Benign breast diseases

Fibrocystic breast changes is a condition of the breasts where there may be pain, breast cysts, and breast masses. The breasts may be described as 'lumpy' or 'doughy'. Symptoms may worsen during certain parts of the menstrual cycle. It is not associated with cancer. Fibrocystic breast changes is a condition of the breasts where there may be pain, breast cysts, and breast masses. The breasts may be described as 'lumpy' or 'doughy'. Symptoms may worsen during certain parts of the menstrual cycle. It is not associated with cancer. Risk factors include an early age at first menstrual period and either having children late or not having children. It is not a disease but represents normal breast changes. Diagnosis typically involves ruling out breast cancer. Fibrocystic change includes fibroadenomas, fibrosis, and papillomas of the breast. Management may involve education about the condition, a well fitting bra, and pain medication. Occasionally danazol or tamoxifen may be used for pain. It is estimated that up to 60% of women are affected. Women between the ages of 30 and 50 are most commonly affected. The changes in fibrocystic breast disease are characterised by the appearance of fibrous tissue and a lumpy, cobblestone texture in the breasts. These lumps are smooth with defined edges, and are usually free-moving in regard to adjacent structures. The bumps can sometimes be obscured by irregularities in the breast that are associated with the condition. The lumps are most often found in the upper, outer sections of the breast (nearest to the armpit), but can be found throughout the breast. Women with fibrocystic changes may experience a persistent or intermittent breast aching or breast tenderness related to periodic swelling. Breasts and nipples may be tender or itchy. Symptoms follow a periodic trend tied closely to the menstrual cycle. Symptoms tend to peak in the days and, in severe cases, weeks before each period and decrease afterwards. At peak, breasts may feel full, heavy, swollen, and tender to the touch. No complications related to breastfeeding have been found. The exact mechanism of the condition is not fully understood, though it is known to be tied to hormone levels, as the condition usually subsides after menopause and is also related to the menstrual cycle. Post-menopausal women placed on hormone replacement therapy have also reported symptoms of fibrocystic breast change indicating hormones may play a role. Fibrocystic breast changes is a cumulative process, caused partly by the normal hormonal variation during a woman's monthly cycle. The most important of these hormones are estrogen, progesterone and prolactin. These hormones directly affect the breast tissues by causing cells to grow and multiply. Many other hormones such as TSH, insulin, growth hormone and growth factors such as TGF-beta exert direct and indirect effects amplifying or regulating cell growth. Years of such fluctuations eventually produce small cysts and/or areas of dense or fibrotic tissue. Multiple small cysts and an increasing level of breast pain commonly develop when a woman hits her 30s. Larger cysts usually do not occur until after the age of 35. Over time, presumably driven by aberrant growth signals, such lesions may accumulate epigenetic, genetic and karyotypic changes such as modified expression of hormone receptors and loss of heterozygosity.