From the Guidelines
The breast ultrasound shows benign fibrocystic changes with no concerning solid masses or enlarged lymph nodes in the armpit area, classified as BIRADS 2, indicating definitively benign findings with no further testing needed at this time. Fibrocystic changes are very common, affecting more than half of women at some point, and represent normal variations in breast tissue that can cause lumpiness, tenderness, or pain. These changes are not cancerous and don't increase cancer risk significantly, as noted in the NCCN guidelines 1. You should continue with routine breast cancer screening as recommended for your age group, typically annual or biennial mammograms for women over 40-50. No treatment is necessary for fibrocystic changes unless you experience discomfort, in which case over-the-counter pain relievers, wearing a supportive bra, or applying warm compresses may help. Some women find that limiting caffeine and salt intake before their menstrual period can reduce symptoms.
According to the most recent guidelines from the NCCN 1, simple cysts, which are considered benign, do not require further testing if the clinical findings and ultrasonographic results are concordant. The patient can then be followed with routine screening.
Key points to consider:
- Fibrocystic changes are common and benign
- No further testing is needed for BIRADS 2 findings
- Routine breast cancer screening should continue as recommended
- Treatment for fibrocystic changes is only necessary if discomfort is present
- Limiting caffeine and salt intake may help reduce symptoms in some women.
From the Research
Sonographic Findings
- The sonographic interrogation of both breasts reveals benign fibrocystic changes, which is a common benign breast condition characterized by adenosis, fibrosis, and cyst formation 2, 3.
- The findings indicate no worrisome solid mass and no axillary lymphadenopathy, suggesting that the condition is likely benign 4, 5.
- Fibrocystic changes can occur in postmenopausal women, although they are rare in this demographic, and can be associated with hormonal imbalances 2.
Impression and BIRADS Classification
- The impression is that there is no sonographic evidence of malignancy, which is consistent with the BIRADS 2 classification of benign findings 5.
- BIRADS 2 indicates that the findings are benign and do not require further evaluation or biopsy 5.
Fibrocystic Changes
- Fibrocystic changes can present as solid masses, cysts, or heterogeneously echogenic tissue on sonography 4.
- The sonographic features of fibrocystic changes are not specific enough to differentiate between different histologic subtypes 4.
- Recognition of classically benign findings of fibrocystic changes can prevent unnecessary follow-ups and biopsies 5.
Note: The study 6 is not relevant to the topic of fibrocystic breast changes and sonographic findings.