Fibrocystic Breasts

Question 1

Define fibrocystic breasts.

Answer 1

Fibrocystic change of the breast is a non-specific term, commonly understood as a continuum of physiological changes that expand to the pathological spectrum. It is a condition characterised by ‘lumpy’ breasts, associated with pain and tenderness that fluctuate with the menstrual cycle.

Question 2

Explain the aetiology/risk factors of fibrocystic breasts.

Answer 2

Late-onset menopause
Later age at first childbirth
Nulliparity
Obesity
Oestrogen replacement therapy

Question 3

Summarise the epidemiology of fibrocystic breasts.

Answer 3

It is difficult to determine the exact incidence of this condition, given that there is no clear definition or diagnostic criteria and that it is often a diagnosis of exclusion. The estimated incidence rate of fibrocystic changes increases with age, peaking at 40-44 years old before incidence decreases.

Question 4

Recognise the presenting symptoms of fibrocystic breasts on physical examination. Recognise the signs of fibrocystic breasts on physical examination.

Answer 4

Mastalgia
Diffuse symmetrical lumpiness through both breasts
Age 30 to 50 years
Nipple discharge
Palpable breast mass

Question 5

Identify appropriate investigations for fibrocystic breasts and interpret the results.

Answer 5

Mammography
Breast ultrasound
Cyst aspiration
Breast biopsy