Fibrocystic change of the breast represents a wide spectrum of morphological alteration in the female breast ranging from innocuous to those associated with the risk of carcinoma. The term is a rather misleading description of subjective findings associated with normal or abnormal breast physiology and pathology. The term confuses both patients and health care workers. One person's normal breast physiology is another person's fibrocystic change.
The alterations are often with no clinical implications.
A potentially more useful and accurate term is Aberrations in Normal Development and Involution of the breast (ANDI)5. The term encompasses all the changes associated with normal variations in breast parenchyma associated with changes in hormone levels and ageing. In general, younger women have proportionally more gland relative to fat in the breast and the converse is true for post menopausal women.
The confusion persists with terms like "fibrocystic disease" which actually has no place in the medical lexicon. The process implies a disease process where it is actually normal breast physiology. It categorizes healthy women as having a disease and not necessarily are cysts actually involved. The term is best avoided.
The morphologic changes include lesions like :
- fibrous stroma changes and / or overgrowth
- stromal and epithelial proliferation
- predomination of epithelial proliferation
However, there are practically three dominant patterns of morphologic change:
- cyst formation and fibrosis (simple fibrocystic change and / or gross cysts)
- epithelial hyperplasia (ductal and / or lobular) which can include cystic hyperplasia
- sclerosing adenosis
It is worth mentioning that of all patterns, atypical epithelial hyperplasia is associated with increased risk of carcinoma.
Fibrocystic change is unusual before adolescence. These are most often diagnosed between the age of 20 and 40 with the peak before or at menopause. Hormonal imbalances are considered to have the crucial role in the development of the changes.
- 1. Jancic-Zguricas M, Spuzic I. Osnovi onkolgije. Medicinski Fakultet u Beogradu, Elit Medica, Belgrade, 1995
- 2. Nikolic S, Opric M. Proliferativne bolesti dojke. Beograd - Kultura. Belgrade, 1990
- 3. Cotran RS, Kumar V, Robbins SL. Robbins pathologic basis of disease. W.B. Saunders Company. (1994) ISBN:0721650325. Read it at Google Books - Find it at Amazon
- 4. Eurorad teaching files : Case 915
- 5.Hughes, LeslieE, RobertE Mansel, and DavidJ T. Webster. "Aberrations of normal development and involution (ANDI): a new perspective on pathogenesis and nomenclature of benign breast disorders." The Lancet 330.8571 (1987): 1316-1319.
Synonyms & Alternative Spellings
|Synonyms or Alternative Spelling||Include in Listings?|
|Breast fibrocystic change||✗|
|Fibrocystic change in the breast||✗|
|Mammary fibrocystic disease||✗|