Generality
Fibrocystic mastopathy is a benign breast condition affecting numerous women of childbearing age.
This condition is characterized by the presence of fibrous areas in the breast tissue and by the appearance of nodules and cysts of various sizes, which can be appreciated even when the breast is palpated.
In most cases, no treatment is needed; the manifestations associated with the condition tend to decrease, in fact, after the menopause.
Despite being a benign condition that does not evolve, as a rule, towards malignancy, fibrocystic mastopathy still makes clinical monitoring appropriate, possibly associated with complementary investigations (radiological examinations, ultrasound, mammography and biopsy).
Furthermore, it is a good habit to regularly practice breast self-examination, a method which is not diagnostic in itself, but is able to signal, at an early stage, any changes with respect to the basic framework.
Causes
Fibrocystic mastopathy is a mammary dysplasia, which is a benign alteration of breast tissue. This condition occurs mainly in the fertile period, between 30 and 50 years, but it can also affect younger women and may be present even after menopause, especially if hormone replacement therapy is used.
The causes of fibrocystic mastopathy are still not completely clear. However, it is known that the development of this form of dysplasia is closely related to changes in hormonal balance (eg alteration of the estro-progestin ratio, excess of estrogens, etc.) and to cyclic changes that normally take place in the gland mammary in the different phases of the menstrual cycle.
Some scientific sources consider fibrocystic mastopathy a "paraphysiological" condition (ie almost normal, in some respects); the manifestations of fibrocystic mastopathy tend to be reduced after menopause.
Often, women who have breasts with a rich glandular component are more prone to this problem. THE
and likelihood of developing a fibrocystic mastopathy is also higher if no pregnancies have ever been undertaken and when the family history for the disorder is positive.
This form of mammary dysplasia can also be predisposed for women who, during their fertile life, have suffered repeated irregularities in their menstrual cycles.
Symptoms
From a clinical point of view, fibrocystic mastopathy is characterized by the presence of fibrous areas, cysts with liquid content, solid nodules and irregular proliferation of the ducts and glandular epithelium; these alterations affecting the breast tissue occur in isolation or can be variously associated.
Fibrocystic mastopathy lesions are more or less numerous and usually affect both breasts.
At breast self-examination, agglomerates of various sizes (from a few millimeters to a few centimeters) or well-defined masses can be found, moving in the context of the breast tissue and without signs of skin retraction.
Near menstruation, nodular and cystic areas tend to increase in volume due to hormonal fluctuations.
Fibrocystic mastopathy can also cause hypersensitivity, pain (mastodynia) and a sense of tension, particularly in the upper quadrant of the breast. Typically, these symptoms increase in intensity before the onset of menstruation and tend to progressively decrease after the onset of flow.
Tenderness can also be felt when the breast is compressed in some way, for example during sleep or physical activity. Sometimes, the painful symptoms can also extend to the arm.
Does fibrocystic mastopathy increase the risk of breast cancer?
Many scientific studies have shown that fibrocystic mastopathy is not a preneoplastic condition, therefore it does not constitute a risk factor, nor does it increase the chances of developing breast cancer.
However, a moderately increased risk of developing a carcinoma of the breast can be determined by the presence of an atypical epithelial hyperplasia, an alteration that causes subjective symptoms and palpatory modifications not easily distinguishable from those of fibrocystic mastopathy. From the histological point of view, this picture is characterized by an excess growth of epithelial cells of the mammary gland, some of which present an anomalous structure, which can potentially evolve, over time, in a malign sense.
Therefore, if atypical epithelial proliferation is found during a histological examination, performed for any reason, regular clinical and mammographic monitoring of the patient is indicated.
Diagnosis
Considering that the characteristics of benignity or malignancy of a breast nodule are not easy to distinguish, it is always advisable to consult your doctor or a gynecologist for a first evaluation, and a radiologist-senologist for a further diagnostic.
The direct examination with palpation of the breast allows to ascertain the disorder. Subsequently, the diagnosis of fibrocystic mastopathy must be confirmed by performing a mammary ultrasound, a mammogram or a histological examination (sampling by biopsy and tissue analysis to clarify its benign or malignant nature).
Treatment
In most cases, fibrocystic mastopathy does not require special treatment. However, this condition must not be neglected and requires an attitude of constant surveillance through self-examination, periodic medical examination and mammography.
Despite being a benign condition, in fact, it is necessary to consider that the clinical picture of fibrocystic mastopathy makes it less easy to recognize any preneoplastic or frankly malignant alterations, which may arise over time.
In the presence of breast pain during the premenstrual period, the use of an analgesic may be useful. In some cases, moreover, to alleviate mastalgia or the sense of breast tension, the doctor can indicate the application of topical products (gels or creams) based on progesterone.
When the symptoms are particularly pronounced, however, the therapy consists in draining the fluid from cystic formations with an outpatient procedure or in surgical removal of fibrocystic nodules and portions of altered breast tissue.
