How much does it cost to see a mammologist? Where can you see a mammologist: which specialist is better to choose. When to consult a mammologist

The doctor organizes preventive and emergency appointments for early detection of breast cancer pathologies. To detect cancer, the doctor performs the following procedures:

palpation,
tests for tumor markers,
biopsy soft tissue,
mammography,
scintigraphy,
ultrasound diagnostics,
ductography,
magnetic resonance and computed tomography.

An appointment with a doctor should be made not only if a tumor is suspected, but also for preventive purposes. The clinician sees women who complain of pain in the mammary glands, lumps, recessed nipples, and enlarged lymph nodes. The physician diagnoses benign neoplasms and treats intraductal papillomas, lipomas, fibroadenomas, galactoceles, and fibrocystic changes. The doctor identifies malignant pathologies and supervises women with adenocarcinomas, sarcomas and carcinomas.

To eliminate the pathological process, the oncologist-mammologist draws up a paid therapy program. The doctor prescribes immunotherapy, chemotherapy, radiotherapy, radiation, hormonal or anti-estrogen treatment.

To eliminate the affected area, the physician performs surgery:

lumpectomy,
enucleation,
sectoral resection,
mastectomy,
quadrantectomy or hemimastectomy with lymphadenectomy.

At the end of treatment, the patient registers with a clinic in Moscow and regularly undergoes medical examinations to prevent relapses.

If you need a good mammologist in Moscow, do not rely on chance when choosing. Of course, you can ask your acquaintances, colleagues, friends at the fitness club, or ask on an online forum. But such advice is sometimes emotional and subjective. So listen, but also use factual material.

Refer to a specialized website - take advantage of the offer of our resource. Here is an opportunity to clarify the doctor’s specialization, find out what professional experience he has, get acquainted with his achievements, and read the opinions of patients who have already been seen or undergone treatment. The desire of patients to entrust serious problems depends not only on the professional competence of the mammologist, but also on his human qualities, contact, and attentiveness. Only after this can you make a decision and make an appointment.

Women's fears

The majority of women who accidentally or during self-examination noticed changes in appearance mammary glands or feel pain, first of all, there is an assumption of cancer. These fears are quite understandable. The number of people with this pathology continues to grow steadily every year. Breast cancer ranks third in the list of causes of female mortality.

It should be noted that most cysts, tumors, and lumps of breast tissue - almost 80% - are benign, that is, they do not pose a threat. A visit to a mammologist will help you make sure that this is really the case. But even if the tumor turns out to be dangerous, with early diagnosis and adequate treatment the patient will be completely cured in 9 out of 10 cases.

Who is a mammologist

Mammologists are medical professionals who deal with diagnosis, treatment and prevention. pathological conditions, breast neoplasms. Specialists of this profile work in outpatient clinics and also provide inpatient treatment with the help of medicines. If necessary, many of them can carry out surgical operations. The listed types of treatment can be shared or performed by one physician. Therefore, when looking for a good mammologist in Moscow, take this into account, paying attention to the specialization and practical capabilities of the candidates.

Note that in Russian Federation, as in other CIS countries, mammology is not a separate specialty. Despite the fact that there are many mammology departments in Moscow (and other regions), this is a subspecialization for related areas medical workers. Among mammologists, the largest number are oncologists, since they are the ones who treat patients with malignant tumors and other similar diagnoses. A slightly smaller number of specialists in breast diseases are surgeons, plastic surgeons, gynecologists, obstetricians.

A mammologist in Moscow treats:

Diseases accompanied by tumors of the mammary glands (fibroadenoma, lipoma, sarcoma, oncological pathologies, etc.).
Pathologies of the mammary glands caused by a violation hormonal balance(diffuse fibrocystic and nodular mastopathy).
Diseases of an inflammatory, purulent nature (mastitis).
Congenital malformations of the mammary glands.

How often should a woman visit a mammologist?

Experts recommend that 15-16 year old girls come to see a mammologist for the first time. This will allow us to identify pathological processes at the beginning of their development and take timely measures. Moreover, it is early diagnosis that ensures the use of conservative, least traumatic methods and complete cure. Or you can rejoice in the absence of breast diseases. You can and should make an appointment for the first time and then undergo an examination by a mammologist, feeling completely healthy. If at least one unusual symptom is noticed (pain in the gland tissue, fluid discharge from the nipples), immediate consultation with a specialized specialist is needed.

After turning 30, women who do not have complaints about the condition of the mammary glands, as well as breast pathologies among relatives, are recommended to visit a mammologist at least once every two years. If there are aggravating hereditary factors or symptoms, visits should be more frequent, at least 2 times a year. At this age, self-examination of the mammary glands after the end of menstruation (on the 5-7th day of the cycle) should become regular. But such monthly feeling of the breast does not guarantee timely detection of hidden tumors, so a visit to a mammologist is mandatory.

After 45 professional preventive examination mammary glands should be performed every year.

Please note that the examination results will be most revealing and reliable if you schedule a visit to the mammologist on certain days. Go to the doctor in the period after the end of discharge before ovulation, this is the 5-6th day menstrual cycle.

Reasons for an unscheduled visit

Some conditions of the mammary glands are a serious reason to urgently find out their true cause. These symptoms include:

Redness (hyperemia) of the mammary glands or areas thereof.
Breast reduction or enlargement.
The appearance of compactions in the tissues of the mammary glands.
Secretion from the nipples, regardless of color. Particular caution should be exercised if these secretions contain streaks of blood.
The appearance of pain in or near the armpits.
Pain in the mammary glands or in one of them.
Changing the shape of the nipples to more convex or, conversely, retracted.
Changes in the condition of the skin around the nipples (swelling or retraction).
Asymmetry of the right and left mammary glands.

But even in the absence of such signs, if you have a history of certain factors predisposing to the development of dysfunction or structure of the mammary glands, you should visit a mammologist more often. Among such circumstances are the following:

Gynecological diseases that exist in this moment or previously transferred.
Difficult birth.

The presence of even minor discomfort in the breast area (chest pain, feeling of fullness, hardening, discharge from the nipples, swelling of the glands, etc.).
Breast problems during pregnancy and/or lactation.
Old or recent injuries to the mammary glands or one of them.
Functional pathologies of the liver.
Prolonged stay in a state of tension nervous system, repeated or single traumatic stressful situations, anxiety.
Hereditary predisposition - if close relatives on the female side had breast cancer or other pathologies.

Such problems are the subject of specialist competence. A mammologist in Moscow will see the patient on an outpatient basis and provide professional assistance.

How does an appointment with a mammologist work?

At an appointment with a mammologist, the patient outlines all existing complaints about the health of the mammary glands. A good specialist will definitely ask a number of questions that will help find out the reason for your visit and the appearance of changes in the breast. Then a visual inspection of the glands and palpation (palpation) is carried out. If the doctor finds grounds for a more detailed diagnosis, he will recommend several or one of the following types of examinations:

Mammography (X-ray examination of the mammary glands using a special machine - a mammograph).
Ultrasound examination (ultrasound) of the breast.
If necessary, an aspiration biopsy is prescribed - analysis of breast tissue, which is taken using a thin needle, while simultaneously monitoring the process using an ultrasound machine. The material is then sent to the laboratory for cytological examination.
Scintigraphy is a procedure that uses the injection of a small amount of radioactive substance followed by analysis of tumor formations on a gamma tomograph.
Ductography - a method x-ray examination condition of the mammary gland ducts.

MRI or CT chest.
Taking a sample of material (liquid) released from the nipple with a referral for cytology testing (detection of structural changes in the biomaterial).

After receiving and evaluating the research results, the oncologist mammologist in Moscow will offer adequate treatment tactics for the disease and prescribe a number of procedures that will help overcome the disease. The best option- so that the same doctor treats the patient and observes her until complete recovery.

Help in choosing a doctor: how to make an appointment

Often on the Internet, women ask: “Recommend a good mammologist and advise on the price per appointment.” Our website contains a large amount of information useful to you. These are profiles of experienced doctors who successfully help women with breast problems. You will find information about specialists' education and work experience. But the most important thing is to get acquainted with the opinions of real patients about mammologist doctors. This is the only way patients can help each other by exchanging experiences and leaving honest feedback. The average cost of a consultation with a mammologist in Moscow is 1,850 rubles.

Mammologist– disease specialist mammary glands. Mammologist ( from the Latin word “mamma” – mammary gland) deals with inflammatory, dyshormonal and tumor diseases of the mammary gland.

The need for a doctor who would deal exclusively with breast pathology arose, first of all, due to the prevalence of breast cancer, which was most often discovered at a stage when treatment was ineffective.

This medical specialty is not officially registered in Russia. To obtain the qualification of a mammologist, except for the highest medical education, the doctor must have a primary specialty in one of three areas - gynecology, surgery, oncology.
After this, the doctor undergoes retraining on the topic “Mammology” and receives the right to work as a mammologist. Thus, mammologist services are provided by doctors who, in their work, constantly encounter breast pathology.

The following specialists are distinguished among mammologist doctors:

oncologist-mammologist– deals with the prevention, diagnosis and treatment of malignant breast tumors;
breast surgeon– deals with breast pathologies that require surgical intervention ( benign tumors, nodular mastopathy, mastitis and other diseases);
gynecologist-mammologist– deals with dyshormonal diseases of the mammary gland;
radiologist-mammologist– carries out such diagnostic studies How mammography and tomosynthesis ( X-ray examinations of the breast);
Ultrasound specialist-mammologist– conducts ultrasonography ( Ultrasound) mammary gland.

“Radiologist-mammologist” and “mammologist-ultrasound specialist” are not official names of specialties, but only an indication that these radiologists have in-depth knowledge of the signs of breast pathology, which can be identified using X-ray or ultrasound examinations.

The mammologist works in the following institutions:

Women's consultation– as an obstetrician-gynecologist who has undergone thematic advanced training in breast pathology;
cancer centers (institutions) – as an oncologist, surgeon, radiologist or ultrasound specialist ( Ultrasound specialist) who work in the mammology department;
mammology centers– highly specialized medical centers where mammologist-surgeons, mammologist-oncologists, mammologist-gynecologists work ( including gynecologists-endocrinologists), as well as diagnostic doctors ( radiologists and ultrasound specialists).

What does a mammologist do?

A mammologist deals with the identification and treatment of various pathologies of the mammary gland, carries out the prevention of malignant tumors of the mammary gland, as well as the rehabilitation of women after treatment. Some breast surgeons also deal with aesthetic problems related to the mammary gland, plastic surgery and prosthetics.

The responsibilities of a mammologist include:

identification of risk factors for breast cancer;
conducting a comprehensive preventive examination of the mammary glands ( mammological screening);
training women in breast self-examination;
clinical examination ( registration and active surveillance) women with any pathology of the mammary gland;
detecting cancer at early stages;
carrying out clarifying diagnostics ( radiologists and ultrasound specialists);
treatment of breast diseases in women;
treatment of dishormonal diseases of the mammary glands in men.

A mammologist treats the following breast diseases:

benign breast tumors ( lipoma, fibroadenoma);
intraductal papilloma;
lipogranuloma;
breast cysts;
mastopathy ( benign breast dysplasia);
mammary cancer;
Paget's cancer;
gynecomastia;
galactorrhea;
mastodynia ( Cooper's disease);
ductectasia;
mastitis;
breast injuries;
congenital anomalies of breast development;
problems associated with lactation ( secretion of milk) and breastfeeding ;
Mondor's disease.

Benign breast tumors

Benign breast tumors occur most often between the ages of 15 and 35 years. They consist of tissues that are present in the mammary gland and do not affect general state female body, do not form again after their removal.

The main cause of benign tumors is considered to be hormonal imbalance, since there are many receptors in the mammary gland ( sensory nerve endings), which react very sensitively to any excess of hormone levels, especially estrogen, progesterone and prolactin.

Benign breast tumors include:

adenoma– a tumor of glandular tissue that secretes breast milk;
fibroma– tumor from connective tissue (component of the supporting frame of the organ);
fibroadenoma– a tumor that consists of glandular and connective tissue in equal proportions;
lipoma– tumor of their adipose tissue ( wen).

Intraductal papilloma

Intraductal papilloma ( wart) is a benign tumor that is formed from epithelial ( lining the inside) mammary duct cells. Intraductal papilloma has its own characteristics. It is almost impossible to detect when palpating the mammary gland, but it is manifested by frequent bloody discharge from the nipple, which very frightens the woman. Because of this symptom, intraductal papilloma is called “bleeding mammary gland.”

Lipogranuloma of the breast

Lipogranuloma ( oleogranuloma) is non-inflammatory necrosis limited to healthy tissue ( necrosis) fatty tissue of the mammary gland. Often occurs after a bruise of the mammary gland, surgery or injections into the gland. Sometimes observed with systemic diseases connective tissue ( rheumatoid arthritis, systemic lupus erythematosus).

Depending on the prevalence, mastopathy is:

nodal– one or more nodes are detected;
diffuse– changes occur throughout the mammary gland.

Depending on the predominant element, mastopathy is:

fibrous– mastopathy due to the proliferation of connective tissue in the gland;
adenous ( adenomatous) – enlargement of lobules, that is, mastopathy due to the glandular component;
cystic– mastopathy, with the formation of grape-shaped cavities with liquid inside.

Most often there are mixed forms.

Mammary cancer

Breast cancer is a malignant tumor that mainly has hereditary cause and develops in the presence favorable factors (risk factors).

The following risk factors for developing breast cancer are:

breast cancer in the mother, especially if it occurred before age 60;
breast cancer in two relatives;
detection of mutations in the BRCA1 and BRCA2 genes ( Breast Cancer - breast cancer);
onset of menstruation before age 13;
first birth after 30 years;
absence of childbirth;
frequent abortions;
refusal to breastfeed;
menopause before 50 years of age;
the presence of a benign breast tumor;
the presence of diseases of the female genital organs;
alcohol consumption.

Paget's cancer

Paget's cancer is a malignant tumor of the nipple and adjacent pigmented skin ( areolas) mammary gland. The tumor manifests itself as redness, eczema ( itching, rash, burning, weeping) and ulceration of the nipple. Sometimes scales form that resemble psoriasis. This type of cancer occurs in both women and men.

Galactorrhea

Galactorrhea is a milky discharge that occurs in non-pregnant women and in men. The reason for such discharge is hormonal changes associated with the pituitary gland, thyroid gland or adrenal glands. Sometimes galactorrhea is side effect when taking certain medications. The result of all these diseases is the same - high level the pituitary hormone prolactin, which stimulates milk production in the mammary glands.

Gynecomastia

Gynecomastia is enlargement of the mammary glands in men. This pathology is a consequence of endocrine disorders, therefore it is most often dealt with by endocrinologists and andrologists, however, due to the existing risk of developing breast cancer in men ( usually in old age), gynecomastia is also included in the scope of activity of a mammologist.

Mastodynia ( Cooper's disease)

Mastodynia is a feeling of fullness in the mammary glands that occurs during the premenstrual period and disappears after the onset of menstruation.

Ductectasia

Ductectasy is an extension ( ectasia) large channels ( ductus) mammary glands located closer to the nipple. The cause of expansion is a chronic inflammatory process. Ductectasia is more often observed in older women, when involutive processes begin in the mammary gland ( organ reversal).

Mastitis

Mastitis ( from the Greek word “mastos” - breast, nipple) – inflammation of the mammary gland. The cause of mastitis is an infection that penetrates the mammary gland ( usually through the nipple). Sometimes breast cancer occurs under the guise of mastitis ( inflammatory form of cancer).

Mastitis can be caused by the following pathogens:

nonspecific microorganisms– staphylococci and streptococci;
specific microorganisms– Treponema pallidum ( causative agent of syphilis), Mycobacterium tuberculosis, actinomycetes ( fungi that cause actinomycosis).

Problems associated with lactation ( secretion of milk) and breastfeeding

They also contact a mammologist if after childbirth the process of breastfeeding is difficult or causes painful sensations. In this case, the woman is observed by a mammologist-gynecologist who works in the antenatal clinic at the maternity hospital.

Lactation disorders include:

Milk fever ( lactation mastitis) – develops on the 3rd – 5th day after birth due to stagnation of milk, which begins to be reabsorbed. The milk that is absorbed back has pyrogenic properties, that is, it can cause an increase in temperature. Unlike infectious mastitis, the mammary gland does not thicken.
Hypogalactia ( galactos - milk) – insufficient milk supply in a woman;
Agalaktiya – complete absence milk in the mammary glands after childbirth;
Cracked nipples– small linear defects or tears in the skin of the nipple and around it. Cracks occur if the skin of the nipples is overdried by certain cosmetic products ( alcohol based), or the nursing mother does not observe hygiene rules before and after feeding.

Congenital anomalies of breast development

Breast malformations are usually dealt with by breast surgeons, since their correction requires surgery.

TO congenital defects mammary glands include:

amastia– both mammary glands are absent;
monomastia– there is only one mammary gland;
polymastia– there are additional nipples or lobes of the mammary gland.

Breast injuries

A breast injury is a soft tissue contusion, that is, it causes swelling, cyanosis, and breast pain. In some cases, hemorrhage occurs in the mammary gland ( hematoma), which quickly spreads throughout the gland, due to the organ’s weak ability to limit this process.

Mondor's disease

Mondor's disease is an inflammation of the superficial veins of the anterior or lateral chest, as well as in the breast area. This pathology is of interest to a mammologist, since, when inflamed, the veins and the skin over them tighten, which is reminiscent of the tightening of the skin over the mammary gland during cancer.

How is an appointment with a mammologist?

Women are seen by a mammologist on certain days of the menstrual cycle. A woman should make an appointment with a mammologist so that the day of the visit falls on days 5–12 of the cycle ( you need to count from the first day of menstruation). The fact is that after ovulation ( 13 – 14 days after the start of menstruation) the mammary glands swell somewhat and become a little denser than usual, which is associated with hormonal changes. Examination these days may lead to false positive results. This rule applies to women of reproductive age. After menopause, you can apply any day.

At the appointment, the mammologist performs the following actions:

asks the patient about her complaints;
asks questions to find out if she has risk factors for breast cancer;
examines and palpates the mammary glands;
prescribes the necessary tests;
directs for the necessary instrumental studies.

The mammologist's office is located on the bright side of the building, since natural light is needed for examination and examination; the blinds are closed during the examination.

At the appointment, the mammologist asks the following questions:

At what age did you have your first menstruation?
When was your last menstruation?
What is the duration and regularity of the menstrual cycle?
At what age did menopause begin?
How many pregnancies have you had?
How many births were there?
How many abortions were there?
At what age did you have your first birth?
Was enough milk produced in the mammary glands during breastfeeding?
Is there a history of breast cancer in the family?
Has the woman suffered or are there any currently diseases such as ovarian cysts, fibroids or uterine polyps, endometriosis, ovarian dysfunction or infertility?
Has the woman had breast surgery?
Has the woman ever had mastitis or breast bruises?
Does the woman accept birth control pills or hormonal drugs?
Has the woman experienced in the past ( or whether she currently has) severe stress associated with personal life, family, work, and so on?
Does the woman drink alcohol in large quantities and/or regularly?

After questioning, the mammologist asks the woman to undress to the waist in order to conduct examination and palpation ( palpation) mammary gland and local lymph nodes (they increase with cancer or mastitis).

Examination and palpation of the mammary gland is carried out in a standing and lying position ( For this purpose, there is a couch in the mammologist’s office). In both positions, the symmetry and size of the gland are visually assessed. The mammologist palpates the mammary gland with the palmar surface and the pads of four fingers folded together ( the thumb is slightly retracted).

The mammologist uses the following models for palpating the breast:

by quadrant– the mammary gland is conventionally divided into four quadrants ( equal areas), which are examined in turn, starting from the upper-outer quadrant, after which the upper-inner, lower-outer and lower-inner quadrants are palpated;
in a spiral– palpation is carried out in a circle, starting from the center ( pacifier) in conventional circles;
along radial lines– the mammary gland is palpated along conventional lines running from the nipple in the form of spokes in a wheel;
up and down movements- the mammologist feels the gland along imaginary vertical lines from bottom to top and top to bottom.

Palpation is carried out in the following positions:

the patient's hands are located on the hips, relaxed in shoulder joints – in this position, the pectoral muscles relax, and it is easier for the doctor to palpate deep-lying formations and lymph nodes;
the patient's hands are raised and placed behind the back of the head– in this position, the ligaments of the mammary gland are stretched, and you can notice areas of retraction of the skin over the gland ( is a sign of cancer, but can also be observed in non-cancerous processes).

Both positions are used when examining standing and lying down.

The mammologist describes the following features of a tumor or breast node:

Size. The size is assessed not subjectively, but using a measuring tape or a plastic compass.
Localization. Location descriptions pathological changes carried out according to the clock dial diagram ( for example, at 6 o'clock, at 12 o'clock) or indicate the name of the quadrant of the mammary gland where the formation is palpable ( upper inner, upper outer, lower outer, lower inner).
Soreness. If the pathological focus “hurts,” then most likely it is benign in nature ( cancerous tumor on early stage does not cause pain).
Consistency and compaction. The cancerous tumor is considered to have a rocky consistency, but in some cases it may appear as a lesion with a jelly-like consistency. If a soft, easily compressible formation is palpated, then most likely it is a cyst.
Form. To describe the shape, the mammologist evaluates the evenness or unevenness of the contours of the formation. The more irregularities around the edges, the more likely it is that the node is malignant.
Connection with surrounding tissues. The connection is determined by the mobility of the node, that is, the ability to move it during palpation. Malignant nodes are characterized by immobility.
Changes in the skin over the breast. Changes such as redness, cyanosis, swelling, retraction, or ulceration of the skin are described.

The duration of palpation does not depend on the experience of the mammologist. A good mammologist always spends a long time and carefully palpating the glands and lymph nodes, since small formations are not always easy to feel.

The mammologist prescribes the following tests:

General blood analysis. Using this analysis, a mammologist can suspect a latent malignant process in the mammary gland. The presence of cancer may be indicated by changes such as a marked increase in the number of leukocytes, an increase in the erythrocyte sedimentation rate ( ESR) or anemia ( low level hemoglobin and/or red blood cells). These are nonspecific signs, that is, they can be observed in various pathologies.
Blood chemistry. The mammologist pays special attention to the activity of liver enzymes, the level of bilirubin and blood proteins. A change in these indicators may be a consequence of liver pathology, and it is not only involved in regulating the activity of female sex hormones, but is also the first to “take the hit” in breast cancer ( Breast cancer primarily metastasizes to the liver).
Blood test for hormone levels. Almost all hormones secreted in the body act on the mammary gland. Some act on the gland directly, since it has receptors for these hormones, while others act indirectly, that is, through an increase or decrease in the level of those hormones that can directly affect the mammary gland. The basic information about hormonal diseases of the mammary glands is provided by estrogen, progesterone and prolactin, but it is important to exclude any endocrine pathology, so the mammologist may prescribe tests for other hormones. The level of sex hormone binding globulin is also important ( sex steroid-binding hormone), which is produced in the liver.
Analysis for mutations in the BRCA1 and BRCA2 genes ( Breast Cancer - breast cancer). Normally, these two genes are responsible for inhibiting the processes of excessive division of breast cells, especially during puberty and pregnancy. When these genes “break down,” cell division is poorly controlled, and the process of natural death of obsolete cells is disrupted. As a result, cells with “broken” chromosomes are not removed from the gland. This chromosomal instability leads to breast cancer.
Serological blood test. The analysis reveals the presence of antibodies to pathogens of specific mastitis, that is, mastitis caused by syphilis, tuberculosis and actinomycosis.
Bacteriological research. Bacteriological analysis is the culture of material obtained during a diagnostic or therapeutic puncture ( puncturing the gland with a needle), on nutrient medium. The study allows you to identify a specific causative agent of mastitis and determine its sensitivity to antibiotics.

An appointment with a mammologist, in addition to examining women with specific complaints, takes place as part of mammological screening. Screening is preventive actions, allowing you to identify women who need Special attention mammologist.

Mammological screening has its own characteristics depending on the age of the patient. Until 2012, age groups were divided into women before and after 40 years of age, however, cancer is becoming “younger” every year, so caution has begun to be exercised even among young women, especially if they have risk factors for breast cancer. Women with risk factors should be examined by a mammologist 2 times a year, in the absence of risk factors under 35 years old - once a year or once every 2 years. For women over 35–40 years old, a visit to a mammologist once a year is mandatory, even if there are no complaints.

Activities carried out by a mammologist during mammological screening

What does breast screening include for women under 35?	What does breast screening include for women over 35 years of age?
manual ( manual Ultrasound if there are risk factors, but there are no changes in the mammary gland; Ultrasound and mammography if changes in the mammary gland are detected during a manual examination.	questioning women to identify risk factors for breast cancer; manual ( manual) examination of the mammary glands; mammography every 1.5 years, even if there are no changes in the mammary gland; DNA blood test to detect gene mutations if there is a history of breast cancer in the family; development of an observation and treatment plan if mutations in the BRCA1 and BRCA2 genes are detected.

What symptoms do you see a mammologist with?

Not only women who have complaints from the mammary glands turn to a mammologist, but also those who have no pain. The latter group of patients makes up the vast majority of women seen by a mammologist. This is precisely the specific work of this specialist - to identify the disease before symptoms appear. The fact is that the presence of obvious manifestations of breast tumors basically means that the disease has already “taken root.” In addition, many tumors, both benign and malignant, “do not give away” themselves, that is, they proceed without complaints.

It is important to know that you can and should contact a mammologist not only at the age of 35–40 years and if there are problems, but also during puberty, since the mammary gland requires the same attention as the menstrual cycle.
The fact is that the mammary gland reacts to any hormonal change in the body, especially in women in whom this organ has not yet fulfilled its main function - feeding the baby. From this point of view, going to a mammologist is equivalent to going to a gynecologist.

Symptoms for which you should contact a mammologist

Symptom	Mechanism of occurrence	What tests are performed to diagnose the causes of a symptom?	What disease might this symptom indicate?
*Pain or tenderness in the breast*	swelling of the mammary gland caused by inflammation or fluid retention during hormonal imbalance; with a high level of estrogen in the mammary gland, the number of ducts increases, which easily transform into cysts; decay process cancerous tumor in the mammary gland is accompanied by the release of substances that cause inflammatory reaction in the form of edema; The growth of a cancerous tumor into the skin causes ulceration.	examination and palpation of the gland; Ultrasound of the mammary glands and local lymph nodes; mammography; tomosynthesis; ductography ( X-ray contrast examination of the ducts); mammoscintigraphy ( radioisotope research); diagnostic puncture; biopsy ( taking a piece of pathological tissue); blood test for tumor markers; blood test for mutant breast cancer genes; general blood test and biochemical blood test;	fibroadenoma; mastodynia ( Cooper's disease); intraductal papilloma; mastopathy; ductectasia; cysts; mammary cancer ( on late stages ); breast injury; mastitis; Mondor's disease.
*Breast lump*	thickening of the entire mammary gland most often occurs due to the proliferation of connective tissue in the mammary gland due to hormonal imbalance, and less often due to advanced cancer.	feeling the mammary gland; mammography; Ultrasound of the breast; mammoscintigraphy; tomosynthesis; diagnostic puncture; cytological examination; tomosynthesis; hormone analysis; analysis for tumor markers.	mastopathy; mammary cancer.
*Presence of a formation in the mammary gland* *(according to palpation)*	malignant process in the mammary gland in the form of a node; proliferation of glandular or connective tissue with the formation of cavities filled with fluid and dense nodules; limited destruction of the fatty tissue of the gland or accumulation of blood due to injury; inflammation of the mammary gland in a limited area.	Ultrasound of the breast; mammography; ductography; tomosynthesis; diagnostic puncture; cytological examination; biopsy; histological examination; mammoscintigraphy; analysis for tumor markers; analysis for mutations in the BRCA1 and BRCA2 genes; hormone analysis; serological blood test; bacteriological analysis; analysis for BRCA1 and BRCA2.	benign tumors ( fibroadenoma, lipoma); lipogranuloma; breast cysts; mammary cancer; mastopathy; mastitis; breast injuries.
Asim- mammary gland measurements
*Discharge from both nipples that resembles milk*	when prolactin levels are high in non-pregnant women or men, the mammary gland stimulates production breast milk or liquid that resembles milk.	feeling the mammary gland; Ultrasound of the breast; mammography; ductography; diagnostic puncture; cytological examination of nipple discharge; general and biochemical analysis blood; blood test for hormones; tumor markers.	gynecomastia; galactorrhea; breast injury; mastitis; breast cyst; metastatic breast tumor ( for lung cancer, kidney cancer).
*Discharge from one or both nipples* *(colorless, yellowish, green, brown)*	temporary hormonal changes in the body in the second phase of the menstrual cycle; hormonal changes in the mammary gland, causing expansion of its ducts and the formation of cysts; increased contraction of the ducts during sexual arousal; inflammatory process in the mammary gland, with the formation of pus.	palpation of the mammary gland; Ultrasound of the breast; diagnostic puncture; cytological examination of discharge; mammography; tomosynthesis; ductography; general and biochemical blood test; analysis for tumor markers; hormone analysis; serological blood test; bacteriological analysis of secretions; analysis for BRCA1 and BRCA2.	mastopathy; ductectasia; mastitis; mammary cancer ( inflammatory form).
*Bloody discharge from the nipple*	ulceration or rupture of blood vessels of a cancerous tumor that has formed in the ducts of the mammary gland; trauma to the skin of the nipple during breastfeeding and damage to small skin vessels; ulceration of a wart that has formed in the mammary duct.		intraductal papilloma; breast injury; mastitis; cracked nipples; mammary cancer.
*Nipple retraction*	the growth of scar tissue around the nipple disrupts its anatomical structure and draws it inward.	Ultrasound of the breast; mammography; ductography; tomosynthesis; mammoscintigraphy; diagnostic puncture; biopsy; cytological and histological examinations; hormone analysis; analysis for tumor markers; general and biochemical blood test; serological blood test; analysis for mutations in the BRCA1 and BRCA2 genes.	congenital feature; mastitis ( for tuberculosis and actinomycosis); mastopathy; mammary cancer Paget's cancer; long-term breastfeeding; breast injury.
*Retraction of the skin over the breast* *("Orange peel")*	The ligaments of the mammary gland, shortened as a result of a pathological process, “pull” and fix in this position the area of skin with which they are connected.	examination and palpation of the mammary gland; mammography; ductography; ultrasonography mammary gland; tomosynthesis; mammoscintigraphy; diagnostic puncture; breast biopsy; cytological and histological examination; analysis for tumor markers; bacteriological examination; serological blood test; analysis for BRCA1 and BRCA2.	mammary cancer; lipogranuloma; Mondor's disease; mastopathy; mastitis.
*Change in breast skin color*	cyanosis of the skin may be a consequence of compression of blood vessels and poor circulation; redness occurs when blood flow to the breast skin increases.	examination and palpation of the mammary gland; ultrasonography; mammography; diagnostic puncture; breast biopsy; histological and cytological examination; general and biochemical blood test; serological blood test.	mastitis; mammary cancer; Paget's cancer; benign skin tumors; breast injury.
*Thickening, ulceration of the skin of the breast and/or nipple area*	a chronic pathological process in the mammary gland or on the skin that covers it, causing either destruction skin, or its thickening.
*Increase in breast size in women*	swelling and venous congestion in the mammary gland, caused by a tendency to retain fluid during the premenstrual period ( bilateral magnification); an increase in the amount of glandular component of the mammary gland or the formation of cysts due to hormonal imbalance ( unilateral or bilateral enlargement); inflammatory swelling of the mammary gland ( unilateral increase); hemorrhage into the mammary gland ( usually unilateral enlargement).	examination and palpation of the mammary gland; Ultrasound of the breast; blood test for hormones; general and biochemical blood test; serological blood test.	mammalgia; mastopathy; mastitis; breast injury.
*Breast enlargement in men*	high levels of female sex hormones in men stimulate the growth and development of glandular tissue and ducts in the male mammary glands.	examination and palpation of the mammary glands; ultrasonography; hormone analysis; general and biochemical blood test; analysis for tumor markers.	gynecomastia; breast cancer in men.

What kind of research does a mammologist conduct?

The mammologist performs instrumental and laboratory methods research not only if changes were detected during examination and palpation, but also as part of mammological screening. If a mammologist has identified obvious symptoms of breast cancer in a woman or manifestations that raise suspicions of cancer, then the mammologist must conduct a full examination of the woman within 8 to 10 days. What kind of examination the mammologist will prescribe depends on the age and the presumptive diagnosis that needs to be clarified or excluded. The mammologist may prescribe several instrumental studies.

Tests prescribed by a mammologist

Study	What pathologies does it detect?	How is it carried out?
*Mammography*	fibroadenoma; lipoma; intraductal papilloma; breast cyst; ductectasia; mastopathy; mammary cancer.	Mammography is an X-ray examination of the breast. Mammography is carried out in the first phase of the menstrual cycle somewhere between 5 – 6 and 12 days of the cycle, since in the second phase the mammary glands swell and become painful. The study is carried out with the woman in an upright position ( standing or sitting). Each mammary gland is alternately pressed between two mammograph plates ( mammography machine). The image can be saved in two forms - film ( the image is immediately printed onto film) or digital ( the image is sent to the computer).
*Ultrasound examination of the breast*	fibroadenoma; lipoma; intraductal papilloma; lipogranuloma; breast cyst; mastopathy; mammalgia; ductectasia; mammary cancer; gynecomastia.	Ultrasound examination is best performed in the first week of the menstrual cycle to avoid false positive results associated with hormonal changes in the mammary glands after ovulation ( to the second phase). During the examination, the woman lies down on a couch and a gel is applied to the mammary glands to facilitate the sliding of the ultrasound sensor. An ultrasound probe is placed above the skin of the breast and moved to obtain images of different parts of the breast. Ultrasound also allows you to assess the condition of local lymph nodes.
*Ductography*	ductectasia; intraductal papilloma; mastopathy; mammary cancer.	Ductography is an X-ray examination of the mammary gland ducts after the injection of a contrast solution into them through the nipple. Before administering the substance, the area of the areola and nipple is treated with alcohol. Using a drop of secretion from the nipple, the opening of the milk duct is found and a needle is inserted to a depth of approximately 5 mm. A contrast agent is injected through the needle ( verografin or urografin), after which a series of x-rays are taken, which show the entire path of passage of the substance through the ducts.
*Tomosynthesis*	fibroadenoma; breast cysts; mammary cancer.	Tomosynthesis is an X-ray examination in which X-rays The mammary gland is irradiated in an arc. As a result, after computer processing, the mammologist receives thin sections of the gland. During the examination, the woman stands or sits, each breast is alternately pressed between the glass and the signal receiver, while the discomfort from compression is much less than during mammography.
*Diagnostic puncture*	fibroadenoma; intraductal papilloma; cysts; mammary cancer; Paget's cancer; mastitis; mastopathy; breast injuries; gynecomastia.	A diagnostic puncture is a puncture of breast tissue under ultrasound guidance. The purpose of the puncture is to obtain material for cytological examination. The resulting material is squeezed onto a glass slide and sent to the laboratory.
*Cytological examination*		Discharge from the nipple or punctate can be used as material for cytological examination of the mammary gland ( liquid obtained during diagnostic puncture ). To collect nipple discharge, the mammary gland in the areolar ( pigmented) areas are squeezed with one hand between the large and index finger. With the other hand, hold a glass slide at a short distance near the nipple. To take a swab impression, a glass slide is applied to the ulcerated surface of the nipple. The purpose of the study is to identify the composition of the resulting liquid. In case of malignant formation, atypical ( cancerous) cells and erythrocytes, with intraductal papilloma - erythrocytes, with mastitis - leukocytes and fibrocytes.
*Breast biopsy*	mammary cancer; Paget's cancer fibroadenoma; lipoma; intraductal papilloma; lipogranuloma; mammary cancer; mastopathy; mastitis.	A biopsy is an intravital tissue sampling for histological examination. The biopsy can be performed using a scalpel or scissors under local anesthesia if the tumor has grown into the skin ( incisional biopsy). If the formation is located deep, then the skin and subcutaneous tissue are dissected, and after isolating part of the tumor, sutures are applied ( open biopsy). A biopsy can be performed with a special thick needle ( trephine needle), which is injected with rotational movements until the tumor ( trephine biopsy). The resulting material is placed in formaldehyde and sent to the laboratory.
*Histological examination*		For histological examination, you can use material obtained during a biopsy ( biopsy) or the tumor itself, which was removed during surgery. Histological examination can be urgent if carried out within 30 – 60 minutes ( during the operation) or planned, if the conclusion is received in 7–10 days ( more informative).
*Magnetic resonance examination* *(MRI)*	breast cyst; lipoma; ductectasia; mammary cancer; mastopathy.	During the examination, the woman lies face down on the diagnostic couch. A special coil is placed under the mammary glands, which has holes, thanks to which the mammary glands hang down and are not pressed. MRI is used to determine metastases ( secondary tumors ) breast cancer or to diagnose the nature of tumor formation. To distinguish different types In breast tumors, tissue contrast enhancement with intravenous gadolinium is often used.
*Tumor markers*	mammary cancer; mastopathy ( low level); pregnancy ( in the third trimester).	Tumor markers are substances that are secreted by a malignant tumor or are its protein fragments ( antigens). Tumor markers for breast cancer are carcinoembryonic antigen ( REA), ferritin, CA 15-3 antigen ( serum mucin glycoprotein) and mucin-like cancer antigen ( M.C.A.). To detect these tumor markers, a blood test is taken.
*Mammoscintigraphy*	mastopathy; mammary cancer; benign breast tumors.	Mammoscintigraphy is a diagnostic method using radioisotopes, which tend to accumulate in cancer cells, enhancing their glow on the screen. The drug is administered intravenously. During the study, the woman lies on the couch, and a gamma camera is brought to her chest to record the radiation of the drug. The study is carried out 5–7 days after menstruation.

If a woman is diagnosed with breast cancer, a HER-2 test is performed before starting treatment. HER-2 is a receptor ( cell wall sensitive protein), which binds to growth factors - substances that can enhance cell division. This analysis It is performed only for women who have been diagnosed with breast cancer. The material for analysis is a cancer cell, or rather its DNA, obtained during a biopsy or after removal of the tumor. If a woman is found to have this protein, this is designated as “positive HER-2 status,” requiring the use of a drug that blocks this receptor.

What methods does a mammologist use to treat?

A mammologist uses both medical and surgical methods to treat breast pathology. Gynecologists and mammologists adhere more to the so-called conservative approach, that is, they use medications. This tactic is due to the fact that gynecologists and mammologists deal mainly with hormonal diseases of the mammary gland. Breast oncologists and breast surgeons actively use surgical methods. For some benign tumors mammologists may not accept therapeutic measures, monitoring the formation with regular breast ultrasound, intervening if the tumor enlarges.

Treatment methods for breast pathology

Pathology	Treatment method	Mechanism therapeutic effect	Approximate duration of treatment
*Fibroadenoma*	*Surgical removal*	During the operation, the sector of the mammary gland in which the tumor is located is removed.	To perform the operation, it is necessary to be under the supervision of a doctor in the hospital for several days, since the patient can be discharged after receiving data from a histological examination of the removed tumor.
*Lipoma*	*Surgical removal*	Small lipomas are removed under local anesthesia, and large ones under general anesthesia. An incision of the required depth is made on the mammary gland, after which the lipoma is cut off and removed along with the fatty membrane.	Depending on the scale of the operation, a woman can spend from several hours to a day in the hospital.
*Lipoma*	*Puncture-aspiration removal*	The contents of the wen are drawn out using a needle, which is used to pierce the mammary gland up to the wen. With this method, no incision is made.	The manipulation lasts 15–20 minutes, after which the woman can go home.
*Intraductal papilloma*	*Surgical removal*	During the operation, the sector of the mammary gland in which the papilloma is located is removed.	To perform the operation, you need to be under the supervision of a doctor in the hospital for several days, during which data from a histological examination of the removed papilloma are obtained. If there is no indication of a malignant tumor, the patient is discharged.
*Lipogranuloma*	*Surgical removal*	To remove lipogranuloma, an incision is made and the affected sector of the breast is removed under general anesthesia.	The hospital stay is several days. The patient is discharged if there are no signs malignant tumor according to histological examination.
*Breast cysts*		Under ultrasound guidance, the cyst is pierced with a needle and aspirated ( pull out) its contents into a syringe, after which a substance is injected into the cavity of the cyst, causing the walls of the cyst to stick together and scar it. The introduction of sclerosing substances is necessary to prevent the fluid in the cyst from re-forming.	The procedure is carried out under local anesthesia, so the woman is discharged after the procedure if no malignant cells are found in the fluid ( cytological examination).
*Breast cysts*	*Surgery*	The cyst is removed along with the sector in which it is located.	The length of hospital stay depends on the number of cysts, but a minimum of 3 days is required.
*Breast cancer, Paget's cancer*	*Radiation therapy*	Radiation causes DNA destruction cancer cells, they stop dividing and die.	Radiation of the breast is carried out 5 times a week until the woman receives the total dose. The number of radiation therapy sessions to achieve the total dose depends on the single dose that is prescribed for each session.
	*Surgery*	Depending on the size, shape and extent of the cancer, the tumor is removed within healthy tissue ( for small sizes) or together with the mammary gland and local lymph nodes.	After the operation, the woman must remain in the hospital for further treatment.
	*Chemotherapy* *(antitumor antibiotics, taxanes, alkylating drugs)*	All chemotherapy drugs disrupt the division of cancer cells, affecting either the genes that regulate this process or the structures of the cell ( microtubules), which are formed during division.	The drugs are taken every 3–4 weeks ( 1 cycle).
	*Monoclonal antibodies*	Monoclonal antibodies bind to the HER-2 receptors of cancer cells, which makes it impossible for this receptor to contact the tumor growth-promoting substance. As a result, cancer growth is inhibited.	The drug is administered every 3 weeks or once a week.
	*Antihormonal drugs*	Reduce the formation of estrogenic hormones, which stimulate the uncontrolled formation of new cells in the mammary gland ( effective in hormone-dependent forms of cancer).	The drugs are used for a long time.
*Mammalgia* *(Cooper's disease)*	*Hormonal drugs*	They normalize the balance of female sex hormones in the body, eliminating premenstrual swelling of the gland.	The drugs are taken for 3 months, take a break for 2 - 3 months, then repeat the course.
	*Homeopathic medicines*	Affects central organs ( in the brain) regulating the menstrual cycle.
		Reduce swelling of the mammary gland, thereby eliminating the cause of pain and bloating.	Nonsteroidal anti-inflammatory drugs are taken for 1 to 2 weeks before menstruation.
	*Diuretics*	Eliminates fluid retention in the body that occurs during the premenstrual period. As a result, swelling and tenderness of the breast are reduced.	Taken during the second phase of the cycle.
*Mastopathy*		Antihormonal drugs reduce the production of prolactin, estrogens, or pituitary hormones that stimulate the release of estrogens. Hormonal drugs replace the deficiency of progesterone and thyroid hormones. Normalization of hormonal balance eliminates pathological stimulation of the growth of mammary gland elements.	Treatment is carried out for at least 6 months.
	*Nonsteroidal anti-inflammatory drugs*	The drugs reduce swelling and pain in the mammary glands.	The drugs are taken in the second phase of the menstrual cycle before the onset of menstruation.
	*Homeopathic medicines*	Affects brain centers regulating hormone production ( hypothalamus-pituitary gland).	The course of treatment is 3 – 6 months. Longer use may be required.
	*Iodine preparations*	The drugs replenish the lack of iodine in the body, which helps increase the level of thyroid hormones.
	*Aspiration and use of sclerosing agents*	At cystic mastopathy The cysts are punctured and their contents are suctioned, after which solutions are injected into the cavity of the cysts, causing their sclerosis, that is, scarring and gluing of the walls.	The operation is not complicated, so the woman is discharged within 1 to 2 days.
	*Surgery*	Under general anesthesia, dense nodes and the sector in which they arose are removed.	After the operation, the woman remains in the hospital for 7 days until the results of the histological examination are received.
*Gynecomastia*	*Hormonal and antihormonal drugs*	Antihormonal drugs inhibit the formation of female sex hormones in the male body. Hormonal drugs restore testosterone levels.	Treatment is carried out for 1.5 – 2 months.
*Gynecomastia*	*Surgery*	The breasts are removed using open surgery or endoscopic method (insertion of a catheter with a camera through an opening in the armpit).	The length of the recovery period after surgery depends on the method used to remove the mammary gland.
*Galactorrhea*	*Hormonal and antihormonal drugs*	Antihormonal drugs inhibit the production of prolactin in the pituitary gland. Hormonal drugs replace hormone deficiency, thereby normalizing the functioning of the pituitary gland.	The duration of drug treatment is at least 6 months.
*Ductectasia*	*Drug treatment* *(antibiotics, non-steroidal anti-inflammatory drugs)*	Drug treatment prevents further dilation of the ducts when infection is present ( antibiotics) And inflammatory process (non-steroidal anti-inflammatory drugs) in the mammary gland.	Antibiotics are prescribed if available bacterial infection (according to nipple discharge tests) within 7 – 10 days. Non-steroidal anti-inflammatory drugs are taken until symptoms disappear ( breast pain and fever).
*Ductectasia*	*Surgery*	Dilated ducts are partially excised within healthy tissue. If a malignant tumor is discovered along with the dilated ducts, the mammary gland is completely removed.	After the operation, the woman must remain in the hospital under the supervision of doctors for about a week.
*Mastitis*	*Antibiotics*	Antibacterial drugs destroy the cell wall of the mastitis pathogen or disrupt the process of microbial division.	The duration of taking the drugs depends on the severity of mastitis. For mild forms, medications are taken for 7-10 days, for severe forms - until signs of infection and inflammatory reaction disappear.
	*Nonsteroidal anti-inflammatory drugs*	These drugs, when applied topically in the form of ointments, eliminate inflammatory swelling and reduce pain. When taken orally, they also help normalize body temperature.
	*Surgery*	At purulent inflammation The purulent focus is opened, pus and dead tissue are removed, and drainage is performed. In case of widespread purulent lesion, part of the mammary gland is removed; in very severe cases, the entire gland can be removed.	The length of hospital stay depends on the severity of the condition. For purulent mastitis, hospitalization is required for at least 1 to 2 weeks.
*Congenital anomalies of breast development*	*Surgical correction*	Additional nipples and lobes of the mammary gland are removed, and in the absence of one or both mammary glands, prosthetics or other types of plastic correction are performed.	The length of hospital stay depends on the extent of the operation.
*Congenital anomalies of breast development*	*Drug treatment*	It is used for additional lobules that enlarge according to the type of mastopathy. Prescribed treatment with hormones and antihormones reduces the volume of the lobules.	The duration of treatment is at least 6 months.
*Breast injuries*	*Applying a bandage*	A bandage placed on the chest fixes the injured mammary gland, reducing painful sensations.	Complete resorption of the hematoma ( hemorrhages) lasts 1 – 1.5 months.
	*Antibiotics*	Antibacterial drugs are prescribed to prevent inflammation at the site of bruise and hemorrhage.
	*Local treatment* *(compresses and ointments)*	Dry heat and anti-inflammatory ointments promote the resorption of accumulated blood.
	*Surgery*	To remove accumulated blood from the gland, a closed aspiration method is used ( puncturing with a needle and drawing out blood) or open surgery.
*Problems associated with lactation and breastfeeding*	*Compliance with feeding technique*	After feeding, you need to express milk and massage your breasts to stimulate the formation of new portions of milk and prevent its stagnation.	These rules should be followed throughout the entire period of breastfeeding.
	*Emollient ointments*	Ointments containing vitamin B and lanolin help heal cracked nipples and prevent dry skin.
	*Proper nutrition*	Food should be high in calories, contain proteins and vitamins to stimulate milk production.
	*Physiotherapy*	Physiotherapeutic procedures improve blood circulation and metabolic processes in the mammary gland, resulting in increased milk production.	Physiotherapy sessions are carried out over 5 – 10 days.
	*Hormonal treatment*	A woman is injected intramuscularly with the pituitary hormone prolactin, which stimulates milk production in the mammary glands.	Prolactin is administered for 7 days.
*Mondor's disease*	*Anti-inflammatory drugs*	Eliminate the inflammatory reaction in the vein wall, reduce pain.	Treatment is carried out for 1 month ( sometimes longer).
	*Local treatment* *(compresses and ointments)*
	*Physiotherapy*
	*Surgery*	If the course is prolonged and the veins are blocked by blood clots, the affected veins are excised.

A mammologist is a specialist who diagnoses certain diseases related to the mammary glands, as well as their treatment and the development of subsequent preventive measures to prevent diseases in this area. Thus, answering the question of who is a mammologist, we can supplement the answer with the fact that it is this specialist who should be contacted if a number of different problems arise, ranging from manifestations such as engorgement of the mammary glands, which occurs before the onset of menstruation, to mastitis (and It is with this problem that patients most often turn to a mammologist), mastopathy or tumor formation.

The competence of a mammologist presupposes the possibility of treatment specified type problems within outpatient treatment, as well as the possibility of treatment in a hospital setting (surgical intervention, drug therapy). These areas of activity can be combined or implemented only separately, it all depends on the specific specialist.

It should be noted that in the conditions of the CIS countries, as well as in neighboring countries, such a specialization as “mammologist” does not exist in principle. Basically, the functions that are assigned to mammologists are performed by doctors whose activities are related to the treatment of cancer, related conditions and conditions of similar types. The mammary glands, accordingly, are also among the areas of their profile, and the specialists themselves in this case are oncologists.

Considering the fact that breast cancer is practically the leader in terms of cancer diseases in various countries, including Russia, an appointment with a mammologist is available in almost any serious clinic. The mammologist also works in the clinic, so finding a mammologist, regardless of the situation, is not so difficult.

Mammologist: what does this specialist treat?

The main areas of activity of a mammologist regarding specific diseases are the following:

dishormonal pathologies of the mammary glands - in this case fibrocystic disease or mastopathy, as well as gynecomastia are considered;
tumor pathologies of the mammary glands - this includes breast cancer, lipoma, fibroadenoma, sarcoma, etc.;
pathology inflammatory in nature mammary glands - here mastitis is considered in particular; in general, inflammatory diseases of the glands also fall under the competence of surgeons, whose area of specialization relates to purulent surgery.

When to go to a mammologist: preventive, first and urgent examination

As preventative measure You should visit a mammologist twice a year. You should take into account a certain feature, taking into account which a mammologist can see you - the days of your cycle. Taking this into account, you can go to him after the end of menstruation, before ovulation occurs (about 5-6 days).

It is better if the first consultation with this specialist is carried out in youth, because precisely due to early diagnosis in the presence of any pathology and the need for treatment, the doctor, accordingly, will be able to prescribe it, thereby minimizing as much as possible the possible threat of it development.

As for urgent consultation, it is necessary regardless of age or other factors; the fundamental reason for going to this specialist is the appearance of symptoms (discharge from the nipple, chest pain, etc.). In the absence of complaints, aggravating heredity and other predisposing factors, a visit to a mammologist after 30 years of age can be considered a necessity, implemented within a period of once every one and a half years. Accordingly, with aggravating factors and with hereditary predisposition, visiting a doctor should occur twice a year.
It is also important for women to understand that breast cancer in the initial form of its course is visible and painful symptoms does not show. Moreover, the traditional measure (independent palpation of the glands) may also be ineffective during this period of the disease. Thus, identifying pathology in the latent (initial) form of its existence is possible only when visiting a mammologist’s office.

Examination by a mammologist: when does it become necessary?

There are a number of conditions of the mammary glands that necessarily require an appropriate approach to them, namely, consultation with a mammologist. These are specific symptoms on the basis of which, even without this recommendation, a woman may have serious concerns about her own condition and actual disease. In order for the reader to understand what exactly is meant by such states, let us highlight them in detail:

redness of the mammary glands;
change in the size of the mammary glands (both larger and smaller);
the appearance of a lump in the chest;
the appearance of discharge from the nipples;
pain in armpits and in their surrounding areas;
pain in the mammary glands (or in one of the glands);
bulging or retraction of the skin noted in the area near the nipple;
asymmetry of the mammary glands.

In addition, there are also a number of predisposing factors, against the backdrop of the influence of which attention should also be paid to the need to visit a mammologist; we will highlight them below.

the presence of diseases of the genital organs (currently relevant or previously suffered);
the presence of specific sensations, which may even be insignificant in the nature of their manifestation (a feeling of fullness, pain in the mammary gland, a palpable lump, various types discharge from the nipples/nipple, feeling of engorgement of the glands, etc.);
the course of pregnancy was accompanied by the occurrence of certain unpleasant moments in it;
trauma to the mammary gland/glands occurred in the past, relatively recently or in the present;
there is a pressing problem in the form of liver dysfunction;
heavy and long stay in a state provoked by a psychotraumatic situation, in other words, in this case, stress is considered as a predisposing factor;
the relevance of a hereditary predisposition in which breast cancer occurred in one of the closest relatives.

Basically, the appointment of the specialist we are considering is outpatient, which means consulting a mammologist and performing the necessary diagnostic procedures. In parallel, as already noted, they undergo surgery in a hospital setting, as well as the required treatment.

Mammologist appointment: how does it go?

This specialist’s appointment involves palpation (that is, palpation of the mammary glands), as well as identifying specific complaints that are relevant to the patient. The following options can be assigned as research methods through which subsequent diagnosis of pathology can be made:

mammography (within this study mammary glands are studied using x-rays);
ultrasound examination (ultrasound) of the mammary glands;
examination of tissues removed by biopsy for subsequent oncological analysis of the material.

Additionally, the following methods can be used:

scintigraphy;
CT and MRI of the chest;
ductography (a method of x-ray examination of the ducts of the mammary glands).

Tests prescribed by a mammologist

The option of carrying out analyzes cannot be excluded; they include the following:

taking a smear (the procedure is carried out with the removal of material from one nipple), conducting a cytological examination (the removed material is examined);
taking a smear from both nipple glands, cytological examination of the removed material;
puncture for one of the palpable formations, carried out as diagnostic method using an ultrasound machine during this procedure.

Pediatric mammologist

We have already highlighted the need to visit a mammologist in early age above, a pediatric mammologist is a specialist whose visit is necessary for a child or adolescent to treat certain conditions and diseases. These include pseudotumor formations, asymmetry of the glands, injury to the glands or their hypertrophy (enlargement). This is also age-related mastopathy, fibroadenoma, etc. Let us repeat that with a timely visit to a mammologist, the possibility of a complete cure is possible with the implementation of adequate therapy measures.

IN adolescence consultation with a mammologist is necessary during the period of the so-called “hormonal storm”, because diseases of the mammary glands often begin to develop precisely from this period, and their manifestation can be noted already during pregnancy or lactation (breastfeeding).

It should be noted that a pediatric mammologist must partly also be a psychologist, taking into account the characteristics of the child’s psyche and the psyche of adolescents. The ability to establish contact and inspire trust on the part of patients is important. Taking this into account, a mammologist, reviews of whom are often the best confirmation of compliance with the requirements regarding professionalism and treatment, must be selected carefully, that is, again, taking into account qualifications, the effectiveness of treatment, and attitude towards patients.

Breast cancer: symptoms

Considering that breast cancer is perhaps one of those major diseases that women are especially afraid of, it is important to know what symptoms appear with it at the obvious stages of its relevance, that is, when, in general, any phenomena have already otherwise, but they make themselves felt.

So, first of all, this pain. An important fact is that from time to time women, one way or another, encounter pain in this area. If chest pain occurs frequently, it can be assumed that hormonal changes are the cause of this phenomenon (in up to 90% of cases this is exactly the case). With pain in only one of the mammary glands, as well as with the appearance of discharge in the same gland, with engorgement of the skin and with the detection of a tumor formation during palpation, we can say that the symptoms manifested in a particular case look somewhat more serious than just pain in the breast. breasts

Pain in the armpits, pain in the nipple area – these manifestations occur in approximately 10% of cases in women during the premenstrual period. The pain that appears in this case is characterized as dull. To relieve pain, you should reduce the amount of salt in your diet a few days before your period begins, and you should also avoid drinks that contain caffeine during this period. Due to this, fluid removal from the body will occur unhindered; breast tissue is also no exception.

If you have undergone a previous biopsy procedure or with a previous injury, the pain is of a slightly different nature. Thus, the concentration of pain is noted in a specific area, without connection with the menstrual cycle. The nature of the pain is cutting or shooting. It should be noted that after a biopsy, pain can persist for up to two years, the pain is concentrated mainly in the chest, although the main focus of pain is concentrated in the ribs. With increased pain with deep sharp breath or when pressing on the ribs, there is reason to believe that the patient has nothing more than arthritis.

Stress in pain also has its own position in terms of the manifestation of symptoms. So, if the level of stress hormone in the body is increased, then the pain in it also increases, regardless of the area of their localization; accordingly, this is also true for the mammary glands. If you add this to the influence of alcohol, coffee and poor diet in combination with your daily routine, you will soon notice that pain in the chest increases.

The next symptom that you should pay attention to in the context of this disease is the appearance of discharge. Discharge although they may alarm, in reality they have nothing to do with cancer in most cases. Mainly normal phenomenon, relevant for the second part of the menstrual cycle, the cause of their occurrence is the accumulation of a certain amount of fluid in the area of the milk canals. If pregnancy does not occur, this fluid disappears over time. It should be noted that the excited state of the nipples can lead to the release of a small amount of this fluid; it is mostly either transparent or slightly cloudy. Sometimes such discharge occurs against the background of undergoing significant physical activity.

Despite the fact that discharge is not a direct indication of actual breast cancer, certain features of it should nevertheless raise suspicion:

the constant nature of the discharge (that is, it appears not only in the period of several days preceding menstruation);
accompanying discharge external changes mammary glands (palpation of compactions, engorgement of the skin is noted);
the appearance of a spontaneous type of discharge (that is, discharge appears without prior compression of the chest, without previous physical activity or friction);
the liquid released from the nipples has a certain color (that is, it is not cloudy or transparent, but reddish, greenish, etc.);
the nipple skin itches and is generally inflamed;
discharge is noted from only one breast or discharge is noted from 1-2 pores in the nipple.

Seals, which we have already noted, in many cases are not malignant, but this is not a reason to exclude them as a serious symptom indicating possible breast cancer, quite the contrary. In particular, a visit to a mammologist may include the following symptoms associated with a lump in the breast:

when palpated, the hardness of the seal is noted;
the edges of the seal are uneven;
it is characterized by pain;
there are no similar lumps in the other breast;
the movement of the compaction occurs only with the tissues adjacent to it;
the features inherent in compaction do not change in accordance with the menstrual cycle.

In most cases, a mammologist studies, diagnoses and treats breast problems associated with hormonal disorders in the body or the growth of a malignant tumor. The competence of a mammologist includes the treatment and prevention of the following diseases:

Mastopathy;
Fibrocystic disease;
Adenoma and fibroadenoma;
Lipoma;
Inflammatory diseases of the mammary glands in nursing mothers;
Tumors of the mammary glands of a malignant nature.

It is recommended to visit a mammologist’s office at least once a year, thus, any changes in gland tissue, lumps and diseases will be detected at an early stage of development. Timely initiation of treatment is the key to a successful outcome of the disease.

When is a consultation with a mammologist necessary?

Every woman should be able to perform a breast self-examination. You need to do this every month in front of a mirror with your breasts naked. One hand is raised up, and with the fingers of the other hand, clockwise, you need to carefully palpate the mammary gland, first in a circle, and then from top to bottom. Finally, squeeze the nipple between your fingers; normally, there should be no discharge from the ducts. The self-examination should not cause pain or other discomfort in the woman.

The following conditions are reasons for urgent consultation with a mammologist:

The presence of painful lumps in the chest;
One mammary gland is much larger than the other;
When pressed, the breast is released from the nipple; the body temperature is increased to 39 degrees, and the mammary gland itself is hot to the touch and sharply painful;
Modification of the nipple (retraction, deformation);
Discharge of blood or fluid from the nipple when pressed;
Chest pain, release of colostrum not associated with lactation.

In addition, without waiting for the appearance clinical symptoms, a mammologist should be seen if a woman has suffered a chest injury or bruise of the mammary glands.

Where to find a good mammologist?

A good mammologist in the capital can be found on our website. We have compiled for visitors a list of the best mammologists in Moscow who have a high rating and work experience.

In order not to waste precious time, but immediately choose from a list of specialists the best doctor, go to the reviews section. There you can get acquainted with the truthful impressions of the mammologist from other patients who have already had an appointment.

A mammologist sees patients pre-registration, therefore, as soon as the choice in favor of a specific doctor is made, contact the administrator medical center and discuss a time and date that is convenient for you.