What Is Fibrocystic Breast Disease?

Fibrocystic changes in the breast are the most common breast disorders. They occur in women between the ages of 25 and 45. They reach their peak before menopause. They generally do not progress after menopause, and rarely occur before adolescence. The incidence is mostly related to ovarian endocrine disorders. Progesterone is reduced and estrogen is secreted too much, which plays a role in the occurrence of this disease. But the exact pathogenesis remains unclear.

Cystic fibrosis of the breast

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Fibrocystic changes in the breast are the most common breast disorders. They occur in women between the ages of 25 and 45. They reach their peak before menopause. They generally do not progress after menopause, and rarely occur before adolescence. The incidence is mostly related to ovarian endocrine disorders. Progesterone is reduced and estrogen is secreted too much, which plays a role in the occurrence of this disease. But the exact pathogenesis remains unclear.

Chinese name

Cystic fibrosis of the breast

Foreign name

fibrocystic changes

Make up

The most common breast disorders

More frequently

Women between 25 and 45

Divided into non-proliferative breast fiber cystic changes and proliferative breast fiber cystic changes.

1. Non-proliferative fibrocystic changes

(1) Macroscopic view, often bilateral, multifocal small nodular distribution, unclear borders, cysts of different sizes, varying in number, small cysts that accumulate with each other and proliferating interstitial fibrous tissue are interlaced, which can cause mottle Different appearances. Large cysts are called blue-domed cysts because they contain a translucent turbid liquid with a blue outer surface.

(2) Microscopically, the epithelium covered by cysts can be columnar or cubic epithelium, but most of them are flat epithelium, and the epithelium can also be completely absent. Occasionally calcification. If the cyst is ruptured, the contents overflow into the surrounding interstitial, which can cause inflammatory reactions and hyperplasia of interstitial fibrous tissue, and the fibrotic interstitial further undergoes vitreous changes.

Apocrine metaplasia is often seen in cystic epithelium, with large cell volume and eosinophilic cytoplasm. The top of the cytoplasm shows typical small protrusions of the apical plasma that are similar to the epithelium of the large sweat glands.

2.Proliferative fibrocystic changes

In addition to cyst formation and interstitial fibrous hyperplasia, proliferative fibrous cystic changes are often accompanied by proliferation of peripheral ducts and acinar epithelium. Epithelial hyperplasia can increase the levels and form nipples protruding into the capsule, and the tops of the nipples coincide with each other, forming a sieve-like structure. Cysts are associated with epithelial hyperplasia, especially in the presence of epithelial dysplasia, which may evolve into breast cancer and should be considered as precancerous lesions.

Classification: According to the severity of epithelial hyperplasia, it can be divided into mild hyperplasia; vigorous hyperplasia; atypical hyperplasia; carcinoma in situ.

Non-proliferative fibrous cystic changes have no risk of secondary invasive cancer, and the risk of proliferative fibroblastic cystic carcinogenesis increases by 1.5-2 times, and the atypical hyperplasia of ducts and lobes evolves into invasive cancer opportunities A five-fold increase, while duct and lobular carcinoma in situ is 10 times more likely to progress to invasive cancer. It shows that breast fibrocystic changes, whether clinical, radiographic, or pathological, have some similarities with breast cancer, and do have a certain relationship with the occurrence of cancer, but whether it develops into breast cancer mainly depends on the ducts and acinar The degree of epithelial hyperplasia and the presence or absence of atypical hyperplasia.