What should I do about the pain from lobular hyperplasia of the breast?

Written by Fan Hong Qiao
Breast Health Department
Updated on September 03, 2024
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Breast lobular hyperplasia accounts for more than two-thirds of female breast disease patients and can occur from youth to middle age. In the early stage of the disease, there is breast pain, followed by lumps, or pale yellow nipple discharge. Therefore, women should pay attention to preventing the occurrence of breast lobular hyperplasia. Traditional Chinese medicine believes that breast lobular hyperplasia is caused by liver Qi stagnation and phlegm and Qi stagnation, related to unhappy emotions and depressive moods. If there is a satisfying sexual relationship between spouses, including a coordinated and harmonious sex life, it can maintain a happy mood and smooth liver Qi. The Qi and blood in the collaterals will be harmonized and smooth, and the breast lobule will not easily proliferate. Therefore, we should adjust from life and diet, and of course, necessary medical treatment is essential.

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Will hyperplasia recur after excision?

After the excision of lobular hyperplasia, recurrence generally occurs because mammary gland hyperplasia is related to the glandular tissue, which is associated with the disruption of endocrine balance leading to increased levels of estrogen. External environmental conditions for survival, work and living conditions, interpersonal relationships, and various other stress-induced psycho-neurological factors can alter the body’s internal environment. This, in turn, affects the function of the endocrine system, causing the secretion of one or several hormones to become abnormal. During the menstrual cycle, the hormonal levels within the breast receptors change cyclically. When the balance of estrogen in the body is disrupted, with an increase in estrogen levels and a decrease in progesterone secretion, it can result in incomplete regression of mammary gland hyperplasia, leading to an exacerbation of the condition.

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Is lobular hyperplasia nodules serious?

Small hyperplastic nodules are generally not serious. If the nodules are between 0.2-0.4cm, we can treat them with traditional Chinese medicine, using methods to soothe the liver, regulate qi, and harmonize the thoroughfare and conception vessels to treat breast nodules; If the nodules are between 0.6-0.8cm, breast ultrasound determines them as benign. If the psychological burden is light, regular ultrasound examinations can be scheduled. If the psychological burden is heavy, the nodules can be removed by minimally invasive Mammatome rotation to achieve cure. If the nodules are larger than 1.0cm, it is recommended to first perform cytology aspiration and biopsy to prevent misdiagnosis. If determined to be benign, surgical treatment can be used; if malignant, a full-body exam is recommended to check for distant metastasis to formulate a surgical treatment plan.

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Breast Surgery
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Symptoms of lobular hyperplasia cancerization

The symptoms of lobular hyperplasia transforming into cancer primarily include feeling a painless, solitary small lump in the breast. The lump is hard, with a rough surface, and its boundary with surrounding tissue is not clearly defined. It is not easily movable within the breast. As the lump progresses, it can invade the Cooper's ligaments, causing them to contract, and thus the skin over the lump often appears dimpled, known as the dimpling sign, which is an early sign of breast cancer. As breast cancer continues to develop, it can cause the breast to shrink, become harder, elevate the nipple, and may lead to the ducts being pulled, flattened, retracted, or even invaginated. The affected breast may also significantly enlarge over several months, causing an increase in volume and prominence.

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Breast Surgery
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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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Mammary duct ectasia is classified into several stages and can be treated as follows:

The grading of lobular hyperplasia and the staging of color Doppler molybdenum target are the same, First is grade 0, which is unconfirmed and requires further confirmation. Grade 1 is a negative result, which is normal and does not require treatment. Grade 2 indicates benign lesions, such as breast cysts and lobular hyperplasia of the breast, which are 100% benign at the second level. Lobular hyperplasia can be treated with medication, and benign cysts can be regularly reviewed with color Doppler ultrasound or surgically treated if there is a psychological burden. Grade 3 is possibly benign with a 2% risk of malignancy, typically referring to fibroadenomas of the breast, which can be treated surgically. Grade 4 is suspicious of malignancy, and in such cases, biopsy is recommended to determine benignity or malignancy, with surgical treatment advised if malignant. Grade 5 is highly suspicious of malignancy, and in such cases, surgical treatment is recommended, such as modified radical mastectomy or breast-conserving surgery. Grade 6 is confirmed malignant with pathological evidence of breast cancer.