Fibrocystic change (breast)

Last revised by Ryan Thibodeau on 26 Jan 2025

Fibrocystic change of the breast (also known as diffuse cystic mastopathy) is a benign alteration in the terminal ductal lobular unit of the breast with or without associated fibrosis. It is seen as a wide spectrum of altered morphology in the female breast from innocuous to those associated with an increased risk of developing carcinoma.

Fibrocystic changes are a prevalent condition, observed clinically in up to 50% of women and histologically in 90% of cases 6. These changes are uncommon before adolescence and are most frequently diagnosed between the ages of 20 and 40, with incidence peaking around menopause.

In comparison to the general population, women with nonproliferative lesions do not exhibit a significant increase in the risk of developing breast carcinoma. However, those with proliferative disease have an elevated risk.

  • breast pain that worsens during ovulation

  • tender nodular swellings

  • most often multifocal and bilateral

Hormonal alterations with estrogen dominance over progesterone are considered to be an important factor. The alterations seen are subdivided into:

  • non-proliferative (simple) fibrocystic change that includes simple breast cyst and/or fibrosis (most common)

  • proliferative that includes

Aberrations in Normal Development and Involution (ANDI) of the breast encompass all changes associated with normal variations in breast parenchyma due to hormonal fluctuations and aging. Therefore, fibrocystic changes are more appropriately classified under ANDI rather than being regarded as a pathological condition.

  • breasts show heterogeneous and usually dense parenchyma 

  • partially circumscribed masses may be present reflecting cysts

  • tea-cup, low-density round calcifications in multiple lobes

On ultrasound, findings may show:

  • prominent fibroglandular tissue in the area of a palpable nodule; however, no discernible mass 

  • small cysts in the mammary zone

Cases and figures

  • Case 1
  • Case 2
  • Case 3: MRI
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