Мастодиния. Современные данные о причинах, течении, диагностике и подходах к коррекции
Мастодиния. Современные данные о причинах, течении, диагностике и подходах к коррекции
Лещенко О.Я. Мастодиния. Современные данные о причинах, течении, диагностике и подходах к коррекции. Гинекология. 2023;25(3):282–289. DOI: 10.26442/20795696.2023.3.202341
Leshchenko OYa. Mastodynia: Current data on the causes, course, diagnosis, and treatment approaches. A review. Gynecology. 2023;25(3):282–289. DOI: 10.26442/20795696.2023.3.202341
Мастодиния. Современные данные о причинах, течении, диагностике и подходах к коррекции
Лещенко О.Я. Мастодиния. Современные данные о причинах, течении, диагностике и подходах к коррекции. Гинекология. 2023;25(3):282–289. DOI: 10.26442/20795696.2023.3.202341
Leshchenko OYa. Mastodynia: Current data on the causes, course, diagnosis, and treatment approaches. A review. Gynecology. 2023;25(3):282–289. DOI: 10.26442/20795696.2023.3.202341
Мастодиния является частым клиническим симптомом в общей врачебной и гинекологической практике. Задачи данного библиографического обзора: провести анализ научных сведений об эпидемиологии мастодинии/масталгии, о влиянии на качество жизни, противоречиях в определении этиологии, сформулировать диагностическую концепцию, классификацию, лечение, а также выяснить терапевтические эффекты Vitex Agnus-Castus. Проведен поиск научных публикаций в основных исследовательских базах данных, CochraneLibrary, PubMed, Science Direct, Google Scholar, ELibrary за последние 30 лет; использованы термины «масталгия/mastalgia», «мастодиния/mastodynia», «прутняк/Vitex Agnus-Castus», «боль в груди», «боль в молочных железах/chest pain, breast pain». Патофизиология мастодинии объясняется не одним механизмом, а разными причинами с независимыми путями формирования болезненных ощущений. Большинство исследований подчеркнули важность правильной классификации боли в молочных железах для точной диагностики и эффективной терапии, чтобы уменьшить частоту и выраженность эпизодов боли и улучшить качество жизни при минимизации побочных эффектов. Препараты на основе Vitex Agnus-Castus являются безопасными и эффективными в лечения мастодинии.
Ключевые слова: масталгия, мастодиния, Vitex Agnus-Castus, боль в груди, боль в молочных железах
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Mastodynia is a common clinical symptom in general medical and gynecological practice. The objectives of this literature review are to analyze scientific information on the epidemiology of mastodynia/mastalgia, the impact on quality of life, inconsistencies in the etiology determination, to formulate a diagnostic concept, classification, and treatment, and to assess the therapeutic effects of Vitex Agnus-Castus. Scientific publications over the past 30 years were searched in the main research databases, CochraneLibrary, PubMed, Science Direct, Google Scholar, and ELibrary, using the terms "mastalgia," "mastodynia," "Vitex Agnus-Castus," "chest pain," "chest pain, breast pain." The pathophysiology of mastodynia is multifaceted, with various etiology factors and independent ways of pain occurrence. Most studies have emphasized the importance of correctly classifying breast pain for accurate diagnosis and effective therapy to reduce the frequency and severity of pain episodes and improve quality of life while minimizing side effects. Vitex Agnus-Castus is safe and effective in the treatment of mastodynia.
Keywords: mastalgia, mastodynia, Vitex Agnus-Castus, chest pain, breast pain
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1. Olawaiye A, Withiam-Leitch M, Danakas G, Kahn K. Mastalgia: a review of management. J Reprod Med. 2005;50(12):933-9.
2. Grullon S, Bechmann S. Mastodynia. In: StatPearls [Internet], Treasure Island (FL): StatPearls Publishing, 2022; 2023.
3. Stachs A, Stubert J, Reimer T, Hartmann S. Benign Breast Disease in Women. Dtsch Arztebl Int. 2019;116(33-34):565-74. DOI:10.3238/arztebl.2019.0565
4. Kataria K, Dhar A, Srivastava A, et al. A systematic review of current understanding and management of mastalgia. Indian J Surg. 2014;76(3):217-22. DOI:10.1007/s12262-013-0813-8
5. Kulagina NV, Odintsov VA. Mastodiniia: patogenez, diagnostika, lechenie. Akusherstvo i ginekologiia. 2022;6:33-9 (in Russian). DOI:10.18565/aig.2022-6.33-39
6. Kumar S, Rai R, Das V, et al. Visual analogue scale for assessing breast nodularity in non-discrete lumpy breasts: the Lucknow–Cardiff breast nodularity scale. Breast.
2010;19(3):238-42. DOI:10.1016/j.breast.2010.02.002
7. Scurr J, Hedger W, Morris P, Brown N. The prevalence, severity and impact of breast pain in the general population. Breast J. 2014;20(5):508‑13. DOI:10.1111/tbj.12305
8. Sutton GL, O’Malley VP. Treatment of cyclical mastalgia with low dose short term danazol. Br J Clin Pract. 1986;40(2):68-70.
9. Mansel RE, Dogliotti L. European multicenter trial of bromocriptine in cyclical mastalgia. Lancet. 1990;335(8683):190-3. DOI:10.1016/0140-6736(90)90278-d
10. Fentiman IS, Powles TJ. Tamoxifen and benign breast problems. Lancet. 1987;2(8567):1070-2. DOI:10.1016/s0140-6736(87)91491-7
11. Ader DN, South-Paul J, Adera T, Deuster PA. Cyclical mastalgia: prevalence and associated health behavioral factors. J Psychosom Obstet Gynaecol. 2001;22(2):71-6. DOI:10.3109/01674820109049956
12. Mansel RE, Webster DJT, Sweetland HM. Breast pain and nodularity. In: Benign disorders and disease of the breast. 3d ed. Philadelphia: Saunders, Elsevier, 2009.
13. Padden DL. Mastalgia: evaluation and management. Nurse Pract Forum. 2000;11(4):213-8.
14. Rungruang B, Kelley JL 3rd. Benign breast diseases: epidemiology, evaluation, and management. Clin Obstet Gynecol. 2011;54(1):110-24. DOI:10.1097/GRF.0b013e318208010e
15. Wisbey JR, Kumar S, Mansel RE, et al. Natural history of breast pain. Lancet. 1983;2(8351):672-4. DOI:10.1016/S0140-6736(83)92543-6
16. Goyal A. Breast pain. BMJ Clin Evid. 2011;2011:0812.
17. Malarkey WB, Schrooeder LL, Stevens VC, et al. Twenty-four-hour preoperative endocrine profiles in women with benign and malignant breast disease. Cancer Res.
1977;37(12):4655-9.
18. Sitruk-Ware R, Sterkers N, Mauvais-Jarvis P. Benign breast disease I: hormonal investigation. Obstet Gynecol. 1979;53(4):457-60.
19. Peters F, Pickcardt CR, Zimmermann G, Breckwoldt M. PRL, TSH and thyroid hormones in benign breast diseases. Klin Wochenschr. 1981;59(8):403-7. DOI:10.1007/BF01698519
20. Kumar S, Mansel RE, Scanlon MF, et al. Altered responses of prolactin, luteinizing hormone and follicle stimulating hormone secretion to thyrotrophin releasing hormone/gonadotropin releasing hormone stimulation in cyclical mastalgia. Br J Surg. 1984;71(11):870-3. DOI:10.1002/bjs.1800711123
21. Parlati E, Travaglini A, Liberale I, et al. Hormonal profile in benign breast disease: Endocrine status of cyclical mastalgia patients. J Endocrinol Invest. 1988;11(9):679-83. DOI:10.1007/BF03350214
22. Bonilla-Sepulveda OA, Giraldo-Santa DC. Mastodynia. CES Med. 2019;33(2):111-8. DOI:10.21615/cesmedicina.33.2.4
23. Ledina AV, Prilepskaya VN. Mastalgiya: klinika, diagnostika, lechenie. Gynecology. 2011;13(5):66-76 (in Russian).
24. Leshchenko OYa. Hyperprolactinemia in the postmenopause: versions and contraversions. Terapevticheskii Arkhiv (Ter. Arkh.). 2021;93(10):1234‑9 (in Russian). DOI:10.26442/00403660.2021.10.201073
25. Bundred NJ. Breast pain. BMJ Clin Evid. 2007;2007:0812.
26. Labygina AV, Suturina LV, Leshenko OYa. Change of prolactin against a background of intake of oral contraceptives in girls with functional hyperprolactinemia. Biulleten' VSNTs SO RAMN. 2006;1(47):79-81 (in Russian).
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Авторы
О.Я. Лещенко*
ФГБНУ «Научный центр проблем здоровья семьи и репродукции человека», Иркутск, Россия
*loyairk@mail.ru
________________________________________________
Olga Ya. Leshchenko*
Scientific Centre for Family Health and Human Reproduction Problems, Irkutsk, Russia
*loyairk@mail.ru