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Magill’s Medical Guide, 9th Edition

Fibrocystic breast condition

by Cynthia L. De Vine

Category: Disease/Disorder

Also known as: Fibrocyctic breast changes, benign breast disease, benign breast lesions, diffuse cystic mastopathy, mammary dysplasia, nonmalignant breast neoplasms

Anatomy or system affected: Breasts, endocrine system, skin

Specialties and related fields: Gynecology, histopathology, oncology

Definition: The most common type of noncancerous breast condition, affecting approximately 60 percent of all women, the majority of whom are premenopausal. Because of its widespread incidence, the condition is now considered to be a normal physiologic variant. It is characterized by stromal tissue and glandular (lobules and ducts) changes in the breast or breasts that result in lumpiness, thickening, and localized edema (swelling).

Key terms:

collecting duct: a tubular canal that transports milk from the milk duct to the nipple

lobule: a small gland that, when sent appropriate hormonal cues, produces milk

mammary gland: a group of milk-producing cells consisting of lobules and ducts

milk duct: a tubular canal that transports milk from the lobule to the collecting duct

stroma: the deeper layer of breast tissue

CAUSES AND SYMPTOMS

Fibrocystic breast change is the most common type of noncancerous breast condition. Its incidence rate in females is estimated to be more than 60 percent. Therefore, although once classified as a disease, it is now considered to be a normal physiologic variant. It occurs more commonly in females between the ages of thirty and fifty. Its cause is hypothesized to be an excess of circulating estrogen.

Female breast development begins at puberty, triggered by an increase in estrogen level. The four main components of the mature female breast are adipose tissue (fat), ducts (milk ducts and collecting ducts), groups of lobules (referred to as lobes), and connective tissue consisting of a matrix of suspensory ligaments (strong fibrous bands). Each breast contains approximately fifteen to twenty lobes that radiate from the nipple area in a spokelike pattern, with the highest distribution being in the upper outer quadrant of each breast. Breast lobe consistency tends to be firm and slightly nodular, but may vary by breast or by individual, while breast fat is almost always soft. Breasts of younger women primarily consist of glandular tissue.

Information on Fibrocystic Breast Condition

Causes: Possibly hormonal variations during the menstrual cycle; excess amount of circulating estrogen

Symptoms: Dense, irregular lumpiness in breast tissue, discomfort and tenderness, dull pain, localized edema (swelling), feeling of fullness, possible nipple discharge

Duration: Varies; usually cyclic

Treatments: Symptom dependent, from breast self-examination and properly fitting support bra to hormone therapy

Aging changes result in shrinkage of glandular tissue and replacement with fat, which causes the breast to become softer and less well supported.

Symptoms of fibrocystic breast change result from hormone-induced alterations in the stromal (deeper layer) tissue, glands (lobules) and ducts within the breast. Those changes include possible fibrosis (formation of fibrous tissue like that of scar tissue ) and/or formation of cysts, as fluid accumulates inside the glands. Small amounts of accumulated fluid result in microscopic cysts (microcysts); larger amounts of accumulated fluid result in palpable macrocysts that may grow to an inch or more in size. The two major types of breast cysts are type I, characterized by high concentrations of androgen and estrogen conjugates, epidermal growth factor, and potassium and low concentrations of sodium and chloride; and type II, characterized by high concentrations of sodium and chloride and lower concentrations of androgen and estrogen conjugates, epidermal growth factor, and potassium.

Symptoms of fibrocystic breast change include dense and irregular lumpiness in breast tissue, discomfort, dull pain, localized edema (swelling) and feeling of fullness, tenderness, and possible nipple discharge. Symptoms may vary in intensity throughout the menstrual cycle, peak just prior to menstruation, and range from mild to severe. Symptoms and signs of fibrocystic change may remit after menopause because of decreased amounts of glandular tissue in the breast and decreased levels of estrogen and progesterone.

TREATMENT AND THERAPY

Treatment is not for the condition itself but rather for the symptoms. For those women who are asymptomatic, no treatment beyond monitoring via breast self-examination is required. For those women who are symptomatic, treatment options range from use of a properly fitting support bra to use of hormone therapy-via oral contraceptives, androgens, or tamoxifen (a drug that blocks estrogen activity)-which has the potential to cause side effects. Cysts may require fine needle aspiration or ultrasonogrphy to determine whether a biopsy is needed.

Anecdotal evidence suggests that avoidance of methylxanthine-containing items such as coffee, tea, chocolate, and certain sodas; reduction in sodium intake; use of vitamin supplements; and/or use of herbal supplements may ameliorate symptoms caused by fibrocystic changes. However, these findings have not been clinically proven.

PERSPECTIVE AND PROSPECTS

The preferred term for fibrocystic breast disease is now “fibrocystic breast changes” or “fibrocystic breast condition.” It may also be referred to as benign breast disease, benign breast lesions, diffuse cystic mastopathy, mammary dysplasia, or nonmalignant breast neoplasms. Cohort studies of risk factors associated with this condition have been conducted for up to thirty years. A family history of fibrocystic breast condition is believed to be the highest risk factor. Consumption of a high-fat diet may be a cofactor. No association has been found between incidence rate of this condition and alcohol consumption or cigarette smoking.

Breast tissue changes as a result of fibrocystic breast condition may make breast examination and mammography interpretation more difficult. However, while presence of type I macrocytes-a fibrocystic change characterized by high concentrations of androgen and estrogen conjugates, epidermal growth factor, and potassium-may be linked to a moderate increase in breast cancer risk, most fibrocystic changes associated with fibrocystic breast condition (fibrosis, microcysts, and type II macrocysts) are not associated with an increased risk of breast cancer.

See also Breast biopsy; Breast disorders; Breasts, female; Cyst removal; Cysts; Hormones; Lesions; Mammography; Menopause; Women’s health.

For Further Information:

1 

Ajao, O. G. “Benign Breast Lesions.” Journal of the National Medical Association 71, no. 9 (1979): 867-868.

2 

Bhimji, Shabir, et al. “Fibrocystic Breast Changes.” MedlinePlus, Nov. 5, 2012.

3 

“Breast Diseases.” MedlinePlus, May 3, 2013.

4 

Bruzzi P., L. Dogliotti, and C. Naldoni, et al. “Cohort Study of Association of Risk of Breast Cancer with Cyst Type in Women with Gross Cystic Disease of the Breast.” BMJ 314 (1997): 925-928.

5 

Dixon, J. M., A. B. Lumsden, and W. R. Miller. “The Relationship of Cyst Type to Risk Factors for Breast Cancer and the Subsequent Development of Breast Cancer in Patients with Breast Cystic Disease.” European Journal of Cancer and Clinical Oncology 21 (1985): 1047-1050.

6 

“Fibrosis and Simple Cysts.” American Cancer Society, Aug. 24, 2012.

7 

Guray, M. Sahin. “Benign Breast Diseases: Classification, Diagnosis, and Management.” Oncologist 11 (2006): 435-449.

8 

Haagensen, C. D., C. Bodian, and D. E. Haagensen, Jr., eds. Breast Carcinoma: Risk and Detection. Philadelphia: W. B. Saunders, 1981.

9 

Hartmann, L. C., T. A. Sellers, M. H. Frost, et al. “Benign Breast Disease and the Risk of Breast Cancer.” New England Journal of Medicine 353 (2005): 229-237.

10 

Kamel, O. W., R. L. Kempson, and M. R. Hendrickson. “In situ Proliferative Epithelial Lesions of the Breast.” Pathology 1 (1992): 65-102.

11 

Miller, W. R., et al. “Using Biological Measurements: Can Patients with Benign Breast Disease Who Are at High Risk for Breast Cancer Be Identified?” Cancer Detection and Prevention 16 Suppl. (1992): 13-20.

12 

Polsdorfer, Ricker, and Andrea Chisholm. “Fibrocystic Disease.” Health Library, Sept. 28, 2012.

13 

Santen, R. J., and R. Mansel. “Benign Breast Disorders.” New England Journal of Medicine 353 (2005): 275-285.

14 

Sauter, Edward R., and Mary B. Daly. Breast Cancer Risk Reduction and Early Dectection. New York: Spring, 2010.

15 

Schnitt, S. J., and J. L. Connolly. “Pathology of Benign Breast Disorders.” In Diseases of the Breast, edited by J. R. Harris et al. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2010.

16 

“Understanding Breast Changes: A Health Guide for Women.” National Cancer Institute, Nov. 2, 2012.

17 

Washington C., et al. “Loss of Heterozygosity in Fibrocystic Change of the Breast: Genetic Relationship Between Proliferative Lesions and Associated Carcinomas.” American Journal of Pathology 157, no. 1 (2000): 323-329.

Citation Types

Type
Format
MLA 9th
De Vine, Cynthia L. "Fibrocystic Breast Condition." Magill’s Medical Guide, 9th Edition, edited by Anubhav Agarwal,, Salem Press, 2022. Salem Online, online.salempress.com/articleDetails.do?articleName=MMG2022_0510.
APA 7th
De Vine, C. L. (2022). Fibrocystic breast condition. In A. Agarwal, (Ed.), Magill’s Medical Guide, 9th Edition. Salem Press. online.salempress.com.
CMOS 17th
De Vine, Cynthia L. "Fibrocystic Breast Condition." Edited by Anubhav Agarwal,. Magill’s Medical Guide, 9th Edition. Hackensack: Salem Press, 2022. Accessed October 22, 2025. online.salempress.com.