Fibrycystic Changes


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Fibrocystic Changes of the Breast....

Understanding Fibrocystic Changes of the Breast

If you have ever discovered one or more lumps in your breast, you were probably concerned. Such lumps often are caused by changes that can occur with the natural menstrual cycle of a woman's body.

Most often, women who find lumps in their breasts are between the ages of 30 and 50. The same hormones that control the menstrual cycle - estrogen and progesterone-also can cause the breasts to become lumpy or "fibrocystic." The incidence tends to decrease with menopause.

If you experience these fibrocystic changes, you may have noticed that your breasts tend to be more tender and painful before menstruation begins. The pain and tenderness usually subside after your period.

What are fibrocystic lumps?
Fibrocystic lumps are a benign (not cancerous) breast condition. Your doctor may refer to them as "fibrocystic changes" or a "fibrocystic condition."

How are these lumps found?
Doctors estimate that up to 85 percent of breast lumps are found by patients through self-examination before they consult their physician or undergo a breast X-ray (mammogram).

The National Cancer Institute (NCI) recommends that all women examine their own breasts once a month. Self-examination should be done at least five to 10 days after menstruation, when breast swelling subsides. If you no longer menstruate, choose a date and conduct a self-examination on the same date every month. Call the NCI at 800-4-CANCER for a detailed printed description of how to perform breast self-examination.

How are these lumps diagnosed?
If your physician recommends that a lump in your breast be biopsied (surgically removed and examined), a pathologist (a physician who specializes in laboratory medicine) will examine the lump or tissue and determine if it is benign or malignant (cancerous) by examining the cell structure of the tissue under a microscope. The pathologist will then consult with your attending physician regarding the diagnosis and appropriate treatment.

What does it mean if my doctor tells me I have a fibrocystic condition?
It means that you have a common benign alteration in your breast tissue that may cause scarring and the formation of small, fluid-containing cysts. In fact, there are other benign conditions that cause lumps in the breast.

The pathologist's diagnosis of the removed tissue enables your doctor to estimate what risk, if any, you have of developing a cancer. When you talk to your doctor, he or she can tell you which kind of change is responsible for the lump in your breast.

Do the changes in my breast increase my risk of developing breast cancer?
Based on the pathologist's examination, a benign change may be categorized as "no increased risk," "slightly increased risk" (1.5 to 2 times the normal risk), or "moderately increased risk" (5 times the normal risk).

What is meant by relative risk?
These risks have been grouped into three categories that describe the "relative risk" each has for later developing into breast cancer. Relative risk is an estimate of the likelihood that a woman with a benign breast lesion will develop breast cancer, as compared with a woman who has no known significant breast abnormality.

Breast Changes and Relative Cancer Risk
(These conditions have been grouped according to risk.)

No increased risk of cancer
A woman whose biopsy shows one of the breast changes listed below is at no greater risk for developing invasive breast cancer as compared with a woman who has no known significant breast abnormality:

  • Apocrine metaplasia
  • Duct ectasia
  • Fibroadenoma
  • Fibrocystic change
  • Hyperplasia, mild
  • Mastitis (inflammation)

Slightly increased risk (1.5 to 2 times)
A woman whose biopsy shows one of the changes listed below has a slightly increased risk (1.5 to 2 times) for developing breast cancer as compared with a woman who has no known significant breast abnormality:

  • Sclerosing adenosis
  • Hyperplasia, moderate or severe (florid)
  • Papilloma

Moderately increased risk (5 times)
A woman whose biopsy shows the change listed below has a moderately increased risk (5 times) for developing breast cancer as compared with a woman who has no known significant breast abnormality:

  • Atypical hyperplasia of ductal or lobular type

How often should I have a mammogram?
The College of American Pathologists (CAP) supports the American Cancer Society's mammography screening guidelines for early detection of breast cancer.

Recommended Breast Care
by the American Cancer Society and the CAP

A woman between the ages of 20 and 40 should

  • examine her own breasts each month
  • have a medical breast examination every three years

A woman between the ages of 40 and 49 should

  • examine her own breasts each month
  • have a medical breast examination every year
  • have a mammogram every one to two years (at the discretion of the physician)

A women age 50 and older should

  • examine her own breasts each month
  • have a medical breast examination every year
  • have an annual mammogram

The information provided here is to educate women about fibrocystic changes and other benign conditions of the breast. If you discover any lumps in your breasts, consult your physician. Use this information to help you understand what you may be experiencing and to assist you in knowing what questions to ask your doctor.

The mission of the College of American Pathologists, the principal organization of board-certified pathologists, is to represent the interests of patients, the public, and pathologists by fostering excellence in the practice of pathology worldwide.

Please note: The College of American Pathologists does not offer medical advice. This information is provided as a public service to help you better understand medical conditions. Consult your personal physician to seek medical advice.

Source:  College of American Pathologists

Breast Cysts

Any problem with the breasts can be very frightening because women immediately fear that they may have cancer. However, although breast cancer can develop at any age, it is most likely to develop later in life. Many breast problems are not caused by cancer, especially in women who have not yet gone through menopause (are premenopausal).  What is a normal breast [Read More]

Fibrocystic Breast Disease

Fibroadenoma is a solid benign lump found in the breast which does not contain fluid. It may cause discomfort and can become larger over time or if a woman becomes pregnant. Fibroadenomas vary in size, from those which cannot be felt but which may show up on a mammogram to those which are large and can be easily felt. They can be removed surgically if required but can usually be left alone.

The Fibroadenoma Hub

Fibroadenoma  (up close and personal slide) -- Okay, maybe this is too much information
Fibroadenoma  (mammography image)
Fibroadenoma  (MRI image)

Normal Breast -- The normal mammography image shows a thin, regular skin line with a diffuse, even, soft tissue density of the general glandular tissue and fatty structures organized in a relatively regular way by Cooper's ligaments.  (Courtesy Yale School of Medicine)

  • Fibrocystic Breast Disease (mammogram) (ultrasound)


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