There is no doubt that female genitals and mammary glands constitute a unified systemic whole (fig. 27.1). All mammals show common development of mammary glands and full-fledged intrauterine gestation. Besides, multiple studies have demonstrated that mammary gland diseases and gynecological conditions share a common pathogenesis.
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Fig. 27.1. Systemic uniformity of genitals and breasts
In the population noncancerous breast conditions are noted in 30-70% of women; but in women with gynecological morbidities their rate increases to 76-97.8%. And vice versa, gynecological morbidity in women with breast conditions amounts to 115%, which means 1.1 condition per one woman. Almost 85% of women with benign breast disease have some or other disease of genitals.
Like in some other countries, in Russia breast diseases were for a long time treated by mammologists - surgeons, oncologists, radiologists - who specialized in this field of medicine. Unfortunately, setting up a network of mammology dispensaries failed to produce an expected decrease in benign and malignant mammary diseases. Gynecologists used to neglect the breasts both when performing screening of apparently healthy women (the way it should be done in relation to cervix diseases) and when seeing women with mammary presentations; at most, the woman was referred to see a mammologist.
NB! Successful treatment and effective prevention of mammary diseases is only possible when regarding the breasts as a component of the reproductive system.
According to the order by the Ministry for Public Health №572n ?On approval of procedure for obstetric and gynecologic care...? valid in the Russian Federation since 2012, examination and management of patients with benign breast disease is mandatorily vested with obstetrician-gynecologists.