Hyperplasia of
mammary glands, not inflammatory or tumorous, is a
proliferative disease, which is included in TCM, in the
category of Rupi (nodules of breast) and Ruzhongjiehe
(nodules in breast). Some type of it will develop into
cancer. Most of its subjects are women of 30-45, 5-15% and
even 30% of whom will be3 ill with it.
Etiology
and Pathogenesis
1. Anger impairs
and depresses the liver. Qi stagnation is due to the
depressed liver, and blood stasis is due to qi stagnation.
2. Stagnation of qi
and blood tends to occur in the breast, for it is on the
route of Stomach Channel of Bright-Yang with plenty of qi
and blood.
3. Transverse flow
of the liver qi or anxiety impairs the spleen, the
impaired spleen fails to perform its function in
transportation, and phlegm-dampness is thus produced.
Stagnation of the
liver qi, blood stasis and accumulation of phlegm get
together to form lumps, causing this disease.
Stagnation of the
liver qi can result in this disease alone or lead to
this disease by disturbing the Penetraring and controlling
Channels.
Clinical
Manifestations
The following three
types are established according to different pathologic
manifestations.
1.Syndrome of
Mammary Pain
Usually
intermittent dull. stabbing or vague pain as the main
symptom which is induced of ten before menstruation,
aggravated by anger and relived or wiped away when
menstruation or happiness comes; the pain worsened by the
clothes worn orbed-clothes used and sometimes referring to
the armpit, shoulder or upper limbs; examination through
which no evident masses are found but hypertrophic mammary
tissue or granular nodules with mild tenderness may be
palpable; often-seen emotional depression and irritability.
2.Hyperplasia of
Lobules of Mammary Glands
Onset usually in
both the mammae but occasionally limited in one; pain of
mammary glands with masses as the main symptom which is
severe usually before menstruation, aggravated often by
anger and relieved or stopped after menstruation with the
masses remarkably reduced in size; the pain manifested in
the same way as syndrome of mammary pain; the masses in
different sizes and shapes, tough, indistinctly-bordered and
not cementing with the muscular layers; discharge from
nipple in a small number of cases; hypomenorrhea in most
cases, and sexual hypoesthesia. in part of cases.
3. Cystic
Hyperplasia of Breast
Masses of mammary
glands as the main symptom which is accompanied by mild
mammary pain and manifested as one or more differently-sized
round tough movable indistinctly-bordered and not obviously
painful cysts, general distending pain in the breast, the
masses more painful before menstruation but softened and
shriveled with the pain reduced after menstruation comes,
brown or bloody fluid discharged out of the nipple in some
cases, and symptoms due to emotional disorders, Because this
disease may develop into cancer, examination with
pathological section should be made to identify the
diagnosis if cancer is suspected.
Differential
Diagnosis
1. Adenoscarcoma of
Breast
Usually seen in
women of 20-25; one or more masses in the breast which are
round or egg-shaped, distinctly-bordered, sooth, though,
movable and developing slowly; and no general symptoms.
2. Mammary Cancer
Usually seen in
women of 40-60 just before or after climacteric; masses in
the breast which are as hard as stone, rough, movable in the
early stage and fixed in the advanced stage; skin dimpling,
retreated nipple, enlarged and hard axillary lymph nodes
which become cauliflower-like or rock-like ulcers after
festering, and bloody fluid wit awful smell discharged from
the ulcers. In the early stage pathological section is
needed to make the diagnosis.
Type and
Treatment
Good effects will
be obtained if TCM is relied on in treating this disease.
Remarkable effects without side ones come from correct
differentiation, and proper administration, and long taking,
of Chinese drugs.
1. Internal
Treatment
(1) Syndrome due to
depression of the liver qi, blood stasis and accumulation of
phlegm.
Main Symptoms:
Evident tough masses enlarged or reduced with the change of
emotion, irritability, choking sensation in the chest,
distending or stabbing pain in the breast, white tongue
coating, and taut slippery pulse.
Therapeutic Method:
Soothing the liver, promoting the flow of the liver-Qi,
activating blood circulation to remove blood stasis,
resolving phlegm and dispersing masses.
Prescription:
Rukuaixiao Tang (Decoction for Resolving Masses in the
Breast).
Ingredients:
Gualou Fructus
Trichosanthis
Xiakucao Spica
Prunellae
Shengmuli Concha
Ostreae
Kunbu Thallus
Laminariae seu Echloniae
Haizao Sargassum
Danshen Radix
Salviae Miltiorrhizae
Chaihu Radix
Bupleuri
Tiandong Radix
Asparagi
Sanleng Rhizoma
Spargnii
Ezhu Rhizoma
Curcuae
Juye Folium Citri
Reticulatae
Juhe Semen Citri
Reticulatae
Banxia Rhizoma
Pinelliae
Administration:
Decocted in water twice for the decoction, which is taken
warm in the morning and evening, 1 dose daily. 1 course of
treatment consists of 12 days.
Modification: In
case of irritability and fullness in the chest, the herbs
added are.
Shanzhizi Fructus
Gardeniae
Qingpi Pericarpium
Citri Reticulatae Viride
Xiangfu Rhizoma
Cyperi
In case of harder
masses, the herb added is
Shanjiazhu Squama
Manitis Preparata
In case of severe
pain, the herb added is
Yanhusuo Rhizoma
Corydalis
(2) Syndrome due to
disorder of Penetrating and Controlling Channels resulting
from stagnation f the liver Qi.
Main Symptoms:
Softer mass with indistinct border, soreness of the waist,
irregular menstruation, scanty and pale menstruation,
distending pain of the breast before menstruation, pale red
tongue with white coating, and taut thready or deep thready
pulse.
Therapeutic Method:
Soothing the liver and promoting the flow of the liver qi,
regulating Penetrating and Controlling Channels, resolving
phlegm and masses.
Prescription:
Modified Rukuaixiao Tang.
Ingredients:
Gualou Fructus
Trichosanthis
Xiakucao Spica
Prunellae
Shengmuli Concha
Ostreae
Kunbu Thallus
Laminariae seu Echloniae
Haizao Sargassum
Yinyanghuo Herba
Epimedii
Shudi Radix
Rehmanniae Preparata
Xuduan Radix
Dipsaci
Danshen Radix
Salviae Miltiorrhizae
Xianmao Rhizoma
Curculiginis
Lujiaoshuang Cornu
Cervi Degelatinatum
Chaihu Radix
Bupleuri
Tiandong Radix
Asparagi
Juye Folium Citri
Reticulatae
Banxia Rhizoma
Pinelliae
Administration:
Decocted in water twice for the decoction, which is taken
warm in the morning and evening 1 dose daily.
2. External
Treatment
For a few localized
masses, Yanghe Jiening Gao or Huiyang Yulong Gao is applied
externally. The following is the introduction to Huiyang
Yulong Gao.
Ingredients:
Caowu Radix Aconiti
Kusnezoffii
Ganjiang Rhizoma
Zingiberis
Chishao Radix
Paeoniae Rubra
Baizhi Radix
Angelicae Dahuricae
Nanxing Rhizoma
Arisaematis
Rougui Cotex
Cinnamomi
Administration:
Ground into fine powder and made into a paste, which is
applied externally.
Prevention
1. Live a joyful
life and treat irregular menstruation.
2. Try to live a
natural life such as marrying not too late, giving birth
after marriage, doing breast feeding after giving birth and
living a normal sexual life.
3. Take measure for
birth control and avoid artificial abortion. The breast is
distended during pregnancy. Sudden pause of pregnancy will
make mammary glands fail to be supported by hormone.
However, this sudden restoration of mammary glands is often
incomplete, and masses and pain in mammary glands are easy
to lead to.
4. In case of
prolonged hard tough masses in the breast, biopsy with
pathological section is needed to make sure whether cancer
has been developed or not.