Chapter 150 Breast: Fibrocystic Breast Change
INTRODUCTION
Description: Fibrocystic breast changes are characterized by stromal and ductal proliferation that results in cyst formation, diffuse thickening, cyclic pain, and tenderness. The term fibrocystic change encompasses a multitude of different processes and older terms, including fibrocystic disease. It is the most common of all benign breast conditions, accounting for its linguistic demotion to “change” from the designation “disease.”
ETIOLOGY AND PATHOGENESIS
Causes: The cause or causes of fibrocystic change are unknown, but it is postulated to arise from an exaggerated response to hormones. A role for progesterone has been suggested based on the common occurrence of premenstrual breast swelling and tenderness. Other proposed sources for fibrocystic changes are altered ratios of estrogen and progesterone or an increased rate of prolactin secretion, but none of these have been conclusively established.
CLINICAL CHARACTERISTICS
DIAGNOSTIC APPROACH
Workup and Evaluation
Imaging: Mammography may be used to assist with the diagnosis or to provide a baseline, but it is not necessary for diagnosis. Mammography is more difficult in the younger women who predominantly have these complaints. Ultrasonography may be of more help when imaging is deemed necessary.
