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Updated: Jul 21 2019

Fibrocystic Change

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  • Snap Shot
    • A 28-year-old female recently discovered a lump in her right breast. She has no family history of breast cancer, and her menstrual cycle began at 13 years of age. On exam you find a 1-cm movable mass in the right outer/upper quadrant. There is no skin dimpling. A mammogram is shown.
  • Introduction
    • Most common cause of benign breast masses in premenopausal women
    • Caused by exaggerated response to hormones and fluctuations in mass size
    • Not typically associated with progression to cancer
    • Several histologic types
      • fibrosis
        • breast stromal hyperplasia
      • cystic
        • may show large or small cysts
          • "blue domed"
        • ductal dilation
      • sclerosing adenosis
        • acini proliferation with intralobular fibrosis
        • associated with calcifications
        • commonly mistaken for infiltrating ductal cancer
      • ductal/epithelial hyperplasia
        • epithelial cell proliferation in terminal duct lobule
        • ↑ risk of carcinoma with atypical cells secondary to estrogen stimulation
  • Presentation
    • Symptoms
      • bilateral breast pain or tenderness
        • size/pain varies with the menstrual cycle
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