From the Guidelines
Fibrocystic breast disease does not typically turn into cancer. This condition is characterized by nonproliferative lesions, including benign calcifications, fibrocystic changes, fibroadenomas, lipomas, fat necrosis, and nonsclerosing adenosis 1. While benign breast disease and breast tissue density are independent risk factors for developing breast cancer 1, fibrocystic changes are considered nonproliferative lesions without atypia, which do not increase the risk of breast cancer.
Some key points to consider:
- Benign breast disease can be classified into three broad categories: nonproliferative lesions, proliferative lesions without atypia, and proliferative lesions with atypia 1.
- Nonproliferative lesions, such as fibrocystic changes, are not associated with an increased risk of breast cancer 1.
- Proliferative lesions with atypia, such as atypical ductal hyperplasia and lobular carcinoma in situ, are associated with an increased risk of breast cancer 1.
- Women with fibrocystic breasts should continue routine breast cancer screening as recommended by their healthcare provider, including regular mammograms and clinical breast exams.
For symptom management, over-the-counter pain relievers like ibuprofen or acetaminophen may help with discomfort, and some women find relief by limiting caffeine intake, wearing a supportive bra, and applying heat to painful areas. If you experience any unusual changes in your breasts, such as a new lump or persistent pain, it's essential to consult with your healthcare provider for proper evaluation.
From the Research
Fibrocystic Breast Disease and Cancer Risk
- Fibrocystic breast disease is characterized by breast pain, lumpiness, or cysts, and is experienced by 90% of all women during their lifetime 2.
- The disease is defined by the totality of dystrophic changes of the mammary tissue, including fibrosis, epithelial, cystic, metaplastic, and hyperplastic alterations 3.
- While most breast changes are harmless, women with fibrocystic breast disease need to be concerned with the increased risk of breast cancer, one of the leading causes of death in women in the United States 2.
Risk of Breast Cancer
- Benign breast disease, including fibrocystic breast disease, has generally been reported to be associated with a relative risk of from 1.5 to 3.0 for breast cancer 4.
- However, only 5% of women with fibrocystic mastosis have cellular changes in the form of atypical hyperplasia, which are a risk factor for cancer 3.
- The presence of atypical epithelial hyperplasia is associated with a particularly high risk of breast cancer 4.
- Management of fibrocystic breast disease involves monitoring for breast cancer by repeated physical and mammographic examinations 5.
Diagnosis and Classification
- Fibrocystic breast disease encompasses a variety of histologic changes, and the lack of a clear classification may account for divergent results in studies on the relationship between cystic disease and breast cancer 4.
- The diagnosis of fibrocystic mastosis is compulsory to exclude malignant tumors, and only in cases where a biopsy has been performed can the specific individual risk of developing cancer be calculated 3.
- Ductal carcinoma in situ is the lesion that delimits cancer from non-cancer, and an incidence of over 20% is present in countries that use mammographic screening programs 3.