Description

• Fibrocystic changes (FCC) of the breast is a generalized term for a heterogeneous group of changes affecting the stromal and glandular tissues of the breast.
• It is the most common of all benign breast conditions.
• Commonly presents as mastalgia, engorgement, increased breast nodularity, and/or cysts:
  • Mastalgia (breast pain) is usually in upper outer quadrants of breast, bilateral, and may radiate to shoulders or upper arms.
  • Localized pain may occur with a rapidly enlarging cyst.
  • Nodules are usually small (2–10 mm), diffuse, and bilateral, with a rubbery consistency.
  • Cysts are more common in women in their 40s.
  • Larger cysts may have consistency of a water-filled balloon.
• Symptoms are most prominent in premenstrual (luteal) phase.
• System(s) affected: Endocrine/Metabolic; Reproductive
• Synonym(s): Fibrocystic breast disease; Mammary dysplasia; Chronic cystic mastitis

Epidemiology

Most common in women of reproductive years; occasionally seen after menopause with hormone replacement

Incidence
Unknown but very frequent

Prevalence
50–60% of women without breast disease are found to have this pattern of fibrous change and cyst formation (1).

Risk Factors

• The effect of consumption of methylxanthine-containing substances (e.g., coffee, tea, cola, and chocolate) has not been found to be a contributing factor (2)[A].
• Diet high in fruits and vegetables and high parity independently decrease risk of FCC.
• Diet high in saturated fats may increase risk of FCC.

Pathophysiology

May be the result of an exaggerated response of breast tissue to cycling hormones or a subtle imbalance in the ratio of estrogen to progesterone.

Etiology

Estrogen likely a causative factor for many (3)[B].

Commonly Associated Conditions

Fibrocystic change found clinically confers no increased risk of breast cancer (1).