Health Information

Mammary Dysplasia (Fibrocystic Disease)

Essential of Diagnosis

• Painful, often multiple, usually bilateral masses in the breast.
• Rapid fluctuation in the size of the masses is common.
• Frequently, pain occurs or increases and size increases during premenstrual phase of cycle.
• Most common age is 30-50. Rare in post menopausal women.

General considerations

This disorder, also known as fibrocystic disease or chronic cystic mastitis, is the most frequent lesion of the breast. It is common in women 30-50 years of age but rare in postmenopausal women; this suggests that it is related to ovarian activity. Estrogen hormone is considered a causative factor. The term “mammary dysplasia,” or “fibrocystic disease,” is imprecise and encompasses a wide variety of pathologic entities. The lesions are always associated with benign changes in the breast epithelium, some of which are found so commonly in normal breasts that they are probably variants of normal breast histology but have unfortunately been termed a “disease”.

The microscopic findings of fibrocystic disease include cysts (gross and microscopic), papillomatosis, adenosis, fibrosis, and ductal epithelial hyperplasia. Although mammary dysplasia has generally been considered to increase the risk of subsequent breast cancer, only the variants in which proliferation of epithelial components is demonstrated represent true risk factors.

Clinical findings

Symptoms and signs

Mammary dysplasia may produce an asymptomatic lump in the breast that is discovered by accident, but pain or tenderness often calls attention to the mass. There may be discharge from the nipple. In many cases, discomfort occurs or is increased during the premenstrual phase of the cycle, at which time the cysts tend to enlarge. Fluctuation in size and rapid appearance or disappearance of a breast tumor is common in cystic disease. Multiple or bilateral masses are common, and many patients will give a history of a transient lump in the breast or cyclic breast pain.