Fibrocystic Change Flashcards
What is fibrocystic change?
A common condition of the breast tissue characterised by non-cancerous breast lumps which can sometimes cause discomfort
How many women does fibrocystic change affect?
An estimated 30-60% of women, and at least 50% of women of childbearing age
What is the mechanism of disease in fibrocystic change?
The exact mechanism of disease is not fully understood, but it is thought to be tied to hormone levels
What evidence is there for fibrocystic change being tied to hormone levels?
- The condition normally subsides after menopause
- The condition is related to the menstural cycle
What are the most important hormones linked to fibrocystic change?
- Oestrogen
- Progesterone
- Prolactin
How are oestrogen, progesterone, and prolactin involved in fibrocystic change?
They act directly on the brest tissue, causing cells to grow and multiply
Other than oestrogen, progesterone, and prolactin, what hormones are involved in fibrocystic change?
- TSH
- Insulin
GH
How are TSH, insulin, and prolactin involved in fibrocystic change?
They exert direct and indirect effects amplifying or regulating cell growth
What do years of fluctations in hormone levels eventually produce?
Small cysts and/or areas of dense or fibrotic tissue
What are the symptoms of fibrocystic change?
- Lumpiness of the breast
- Varying degrees of pain and tenderness
Describe the lumps in fibrocystic change?
Described as a ‘cobblestone texture’. The lumps are smooth with defined edges and are usually free moving
How is a diagnosis of fibrocystic change made?
Made on the basis of symptoms after exclusion of breast cancer
What finding is rarely pathological?
Changes that are bilaterally symmetrical
What should be done if there is asymmetry in fibrocystic change?
The patient should be reviewed after one of two menstural cycles, seeing her mid-cycle
What imaging techniques are used to investigate fibrocystic change?
Mammography is often used in older patients
Ultrasound is usually better in younger patients
