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Fibrocystic breasts

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 5 Jun 2025
Last updated: 17 Nov 2023

Summary

Definition

History and exam

Key diagnostic factors

  • mastalgia
  • diffuse symmetric lumpiness through both breasts
Full details

Other diagnostic factors

  • age 30 to 50 years
  • nipple discharge
  • palpable breast mass
Full details

Risk factors

  • late-onset menopause
  • later age at first childbirth
  • nulliparity
  • obesity
  • estrogen replacement therapy
Full details

Diagnostic tests

1st tests to order

  • mammography
  • breast ultrasound
Full details

Tests to consider

  • cyst aspiration
  • breast biopsy
Full details

Treatment algorithm

ONGOING

mastalgia

nipple discharge

Contributors

Authors

Sonia Sugg, MD

Professor of Surgery

Division of Surgical Oncology and Endocrine Surgery

University of Iowa Hospitals and Clinics

Iowa City

IA

Disclosures

SS declares that she has no competing interests.

Ingrid Lizarraga, MBBS, FACS

Clinical Associate Professor

Division of Surgical Oncology and Endocrine Surgery

University of Iowa Hospitals and Clinics

Iowa City

IA

Disclosures

IL declares that she has no competing interests.

Acknowledgements

Dr Sonia Sugg and Dr Ingrid Lizarraga would like to gratefully acknowledge Dr Sophia Fu, Dr Sarah E. Colwick, Dr Hernan I. Vargas, Dr Carol Scott-Connor, Dr Anjali Thawani, and Dr Jesse Dirksen, the previous contributors to this topic. SEC, HIV, CSC, AT and JD declare that they have no competing interests.

Disclosures

SF, SEC, HIV, CSC, AT, and JD declared that they had no competing interests.

Peer reviewers

Fred Dirbas, MD

Assistant Professor of Surgical Oncology

Stanford University

Stanford

CA

Disclosures

FD declares that he has no competing interests.

Justin Stebbing, MA, MRCP, MRCPath, PhD

Consultant Medical Oncologist/Senior Lecturer

Imperial College Healthcare NHS Trust

Charing Cross Hospital

London

UK

Disclosures

JS declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Marchant DJ. Benign breast disease. Obstet Gynecol Clin North Am. 2002 Mar;29(1):1-20. Abstract

Santen RJ, Mansel R. Benign breast disorders. N Engl J Med. 2005 Jul 21;353(3):275-85. Abstract

Love SM, Gelman RS, Silen W. Sounding board. Fibrocystic "disease" of the breast--a nondisease? N Eng J Med.1982 Oct 14;307(16):1010-4. Abstract

Dupont WD, Page DL. Risk factors for breast cancer in women with proliferative breast disease. N Engl J Med. 1985 Jan 17;312(3):146-51. Abstract

Fisher B, Constantino JP, Wickerham DL, et al. Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst. 1998 Sep 16;90(18):1371-88.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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    • Fibroadenoma
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  • Guidelines

    • Screening for breast cancer: recommendation statement
    • ACR appropriateness criteria: palpable breast masses
    More Guidelines

  • Patient information

    Breast cancer: DCIS (very early breast cancer) in women

    Breast cancer, locally advanced: what treatments work?

    More Patient information
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