Fibrocystic Breast Changes

Basics

Description

  • Generalized term for benign breast tissue changes that are often dense, bumpy, and irregular
  • Previously referred to as “fibrocystic breast disease,” however no longer considered a pathologic process as these changes are found in the majority of healthy women
  • Most common of all benign breast conditions; occurs in around 60% of women
  • Pain is often present and most prominent during the premenstrual phase, improves with the onset of menses
  • Symptoms of pain/tenderness persist and usually worsen until menopause
  • Breast pain alone is a rare symptom of cancer and accounts for only 0.2–2% of cases
  • Synonyms: adenosis, benign breast disease, cystic mastitis, cystic disease of the breast, fibroadenosis, fibrocystic disease, mammary dysplasia

Etiology

  • Mechanism of development not completely understood
  • Likely an enhanced or exaggerated reaction of breast tissue to cyclic levels of female reproductive hormones
  • May be caused by:
    • Imbalance of the estrogen to progesterone ratio
    • Increased estrogen receptor sensitivity
    • Increased daily prolactin production
  • Most common in women 30–50 yr old
  • Pain is most likely caused by rapid expansion of simple cysts
  • Symptoms may continue into menopause if patient on hormone replacement therapy
  • Decreased incidence in women taking oral contraceptives
  • Risk factors include:
    • Family history of fibrocystic changes
    • Oral contraceptives
    • Hormone replacement therapy (controversial)
    • Increased age
    • Diet (high fat intake; caffeine/methylxanthines)

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