Fibrocystic Breast Changes
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Basics
Description
- Generalized term for benign breast changes that are poorly defined
- No longer considered a pathologic disease process as they are found in the majority of healthy women
- Most common of all benign breast conditions
- Changes include:
- Benign cysts
- Breast pain (mastalgia or mastodynia), which may or may not be cyclic
- Diffuse and focal nodularity
- Palpable fibroadenomas
- Nipple discharge—may be green or brownish, though usually nonbloody
- Spontaneous, persistent discharge warrants further evaluation
- Occurs in ∼60% of women
- Symptoms of pain and tenderness become progressively worse until menopause
- Pain is often most prominent during the premenstrual phase and improves with the onset of menses
- 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 well 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
- May occur secondary to 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 secondary to hormone replacement therapy
- Incidence is decreased in women taking oral contraceptives
- Risk factors include:
- Family history of fibrocystic changes
- Oral contraceptives
- Hormone replacement therapy (controversial)
- Increasing age
- Diet (high fat intake; caffeine/methylxanthines)
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
- Generalized term for benign breast changes that are poorly defined
- No longer considered a pathologic disease process as they are found in the majority of healthy women
- Most common of all benign breast conditions
- Changes include:
- Benign cysts
- Breast pain (mastalgia or mastodynia), which may or may not be cyclic
- Diffuse and focal nodularity
- Palpable fibroadenomas
- Nipple discharge—may be green or brownish, though usually nonbloody
- Spontaneous, persistent discharge warrants further evaluation
- Occurs in ∼60% of women
- Symptoms of pain and tenderness become progressively worse until menopause
- Pain is often most prominent during the premenstrual phase and improves with the onset of menses
- 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 well 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
- May occur secondary to 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 secondary to hormone replacement therapy
- Incidence is decreased in women taking oral contraceptives
- Risk factors include:
- Family history of fibrocystic changes
- Oral contraceptives
- Hormone replacement therapy (controversial)
- Increasing age
- Diet (high fat intake; caffeine/methylxanthines)
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