Mammologist

A mammologist is a specialist who deals with mammary gland diseases (diagnosis, treatment, prevention). He conducts an examination, and if pathological processes in the mammary gland are detected, he makes a diagnosis and prescribes further treatment of the mammary gland.

Effective treatment of any female breast disease is, first of all, early detection of the disease. Therefore, women should visit a mammologist for a preventive examination at least once a year.

A mammologist examination is mandatory in case of various (even minor) breast injuries, before starting to take oral contraceptives, in case of planning a pregnancy, after inflammatory diseases, especially inflammation of the female genital organs.

The risk group includes women who:

• are prone to frequent gynecological diseases, especially such as cysts, uterine fibroids, polycystic disease, etc.
• are registered with an endocrinologist
• my first birth was after 35 years
• use oral contraceptives (especially those who have not given birth)
• there is a hereditary factor (relatives with cancer, especially on the female side).

You should not delay visiting a doctor if you experience chest pain, any (even the smallest) lumps, a sudden change in the size of the breasts (both or one), redness, discharge from the nipples, retraction or, conversely, protrusion of the nipple, or if you experience pain or lumps in the armpits (lymph nodes).

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When should you see a mammologist?

Since a mammologist is a doctor who deals with pathological processes in the mammary glands, you should contact him if you have nipple discharge, soreness or lumps in your breasts, in general, any abnormal conditions that you feel in your mammary glands. The vast majority of women feel regular pain in their mammary glands. In 90% of cases, pain indicates a hormonal imbalance. If the pain is felt only in one breast, or a small lump has appeared, or there is discharge from the nipples, this should cause concern. Some women feel soreness between the breast and armpit before menstruation. To alleviate the condition, you should give up drinks containing caffeine and wear supportive underwear.

After an injury or biopsy, the painful sensations in the breast are of a completely different nature. A woman feels pain in one place, regardless of menstruation, usually of a cutting nature. After a biopsy, this can last for about two years. Painful sensations under the breast are often echoes of other diseases not associated with the mammary glands.

Stressful conditions increase pain in the mammary glands several times over; severe stress can change hormonal levels, which can negatively affect the condition of the mammary gland and lead to unpleasant diseases.

If you notice that you have discharge from your breasts, this is a reason to consult a mammologist. Many women suffer from discharge, but it is not always related to cancer. Discharge may appear in the second half of the menstrual cycle, when fluid accumulates in the breast canals. In the event that pregnancy has not occurred, the fluid is gradually absorbed. But if a woman is excited, a few drops of this fluid may appear from the breast. Among doctors, there is such a concept as "athlete's milk", since the discharge is caused by physical activity.

Discharge is not always related to cancerous tumors in the breast, but there are still some symptoms that a woman should be wary of:

• discharge of a permanent nature;
• involuntary discharge, i.e. when there was no pressure, physical exertion, friction, etc.;
• discharge is observed from one breast (one or several pores of the nipple);
• discharge is not transparent in color;
• the nipple is inflamed or itchy.

Lumps that form in the mammary gland do not always indicate a malignant tumor, but if you notice the following signs (at least one), you should urgently visit a mammologist:

• immobility of the seal (movement is possible only with adjacent tissues);
• solid seal;
• during menstruation the lump remained unchanged;
• when palpating, you do not find a similar lump on the second breast;
• when pressing on the lump, pain is felt;
• The seal has uneven edges.

There are risk groups that are susceptible to developing malignant breast tumors. These are women who have had:

• early or frequent abortions;
• frequent gynecological diseases;
• refusal to breastfeed without medical indications;
• changes in hormonal levels (endocrine dysfunction, excess weight, uncontrolled use of oral contraceptives);
• severe nervous shock in the last year;
• early onset of menstruation (before age 11) or late menopause (after age 55);
• heredity (breast cancer in mother, grandmother, aunt).

What tests should you take when visiting a mammologist?

When you visit a mammologist, after a mandatory examination and palpation, you will have to take some tests that will help in establishing a diagnosis.

First of all, if there is any discharge from the nipple, you will need to take a smear and send it for cytological examination.

Cytological diagnostics consists of quantitative and qualitative examination of the cell composition. Atypical cells (incorrect) detected in this way may indicate some disease.

If necessary, a diagnostic puncture may be required. It is necessary when nodules, lumps or other formations are detected in the mammary gland. If a mammologist during examination and palpation reveals a change in the color and structure of the skin on the chest, discharge that is bloody or yellowish, then a diagnostic puncture is mandatory, since in this case we may be talking about cancerous processes. The purpose of the puncture is to determine what kind of formation it is: benign or malignant. The doctor preliminarily evaluates the size and shape of the tumor, usually using ultrasound or mammography for this.

You should not take aspirin or anticoagulants one week before the diagnostic puncture.

What diagnostic methods does a mammologist use?

When determining a diagnosis, a mammologist uses the following diagnostic methods:

• Palpation. As a rule, diagnostics should be carried out in the middle of a woman's menstrual cycle. First, the doctor visually evaluates the condition of the mammary glands (color, structure). Then he or she directly begins palpating the mammary gland. Diagnostics are carried out in a standing position, and then lying on the back, with the arms thrown back behind the head. During palpation, the condition of the nipples is assessed. The examination begins in a standing position, each breast is palpated in turn, then the condition of both is assessed simultaneously (with both hands). Then the patient lies on her back, since in a lying position it is easier to determine the formation and its mobility than in an upright position. During palpation of the breast, hypertrophy, cysts, tumors can be detected, but an accurate diagnosis can only be made using this diagnostic method with pronounced manifestations of the disease (inflammation, lipoma, papilloma). All formations of a different nature in the thickness of the mammary gland require additional diagnostics.
• Mammography. Diagnostics involves examining the mammary gland using weak X-rays. The purpose of mammography is to detect cancer at an early stage. Like any X-ray examination, mammography takes a series of images, which are then analyzed by radiologists. Pathological formations can be seen on X-ray images.
• Ultrasound examination. Ultrasound is used as an additional diagnostic method along with mammography. Usually, diagnostics are prescribed for further examination of seals or formations detected by mammography or palpation.
• Ductography. A method that examines nipple discharge when mammography has been insufficient.
• MRI (magnetic resonance imaging). Quite an effective method of examination for questionable formations, as well as for examination of patients diagnosed with breast cancer immediately before surgery. Cancer patients need this method to detect new formations that may affect the course of the operation.
• Computer tomography. It is prescribed to determine the size of the tumor, whether it is subject to removal or not due to its growth into the chest. The examination method consists of taking a series of X-ray images, which are then processed by a computer.
• Thermomammography. This is a modern method of examination, in which a special device detects infrared radiation and tissue temperature in the mammary gland, which is a consequence of pathological cell proliferation. This process makes it possible to examine the cancer process long before the tumor begins to form. The method is absolutely harmless and is intended for the primary examination of women. Such an examination can be done once a year, during preventive examinations.

What does a mammologist do?

A mammologist deals with diagnostics, treatment, and prevention of diseases associated with the mammary gland. Modern technologies allow to cope with rather serious diseases, for example, mastopathy, mastitis, lack of breast milk during lactation, cracked nipples, etc. Today, reflexotherapy, magnetotherapy, laser, and phytotherapy are used in practice. Homeopathy is also successfully used.

A consultation with a mammologist is very important for a woman. At the doctor's appointment, you need to tell about all the sensations in the mammary gland, pain, discharge from the nipples, whether you have had interrupted pregnancies, how many births you have had, stress, whether you are prone to depression. All this will help the doctor assess your psychological state and illness, and draw appropriate conclusions based on all this.

After the conversation, the doctor examines and palpates the mammary glands. During palpation (probing), the doctor evaluates the condition of the breast and lymph nodes. Palpation is mandatory at a mammologist's appointment, since it allows you to identify pathological formations, but, unfortunately, even a very good specialist is not able to feel very small seals or formations. Therefore, additional diagnostics are always necessary.

You should visit a mammologist at least once a year. If there are predispositions (heredity, age, concomitant diseases), then you need to come for a consultation 2 times a year (every six months). Quite often, women make a mistake when they discover any problems with their breasts, they are referred to a gynecologist or surgeon for a consultation. But only a mammologist can conduct a full diagnosis of the mammary gland, identify pathology, make a diagnosis and prescribe treatment.

What diseases does a mammologist treat?

A mammologist treats the following diseases that affect the mammary glands:

• mastitis (inflammation). Commonly known as mastitis. Most often occurs during periods of breastfeeding in women who have become mothers for the first time. But mastitis can also develop before childbirth or independently of pregnancy or childbirth. In rare cases, it develops in men.
• abnormalities in the development of the mammary glands (monomastia, polymastia, micro- or hypomastia, hypoplasia of the mammary glands, etc.).
• diseases caused by hormonal changes (mastopathy, fibroadenomatosis, fibrocystic formations, gynecomastia)
• benign formations in the mammary gland (cystadenopapilloma, fibroadenoma, lipoma, etc.).

Modern methods allow to successfully treat various diseases of the mammary gland. The effectiveness of treatment is directly related to the timeliness of detection of the pathological process. This is most important during periods of so-called hormonal "surges" that occur in adolescence, during pregnancy, before menopause. Very often, lesions are not palpable and do not cause any discomfort to the woman. Such small formations can only be noticed on ultrasound or mammography. It is for this reason that every woman should visit a mammologist once a year, which will allow timely detection of pathological processes in the mammary gland, and therefore effective treatment.

A mammologist collects anamnesis, conducts an examination, prescribes additional diagnostic methods (mammography, cytological examination, etc.), makes a diagnosis, and determines a treatment plan. In addition, a mammologist can provide advice on proper breastfeeding, and also conduct a conversation about the prevention of mammary gland diseases.

Advice from a mammologist

Every mammologist warns about risk factors that can lead to problems in the mammary glands in the future.

Trauma of the mammary gland. The main danger is that malignant tumors may form at the site of the injury later. Therefore, you should try to protect your breasts from blows, bruises, etc. If you cannot avoid the injury, you should definitely consult a mammologist, perhaps he will consider it necessary to undergo a more complete examination.

Infections. Frequent inflammatory processes of the female reproductive system lead to hormonal imbalance. The breasts react immediately to any hormonal changes. Pain, swelling of the mammary glands before menstruation, the appearance of nodules - all this occurs as a result of hormonal imbalance. Ultimately, this leads to mastopathy.

Pathology in the mammary gland occurs from an infection that is transmitted from the genitals, it can be in the body in a "dormant" state until a favorable time for its development comes. Chronic inflammations in the mammary gland, which have the property of acquiring a malignant form, are very dangerous.

Late childbirth. The first pregnancy, which occurred after 30 years, contributes to the development of cancerous tumors in the mammary gland. Most likely, the reason for this is poor ecology, the impact of toxic substances contained in the city air. As a result of external factors, the ability of cells to normally respond to the hormonal surge that invariably accompanies pregnancy weakens.

Oral contraception. Many studies have been conducted in this area and it has been proven that oral contraceptives do not provoke cancerous tumors in the mammary gland. However, it has also been proven that long-term use of contraceptive pills (more than four years) in women who have not given birth can lead to the development of malignant tumors. Therefore, girls who have not yet given birth should find another method of contraception and not abuse oral contraception.

Radiation. According to doctors, radiation exposure to which a woman is exposed before the age of 30 provokes a cancerous process in the mammary gland. X-ray examination, which is usually prescribed no more than once a year, has a safe dose for a person, but the doctor must still record the radiation dose in the medical record each time so that the maximum threshold is not exceeded in the future.

Ultraviolet. The skin in the chest area is very delicate, thin, and easily injured. A mammologist recommends sunbathing (tanning) in the morning (before 1000) or evening (after 1600) hours. If you happen to be in the sun at midday, you need to protect your chest with a special sunscreen with a high filter.

Diet. The main cause of problems in the mammary gland is, first of all, a hormonal imbalance in the body. There are some products that increase the level of estrogens. You need to avoid smoked, fatty foods, replacing them with vegetables, cereals, citrus fruits. There is data according to which the painful condition of the breast before menstruation is caused by products with a high content of methylxanthine (coffee). Replacing morning coffee with a cup of tea (preferably green) will lead to a decrease in breast pain.

The mammologist warns that systematic preventive examination is the main method of early diagnostics of pathological processes in the breast. All questions and problems can be discussed at an appointment with a qualified doctor, get all the information about prevention, possible risks and complications.

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