Fibrocystic breasts are characterised by 'lumpy' breasts associated with pain and tenderness that fluctuate with the menstrual cycle.
Diagnosis often involves exclusion of other significant breast diseases.
Assessment of risk for the development of breast cancer is important and is useful in patient reassurance or to design risk reduction strategies.
Cyclical mastalgia is treated symptomatically with lifestyle modification, analgesics, and hormonal therapy.
Mastalgia and breast cysts run a chronic relapsing course throughout life with improvement at menopause.
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. These changes do not correlate with an increased risk of breast cancer; fibrocystic changes of the breast reflect a broad spectrum of conditions that carry different risks for future development of breast cancer.
History and exam
Key diagnostic factors
- presence of risk factors
- diffuse symmetrical lumpiness through both breasts
Other diagnostic factors
- age 30 to 50 years
- nipple discharge
- palpable breast mass
- late-onset menopause
- later age at first childbirth
- oestrogen replacement therapy
1st investigations to order
- breast ultrasound
Investigations to consider
- cyst aspiration
- breast biopsy
- Chest wall pain
- Screening for breast cancer: recommendation statement
- ACR appropriateness criteria: palpable breast masses
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