for mastopathy. But we hope that this article helped each of our readers who are interested in changing bust parameters make the right decision that is appropriate to the situation. Regardless of whether they suffer from fibrocystic disease or not.

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Risk reduction

It is impossible to avoid or guarantee protection from mastopathy. There is no cure or way to reduce the risk of its occurrence. But doctors note several patterns.

1. Taking oral contraceptives at an early age. According to Irina Petrova, if girls start taking contraceptives early, as a rule, the disease does not develop even in adulthood.

2. Age after 40 years. At this time, the glandular tissue in the breast practically disappears, so the likelihood of the disease occurring is significantly reduced. But this does not mean that if mastopathy occurred earlier, then after 40 years it will go away or be less of a concern. If you have a disease, its course should be monitored and regularly visited by a mammologist.

Proper nutrition, taking care of the liver, and maintaining a normal weight can reduce the risk of mastopathy. And, of course, attention to your health. According to Irina Petrova, every girl over the age of 16 should visit a mammologist every year. You should definitely come to an appointment if you are planning a pregnancy. And if the condition of the breast raises even the slightest suspicions and questions, you need to contact a specialist as soon as possible.

How mammoplasty can harm mastopathy

So, the approach to performing mammoplasty in the presence of signs of mastopathy should be individual; there is no single algorithm and management tactics.

If a woman is not examined on the eve of surgery, then even cysts and fibroadenomas larger than 1 cm may not be detected, which in the future can create certain difficulties in their treatment and even diagnosis.

In addition to the fact that it is necessary to find out the presence of the disease before mammoplasty, it should be taken into account that some types of examination after installation of the implant will not be so informative. The following features in the diagnosis of diseases after surgery can be highlighted:

The performed mammoplasty has practically no effect on ultrasound examination. But the problem is that this examination is informative only until the age of 40-45, after which its diagnostic value drops sharply.
The biggest changes concern mammography. It is this type of examination that is the most revealing, especially after the mammary glands undergo fatty involution.
Performing high-quality mammography has some difficulties after mammoplasty. The fact is that the implant can block some areas during an X-ray scan, and if the pathological foci are located there, they will go unnoticed. The area under study is especially shaded if the endoprosthesis is installed above the pectoral muscles. Therefore, it is advisable to carry out the correction with the placement of the implants underneath them, then the inaccessible area is minimal. Operating surgeons must take this feature into account when planning the course of the operation.
The installed implants do not affect the performance of CT and MRI in any way, but these methods are not routine and are carried out only when indicated.
Some women are also worried about whether it is possible to undergo fluorographic examination of the mammary glands after mammoplasty. Indeed, the installed implants will be visible, but they will not affect the quality of the examination and the percentage of detection of lung diseases.

In addition, after mammoplasty, a woman remains swollen in the mammary gland for a long time, and during the intervention itself, blood and lymphatic vessels are damaged. This can somewhat aggravate the course of mastopathy and intensify its manifestations. Therefore, if the disease is present, it is necessary to undergo preventive courses of treatment both before and after surgery.

Watch the video about the procedure:

How to treat mastopathy

Despite the fact that the disease causes serious discomfort and may be accompanied by the development of lumps in the mammary glands, specialists do not set themselves the task of treating mastopathy.

“If someone tells you that they can cure mastopathy, you need to turn around and leave such a doctor,” comments mammologist-oncologist Irina Petrova. — Mastopathy cannot be cured. We can cure her complications, remove pain, improve the woman’s well-being and condition, but nothing more. Mastopathy goes away on its own with age, when the amount of estrogen in a woman’s body naturally decreases. This happens around menopause."

The doctor chooses tactics to combat the symptoms that accompany the development of mastopathy based on the patient’s well-being, health status and the reasons that caused the development of the disease.

“The doctor must evaluate what kind of mastopathy it is, what is causing it: excess estrogen, prolactin, disruption of the thyroid gland or another reason,” continues Irina Petrova. — The specialist collects anamnesis and only then chooses treatment tactics. We have a huge number of drugs that we can use to help a woman. These could be hormonal drugs to correct hormonal levels or herbal remedies that normalize well-being.”

However, there cannot be a single recommendation for the treatment of mastopathy. Each case is individual, as it is caused by various reasons and has its own symptoms. There is no universal therapy that will help all women without exception. Depending on the examination results, the doctor will clarify the treatment tactics.

In one case, taking medications will be enough, in another, surgery will be required, in the third, self-monitoring and observation can be done. But it is important that this recommendation is given by a specialist, then you don’t have to worry about breast health.

Mastopathy and the reasons for its appearance

There are no reliable and unambiguous mechanisms for the development of mastopathy yet. Existing theories and assumptions make it possible, to some extent, to treat a disease from which it is not always possible to radically get rid of it.

An important point, including taking into account subsequent mammoplasty, is that mastopathy never turns into cancer. But against the background of such a condition of the mammary glands, malignant neoplasms are more common.

According to statistics, today every third woman with a thorough examination can detect certain signs of the disease.

According to available scientific data, the following can be said about mastopathy:

this is a disease that reflects the state of a woman’s entire hormonal system, and not a separate organ;
in most cases, mastopathy reveals an increase in the amount of estrogen and insufficiency of the second phase of the cycle;
against the background of the disease, premenstrual syndrome has a more vivid clinical picture;
mastopathy, even with treatment, rarely goes away; in some cases (fibroadenomas, cysts and others) it is subjected to surgical treatment;
There are diffuse and focal forms (cysts, fibroadenomas). Doctors always treat the latter with caution, since they can be confused with malignant neoplasms. Therefore, more aggressive tactics are applied to them - removal and mandatory subsequent histological examination.

We recommend reading the article about the pros and cons of mammoplasty. From it you will learn about the advantages and disadvantages of the procedure, prohibitions after the operation.

Self-diagnosis of mastopathy

“You can live with mastopathy,” notes Irina Petrova. “You don’t need to be afraid of it, but it’s important to pay attention to your health and visit a doctor regularly. And do this not only when something bothers you. You need to undergo an examination by a mammologist even when everything is normal. The recommended frequency of visits is once every 6–12 months.”

A specialist considers regular examinations of the mammary glands at home to be a good way to monitor breast health. This should be done often, monthly, from the 6th to the 12th day of the menstrual cycle, when the breasts are “calm” and relaxed. It is necessary to examine the armpits and mammary glands and palpate them with gentle movements. But without prejudice: it is important to understand that the structure of the breast is heterogeneous, that it has more and less dense areas. With regular monitoring, a woman gets used to the condition of her mammary glands and if something “new” appears in them, she can consult a doctor in time.

According to Irina Petrova, in order for self-diagnosis to be informative, it is worth discussing the tactics of its implementation with your doctor. The specialist will explain what to look for and how to properly feel your breasts. Gradually, such an examination will become a daily ritual, which will reduce the risk of progression of mastopathy and will allow early detection of a much more formidable enemy - breast cancer.

If suspicions arise during self-diagnosis, you should consult a doctor immediately. Delay is dangerous, since the longer the disease develops uncontrollably, the higher the risk of its undesirable outcome.

Are physiotherapeutic procedures for mastopathy allowed?

If you are diagnosed with mastopathy, massage sessions are allowed. Moreover, for certain forms of the disease they are even recommended. After all, this procedure has a positive effect on the body. But there are 2 exceptions. Firstly, you can only massage specific areas of the body. Secondly, the attending physician should not suspect a malignant tumor.

When planning a course of treatment, the doctor draws up a plan that includes various procedures. As for physiotherapy, among those most often prescribed is therapeutic massage of the abdomen, back and mammary glands. When the procedure is performed regularly, the patient usually feels relief and recovery occurs much faster.

But the massage should be done by a professional massage therapist. After all, only he knows what techniques to use in this case. Otherwise, the body's condition will worsen, and over time, serious complications may appear.