Treatment is directed at symptom control and prevention of complications that may arise by failing to treat the injury. Fibrocystic changes generally do not require any treatment and get better with time.

Changes in lifestyle:

These measures are implemented, not only because it could alleviate the symptoms associated with BBD, but also because of the advantages related to overall health and wellness. Eating a diet low in fat and the elimination of methylxanthines (coffee, tea, chocolate and carbonated beverages) produced improvements in 60% of cases and can be used to treat fibrocystic change, particularly if the pain is shown. Although not established a direct association ultimately promulgating quitting smoking and exercising regularly. Women who undergo fat necrosis, must wear a bra as additional support.

Medications:

The BBD with infectious etiology, such as an abscess or mastitis, is treated with antibiotics, but the duration of therapy depends on the severity of symptoms and response to treatment. Patients commonly require at least 1 week of oral antibiotics. The choice of antibiotic depends on the suspected causative organism, usually gram-positive coccid. Acute mastitis is also treated with hot compresses. In mastitis related to breastfeeding, breastfeeding should continue while the patient is treated for mastitis.

For treatments include:

Diuretics: A few results could be considered almost as placebos.

Progestogens: Based on the hypothesis that lacteal insufficiency have shown a dubious activity in randomized studies against placebo. Have been implemented:

+ Topically: ointment between 1 and 10% of progesterone.

+ Potential route: Hydroxyprogesterone (second phase of the cycle) and MPA (every 3 months).

+ Oral: norestestirone, lynestrenol, didrogesterona second phase or throughout the cycle.

Bromocriptine: As antiprolactinico at doses of 2.5 mg per day has shown great effectiveness. However it should have its unpleasant side effects.

Diazole: As antigonadotrofinico, an initial dose of 200 mg a day, to reduce it to 100 mg daily as maintenance, the medicine has proven more powerful, with relatively low side effects.

Tamoxifen: As anti-estrogen, at doses of 10-20 mg daily, has shown efficacy in the treatment of misalign, but the possibility of inducing liver tumors was recommended to relegate it to a second line.

Methyl testosterone: A dose of 5 mg on alternate days gave results similar to progestin’s, but has an obvious iridizing effect.

Evening primrose oil or evening primrose (Oenothara biennia) (Evening primrose oil): Rich in EFA (72% linoleic acid and 7% acid?-Linolenic acid) has been effective in cyclical misalign. It has the advantage of giving the patient a “natural product”, but its strength is several capsules a day, is expensive and not covered by Social Security.

Pyridoxine (Vitamin B6): Based on that favors decarboxylation of dope to dopamine, is supposed to inhibit PRL levels. It has been used at doses of 200 mg per day without significant clinical results.

Treatment of non-cyclical misalign: Not likely to respond to endocrine treatment, because it’s frequently fibrorretractiles or inflammatory processes. Have been tested, with different results in each case:

- NSAID ’s.

- Local injection of local anesthetic + steroid.

- In cases of “trigger spot” not responsive to previous treatment may be considered local surgical excision (whose histopathology showed no alterations).

Other treatments:

- Vitamin A: Results difficult to interpret.

- Vitamin E: There have been some good results with 600 IU per day of synthetic tocopherol acetate.

- Thyroid hormone: irregular results, except in hypothyroidism.

- Antihistamines: Results point.

- Tranquilizers: If you attach a picture of anxiety, but should be given with caution to avoid secondary boxes iatrogenic galactorrhea and breast tenderness.

Surgical treatment:

Surgical drainage of an abscess is done to prevent the spread of infection and symptomatic relief of pain or discomfort. Fibro adenomas, when symptomatic, can be removed completely. Alternatively, if a patient under 35 years and the mass does not break with the quality of life, a biopsy of the base can be made to establish, above all, that there is a disease of major proportions, so the condition can be managed conservatively.

For the same age, with less than 1 cm fibroadenomas could be expectant and perform surgery if you have sustained growth (greater than 2 cm), breast pain or concern of the patient.

Surgical treatment of mastalgia: excisions larger than that of a “trigger spot” has been practiced from segmentectomy to subcutaneous mastectomy with implantation of prosthesis. Excluding cases in which prophylaxis was indicated as cancer today can not be indicated, because the pictures do not improve obviously painful, but may also end up producing in other categories against capsular retraction painful and foci of necrosis and loss of areola complex nipple.