What is bilateral mammary lobular hyperplasia?

Written by Jia Rui

Obstetrics and Gynecology

Updated on September 11, 2024

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Bilateral mammary lobular hyperplasia is a type of abnormal proliferative disease of the breast tissue. Patients with mammary hyperplasia primarily experience breast pain and have breast lumps, and it is a benign disease. This condition is caused by an imbalance in ovarian endocrine levels, changes in hormone levels in the body, and an increase in estrogen levels, leading to excessive proliferation and incomplete restoration of breast tissue. It is common in clinical practice to examine breast diseases when breast pain and lumps are present.

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Does lobular hyperplasia usually cause pain?

The primary manifestation of mammary gland hyperplasia is cyclical swelling and pain in the breast, often occurring or worsening before menstruation and alleviating or disappearing after menstruation. Mild cases are noteworthy for the patient, while severe cases can affect daily life and work. However, some patients do not exhibit obvious cyclical changes; others may experience unilateral or bilateral breast swelling and pain or needle-like pain. The pain may extend to the shoulder, upper limbs, or shoulder-back area. A few patients may have nipple discharge. During physical examinations, nodular lumps of varying sizes, which are tough but not hard, can be felt in one or both breasts. Sometimes, these lumps are tender to touch, and their boundaries with surrounding tissues are unclear, but they do not adhere to the skin or chest muscles.

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What should I do if lobular hyperplasia recurs?

After the recurrence of lobular hyperplasia of the mammary gland, if there are significant symptoms, Chinese herbal medicine can be used to alleviate the pain through the method of soothing the liver and regulating the Qi, and harmonizing the Chong and Ren meridians. Endocrine treatment is also an option, but should be avoided if possible. However, it can be taken before menstruation if the pain is particularly severe in the pre-menopausal period. Vitamin therapy can also be used, including Vitamin B, Vitamin C, Vitamin E, etc., which have effects on improving liver function, regulating sex hormone metabolism, and improving autonomic nerve function. These can be used as adjunctive therapy for the disease. Some also believe that Vitamin E can relieve pain. Regular follow-ups with breast ultrasound and mammography are also necessary.

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Early symptoms of mammary gland hyperplasia

The early symptoms of mammary gland hyperplasia are cyclic swelling pain, which worsens before menstruation and diminishes or disappears after menstruation, with these being the typical symptoms. During a physical examination, nodular lumps of varying sizes can be felt within the breast, which are firm but not hard, and sometimes tender to the touch. Ultrasonography may not show any lumps, or mammography may reveal a cotton-wool-like appearance, which can diagnose mammary gland hyperplasia. However, it is crucial to be cautious of the potential coexistence of mammary gland hyperplasia and breast cancer. On one hand, patients with significant hyperplasia should be closely followed up, advised to return to the hospital every two to three months for re-examination. On the other hand, for patients with significant hyperplastic lumps or unclear boundaries in the thickening type of mammary glands, a biopsy is recommended.

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Can mild pain from lobular hyperplasia be ignored?

For mild pain associated with lobular hyperplasia, it may not require intervention but regular follow-up is needed. For more pronounced symptoms, symptomatic pharmaceutical treatment should be administered. Supporting the breasts with a bra, using traditional Chinese medicine to soothe the liver, regulate qi, and harmonize the Chong and Ren meridians may alleviate the pain. Endocrine treatment is another option, though generally avoided if possible. However, for severe pre-menopausal pain, taking vitamins such as B, C, and E before menstruation can help as they improve liver function, regulate hormone metabolism, and enhance autonomic nerve function. Vitamin E also helps alleviate pain.

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Can grade II hyperplasia of small leaves become cancerous?

Fibrocystic change grade II generally does not become malignant. Fibrocystic change grade II refers to breast hyperplasia or benign tumors of the breast. It can be identified based on the typical symptoms of cyclic breast swelling and pain that worsens before menstruation and diminishes or disappears after menstruation. During physical examination, there are nodular masses of varying sizes accumulated inside the breast, which are firm but not hard, sometimes with tenderness. Ultrasound examinations show no masses, or mammography shows a cotton-wool appearance, which are main symptoms of breast hyperplasia, but the possibility of concurrent breast hyperplasia and breast cancer needs to be considered. On one hand, patients with significant breast hyperplasia should be closely followed up, advising them to return to the hospital for re-examination every two or three months; on the other hand, for those with obvious hyperplastic lumps or unclear boundaries in the thickened areas, it is recommended to perform a biopsy on suspicious lesions to prevent misdiagnosis.