Questions to mammologist Oleg Georgievich Kiselyov

On September 3 and 4, we traditionally conducted our monthly column ".... I just have to ask", within which the subscribers of the MC "Tomography" account on Instagram @medcenter.mrt.by had the opportunity to ask any question to our oncologist-mammologist Oleg Kiselev Georgievich.

We thank all users for their activity and interesting questions.

And for those who are not active users of social networks, we publish information here.

I AM 31 YEARS OLD. GREAT. A FEW DAYS BEFORE MENSTRUATION, WHEN PRESSED, THE CHEST BEGINS TO PAIN. EARLIER THERE WAS NO SUCH FEELINGS. I HAVE NOT DETECTED ANY SEALS. IS THIS THE NORM?

With hormonal premenstrual changes in the female body and preparation for ovulation (in the 2nd half of the menstrual cycle), changes also occur in the tissues of the mammary gland. There is their premenstrual edema, which is accompanied by pain. This is a normal process. If the painful sensations before the onset of menstruation are pronounced, interfere with comfortable living and working, then this condition requires medical correction. Treatment is prescribed by a mammologist. Also, pain sensations that are more pronounced than before can be triggered by the state of the disease (for example, a cold, diseases in the genital area (ovaries, uterus, STIs) or diseases of the thyroid gland). If you think that you previously endured the premenstrual period more easily, but now the pain bothers you, then you should consult a doctor (first of all, a gynecologist, and then a mammologist, if the problem is not of a gynecological nature).

WHAT IS THE PROBABILITY OF BREAST OR OVARIAN CANCER IF THE FATHER HAS PROSTATE CANCER? HAVE HEARD THIS IS RELATED?

Father's prostate cancer is not genetically directly related to breast or ovarian cancer. Women whose closest relatives (grandmother, mother, sister), had malignant tumors of the mammary gland, uterus, ovaries or rectum have a greater predisposition. In any case, if you have any doubts, you can pass a genetic test for susceptibility to breast cancer - blood for a mutation in the BRCA 1-2 genes.

DOES THE BREAST ALWAYS BE REMOVED WITH MALIGNANT DISEASES OF THE BREAST?

No not always. The issue is resolved in each specific case purely individually and depends on many factors: the stage of the disease, the ratio of the size of the tumor and the size of the affected breast, from the location of the tumor in the gland, from the aggressive factors of a particular tumor, from hereditary and / or genetic predisposition to breast cancer and dr.

10 YEARS AGO FIBROADENOMA WAS REMOVED IN THE BREAST. 5 YEARS AGO, NEW ONE APPEARED IN THE SAME PLACE. SIZE 1.7CM. I AM OBSERVING, UNDERSTANDING an ultrasound scan. NO GROWTH. DO I NEED TO DELETE OR CAN I LIVE WITH IT BY OBSERVING?

Fibroadenoma is a benign breast tumor. However, it has risks of malignancy in breast cancer or breast sarcoma (according to various literature data, this is observed from 1 to 5% of cases). And, unfortunately, it is impossible to predict or predict with a high probability who will fall into this 1%. Therefore, a tumor larger than 1 cm is recommended to be removed surgically (even in the absence of other unfavorable prognosis factors).

3 YEARS AGO DETECTED A CYST IN THE BREAST. SIZE: 6.6 × 7.6 MM, VIEW UNEVEN, FUZZY. EXPERIENCED PAIN. DROP MASTADINON. NEW PAINS REPEAT AGAIN. SOME DOCTORS SAY THAT IT IS NECESSARY TO TAKE BIOPSY, OTHERS - THAT IS TOO SMALL AND NOT NECESSARY. WHAT ARE THE NEXT ACTIONS?

To resolve issues of this nature, it is necessary to perform a fresh ultrasound of the mammary glands in the first phase of the menstrual cycle (on the 5-7th day of menstruation), take all previous examinations with you and contact a full-time consultation and examination with a mammologist.

I WILL BE 47 YEARS OLD IN OCTOBER.

EVERY YEAR (I TAKE HEALTH VERY SERIOUS) I UNDERSTAND ultrasound of the mammary glands and axillary lymph nodes, ultrasound of the small pelvis. MAMMOGRAPHY WAS NOT PASSED. THE DOCTORS SAID THAT MAMMOGRAPHY SHOULD BE PERFORMED AFTER 50 YEARS, AND UNDER 50 YEARS IS ENOUGH USES. IT'S RIGHT? HOW IS IT CORRECT TO BE INSPECTED?

If, according to the results of ultrasound, you have a pronounced involution of the mammary glands (this should sound in the conclusion) or according to the ultrasound there are any unresolved moments and moments for which dynamic ultrasound observation is established, then mammography is advisable. If there is no pathology on mammography, then further research should be performed once every 2 years.

IS IT POSSIBLE TO GET PREGNANT IF THERE IS 3 FIBROADENE, SIZE ABOUT 1 CM. HOW OFTEN DO THIN NEEDLE ASPIRATION PUNCTURE BIOPSY DO?

This issue is resolved individually at an appointment with a mammologist after a detailed survey and examination with the results of the examination (ultrasound of the mammary glands in dynamics for the entire time of observation of fibroadenomas and the results of cytological research).

DO I ALWAYS NEED BIOPSY FOR BREAST FIBROADENOMA?

This is decided individually after an appropriate examination (ultrasound and / or mammography) according to indications, a detailed survey and examination of the patient by a mammologist.

HOW OFTEN DO YOU NEED TO BE OBSERVED BY A DOCTOR AFTER FIBROADENOMA REMOVAL?

The first ultrasound and examination must be performed 3 months after the operation, followed by an ultrasound and examination every 6 months.

DIAGNOSIS FROM 18 YEARS: DIFFUSE MASTOPATHY. I DO BREAST Ultrasound EVERY YEAR. WHAT ELSE EXAMINATIONS DO YOU NEED TO PASS TO NOT RUNNING ANYTHING?

An examination by a mammologist with the results of an ultrasound of the mammary glands is required. The frequency of the examination will be determined by the doctor after examining and studying the results of ultrasound.

I HAVE A BREAST MICROKIST 4.7 MM. WHAT ARE MY FOLLOWING ACTIONS? AND IS IT POSSIBLE TO GET PREGNANT?

It is necessary to undergo an ultrasound of the mammary glands and examination by a mammologist every 6 months. There are no contraindications to pregnancy.

I AM 39. 8 YEARS AGO THE FIBROADENOMA WAS REMOVED, THEN THE CYSTES AND THE FIBROADENOMA WERE DETECTED. ONE DOCTOR SAYS TO DELETE, AND THE SECOND SAYS - NO NEED TO. I DREAM TO BIRTH. 1 YEAR AGO THE OPERATION TO REMOVE UTERINE MYOMA, INJECTED INTO AN ARTIFICIAL CLIMAX AND THE BREAST DOESN'T HURT. AND NOW STARTS TO BE SICK. WHAT TO DO?

It is necessary to perform a fresh ultrasound of the mammary glands in the first phase of the menstrual cycle (on the 5-7th day of menstruation), take previous examinations and consult a mammologist.

A COMPLEX CYST DETECTED ON THE USE (IT IS LIKELY CALLED THIS). THE DOCTOR SAID THAT ANYTHING IS SCARY AND THE USE IS ENOUGH ONE A YEAR AND THERE IS NOTHING TO DO ANYTHING. WOULD YOU LIKE TO KNOW SO IT OR IT IS WORTH SEEING TO ANOTHER DOCTOR?

Questions of the frequency of observation and treatment are the prerogative of a clinician, not a diagnostician. Therefore, with the results of the survey (current and previous), it is imperative to contact a specialized specialist.

DO ALL FIBROADENOMS NEED TO BE REMOVED?

This issue is resolved individually after a detailed survey, examination and study of the relevant examinations of the patient. It is recommended to consult a mammologist for an examination in the first phase of the menstrual cycle (the first 10-12 days from the beginning of menstruation).

COULD YOU COMMENT? DIFFUSE MASTOPATHY WITH LIPID INVOLUTION AND FIBROSIS DOMINATED. BIRADS2.

Fatty involution and fibrosis are practically not oncologically dangerous. BUT! Everything needs to be assessed in a complex: age, predisposing factors, ultrasound, mammography, etc. This is done by a mammologist at an individual appointment.

We thank Oleg Georgievich for the detailed answers!

OUR DOCTORS ARE OUR PRIDE!