Breast: Fibrocystic disease

Question 1

What is the definition of fibrocytic breast disease?

Answer 1

Benign painful lumps in the breast

Question 2

What is the epidemiology of fibrocytic breast disease?

Answer 2

Affects up to 50% of woman

Question 3

What is the pathology of fibrocytic breast disease?

Answer 3

• Caused by ↑ oestrogen and ↓ progesterone – symptoms subside after menopause
• = Ductal and apocrine hyperplasia
• Hyperproliferation of fibrous stroma and epithelium (ducts/lobes)
• Epithelial hyperplasia = cancer risk
• Different types: fibrosis and cysts (micro and macrocysts)

Question 4

What are the risk factors/aetiology for fibrocystic breast changes?

Answer 4

• Woman
• Reproductive age (25-50)
• Genetics

Question 5

What are the signs and symptoms of fibrocystic breast changes?

Answer 5

• Breast soreness/tenderness/pain
• Breast redness
• Unusual discharge from the breast – green/dark brown, should not be bloodstained
• Breast swelling
• Breast lump
• Symptoms changing throughout menstrual cycle/pregnancy/HRT
• Moveable lump
• Pain in the underarm

Question 6

What investigations would be carried out in suspected fibrocystic breast changes?

Answer 6

• Breast examination
• Mammogram
• US with biopsy
aka TRIPLE ASSESSMENT

Question 7

What are the surgical treatments for fibrocystic breast changes?

Answer 7

Aspiration

Question 8

What are the pharmacological treatments for fibrocystic breast changes?

Answer 8

• Analgesia
• OCP
• Vit E

Question 9

What are the non pharmacological treatments for fibrocystic breast changes?

Answer 9

• Supportive bras

* Patient education - Breast examination to check for changes