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.
Dr. Ming's TCM Medical Center,
Hua Xi
Xiao Yuan, Hutian Developing Area,
Huaihua city, Hunan province
China