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Fibrocystic Breast Changes

Fibrocystic Breast Changes is a topic covered in the 5-Minute Emergency Consult.

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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
    • 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
    • Increasing age
    • Diet (high fat intake; caffeine/methylxanthines)

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Citation

Rosen, Peter, et al., editors. "Fibrocystic Breast Changes." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307694/all/Fibrocystic_Breast_Changes.
Fibrocystic Breast Changes. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307694/all/Fibrocystic_Breast_Changes. Accessed April 25, 2019.
Fibrocystic Breast Changes. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307694/all/Fibrocystic_Breast_Changes
Fibrocystic Breast Changes [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307694/all/Fibrocystic_Breast_Changes.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Fibrocystic Breast Changes ID - 307694 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307694/all/Fibrocystic_Breast_Changes PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -