Breast: Fibrocystic Disease

Question 1

what are fibrocystic breasts?

Answer 1

fluid filled cysts and scar tissue which can make the breasts feel lumpy or rope-like

Question 2

When can fibrocystic breast changes become more bothersome?

Answer 2

before your menstrual period, and the pain and lumpiness tends to clear up or lessen once your menstrual period begins

Question 3

what are the 4 components of a fibrocystic breast?

Answer 3

Fluid-filled round or oval sacs (cysts).

A prominence of scar-like fibrous tissue (fibrosis).

Overgrowth of cells (hyperplasia) lining the milk ducts or milk-producing tissues (lobules) of the breast.

Enlarged breast lobules (adenosis).

Question 4

what signs may you have on examination with a patient who has fibrocystic breasts?

Answer 4

Lumps that change in size throughout the month, usually moveable masses, breast discharge.

Question 5

do fibrocystic breasts increase the risk of breast cancer?

Answer 5

no

Question 6

what are the risk factors to developing fibrocystic breasts?

Answer 6

• 20-50 years of age.
• female.
• late menopause.
• HRT.
• Nulliparity.
• Having first child at a later age.
• Family history.
• Alcohol consumption during childhood/early adolescence.

Question 7

what is Nulliparity?

Answer 7

Never having completed a pregnancy beyond 20 weeks.

Question 8

what are clinical features of fibrocystic breasts?

Answer 8

• breast lumps that fluctuate in size (menstrual cycle)
• generalised breast pain or tenderness (mastalgia)
• green/dark brown non bloody nipple discharge
• breast changes similar in both breasts

Question 9

what is mastalgia?

Answer 9

breast pain

Question 10

what other conditions present in a similar way to fibrocystic breasts?

Answer 10

Chest wall pain.
Costochondritis. 
Fibroadenoma. 
Breast cancer. 
Intracystic papillloma.

Question 11

what investigations would you conduct to confirm a diagnosis of fibrocystic breasts?

Answer 11

• clinical breast exam (If the medical history and the clinical breast exam indicate normal breast changes, the patient may not need additional tests)
• mammogram (if over 40)
• ultrasound (if under 40)

Question 12

what is the treatment for asymptomatic fibrocystic breasts?

Answer 12

no treatment

Question 13

what is the treatment for symptomatic fibrocystic breasts?

Answer 13

• fine needle aspiration

- surgical excision

Question 14

what lifestyle changes can a patient with fibrocystic breasts make to improve their condition?

Answer 14

• wear firm, well fitted bra
• limit / avoid caffeine
• decrease fat in diet
• reduce or stop HRT