Fibrocystic disease breast.

FIBROCYSTIC CHANGE/ DISEASE

• The term fibrocystic change refers to benign breast changes caused by hormonally mediated exaggerated breast tissue response

• Common in premenopausal women. Disease subsides in post menopausal women as  there is decrease in estrogen levels. 

• Common age group is 30 -50 years

• Hyperestrogenism has been known to be the significant etiological factor

• Associated with polycystic ovaries and Cowdens syndrome.

• Clinical feature–

  •  Patient presents with painful, tender swellings which are fibrous and have defined edges

  • Usually bilateral and multifocal

• Gross features 

  • Gray white fibrous tissue with multiple cysts filled with semitranslucent fluid giving them blue colour (Blue domed cysts)

• Microscopic features

  • Cystically dilated or ectatic ducts lined by metaplastic apocrine ductal cells having abundant eosinophilic granular cytoplasm. Lumen of the cyst shows eosinophilic secretions and foamy macrophages

  • Mild epithelial hyperplasia without atypia may be present

  • Adenosis with increased number of acini or lobule

  • Stroma shows fibrosis 

  • Other findings – calcification in the lumen of the cyst which on mammography termed as “Milk of magnesia”

 

• Two types – 

  • Non-proliferative fibrocystic change with simple cysts

  • Proliferative fibrocystic change with epithelial hyperplasia which can be ductal or lobular

• Presence of atypical hyperplasia is considered to be associated with increased risk of developing breast cancer. 

By
Dr.B.Chaitanya (Consultant Pathologist, RDT hospital, Anantapur) (bchaitanya.med@gmail.com)
Dr.V.Shanthi (Professor of Pathology, Narayana Medical College, Nellore)