Fibrocystic breast disease

Alternative names

Mammary dysplasia; Benign breast disease

Definition

Fibrocystic breast disease is described as common, benign changes involving the tissues of the breast. The term "disease" in this case is misleading, and many providers prefer the term "change."

The condition is so commonly found in normal breasts, it is believed to be a normal variant. Other related terms include "mammary dysplasia," "benign breast disease," and "diffuse cystic mastopathy."

Causes, incidence, and risk factors

The cause is not completely understood, but the changes are believed to be associated with ovarian hormones since the condition usually subsides with menopause, and may vary in consistency during the menstrual cycle.

The incidence of it is estimated to be over 60% of all women. It is common in women between the ages of 30 and 50, and rare in postmenopausal women. The incidence is lower in women taking birth control pills. The risk factors may include family history and diet (such as excessive dietary fat, and caffeine intake), although these are controversial.

Symptoms

• A dense, irregular and bumpy "cobblestone" consistency in the breast tissue
  
• Usually more marked in the outer upper quadrants
  
• Breast discomfort that is persistent, or that occurs off and on (intermittent)
  
• Breast(s) feel full
  
• Dull, heavy pain and tenderness
  
• Premenstrual tenderness and swelling
  
• Breast discomfort improves after each menstrual period
  
• Nipple sensation changes, itching
  

Note: Symptoms may range from mild to severe. Symptoms typically peak just before each menstrual period, and improve immediately after the menstrual period.

Signs and tests

Physical examination reveals the presence of mobile (non-anchored) breast "masses." These masses are usually rounded, with smooth borders, and either rubbery or slightly changeable in shape. Dense tissue may make the breast examination more difficult to interpret.

• Mammography may be difficult to interpret due to dense tissue.
  
• A biopsy of the breast may be necessary to rule out other disorders.
  
• Aspiration of the breast with a fine needle can often diagnose and treat larger cysts.
  

Treatment