Fibrocystic Breast Changes
Also known as mammary dysplasia or chronic cystic mastitis, fibrocystic breast changes represent the most common benign breast condition. The epithelium of the breast responds to fluctuating levels of estrogen and progesterone, causing breast tenderness and fullness during the luteal phase of the menstrual cycle.
Previously, this hormonally induced, cyclic pain and lumpiness was called a disease. Today, however, many health care professionals feel this term is inaccurate because studies show that about 50% of all females ages 20 to 50 have clinical signs, and nearly 90% have histologic signs of fibrocystic changes, which suggests that these changes are a normal variation.
Fibrocystic changes respond to the changes of the menstrual cycle, and a patient may actually observe a lessening in the size of a lump when her menses begins.
Causes
Fibrocystic changes are probably caused by an imbalance of estrogen and progesterone that distorts the normal changes of the menstrual cycle and causes an exaggerated response of breast tissue to cyclic levels of ovarian hormones.
Complications
Fibrocystic breast changes seldom cause complications, although the signs and symptoms may progress. Rarely, a patient who undergoes biopsy for a benign breast lump is found to have atypical hyperplasia. This clinical finding, combined with a family history of breast cancer, may increase the risk of breast cancer.
Assessment
The patient may report painful, multiple breast masses (cysts) that change rapidly in size. She may complain that the cysts enlarge or that pain intensifies during the premenstrual period. The pain may be described as a localized painful area with large, fluid–filled cysts; if cysts are small, the patient may experience more diffuse tenderness. She may also notice nipple discharge.
Palpation may reveal breasts that feel dense, with areas of irregularity and nodularity or lumpiness.
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