Fact-sheet: Fibrocystic breast disease
Updated on 09/06/2023 at 5:12 PM
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Definition
Histologic variations of the normal breast with the stages of reproductive life and the menstrual cycle, related to endogenous and exogenous hormones responsible for exaggeration of physiologic phenomena and fibrocystic changes
Elementary lesions:
- Cyst: dilation of the terminal portion of the lactiferous duct within the lobule
- Hyperplasia: multiplication of epithelial cell layers and cells (> 4 layers)
- Simple hyperplasia: epithelial and myoepithelial compartment
- Global hyperplasia: epithelial, myoepithelial compartment and mantle tissue
- Metaplasia: morphologic transformation of cells (apocrine = apocrine sweat gland cell) (columnar)
- Adenosis: global lobular hyperplasia with an increase in the number and size of acini
Clinical features
- Mastalgia
- Induration, occasionally a palpable mass
Ultrasound
- Non-mass-like enhancing area, with the presence of cysts, which may appear hard on elastography.
MRI
- After gadolinium injection: ring enhancement
- T2: possible hyperintensity of the lesion center
These abnormalities may resolve on follow-up MRI.
Management
In the setting of significant cancer risk factors or asymmetric enhancement, biopsy or follow-up may be considered.