Fibrocystic change

Epidemiology

• Women aged 20-50 (more common >40) and very common in the general population (around 25% will have some degree of fibrocystic change)
• Usually associated with hormone imbalance
  • Early menarche/ late or prolonged menopause
  • Hormonal contraception

Signs/Symptoms

• Smooth, discreet lumps or general breast lumpiness
• May be associated with sudden/cyclical pain
• May be an incidental finding at screening (or other test)

Gross pathology

• Cysts – may be up to several cm in size; blue domed with pale fluid; usually multiple; associated with other benign changes (see aberrations of normal development)

Microscopic pathology

• Cysts- thin wall (may be fibrotic) lined with apocrine epithelium

Management

• Exclude malignancy and reassure
  • Excise if causing severe problems (symptomatically)