Fibrocystic Breast Disease

Posted by e-Medical PPT
Fibrocystic Breast Disease (FBD)
Most benign breast condition
Incidence-varying, related to age
Menstruating years-20%
30-50% in premenopausal years
Synonyms- Mammary dysplasia,  Cystic disease, Cyclic Mastopathy, Cystic Hyperplasia

Pathophysiology
Hormonal basis
Oestrogen & Progesterone
Oestrogen predominance over progesterone is considered causative
Serum levels  of Oestrogen >
Luteal phase is shortened
Progesterone level decreased to 1/3 normal
Corp. Lut. Deficiency / Anovulation in 70%
Patients with Pre Menstrual Tension syndrome  more likely to develop  FBD
Women with progesterone deficiency carry a five fold risk of premenopausal breast cancer

Prolactin-
levels are increased in 1/3 of women with FDB
Probably due to Oestrogen dominance on pituitary
Thyroid –
Suboptimal levels sensitize mammary epithelium to Prolactin stimulation
Methylexanthiones-
Increased intake of coffee, tea, cold drinks chocolate is associated with development of FDP

Trauma- NOT A CAUSE

Oestrogens stimulate proliferation of connective and epithelial tissues.' The polymorphism of fibroeystic disease is documented by fibrosis, cyst formation, epithelial proliferation, and lobular-alveolar atrophy. FBD entails simultaneous progressive and regressive change. Ductular branching, intraductal epithelial proliferation(papillomatosis), lobular hyperplasia, and proliferation of intralobular connective tissue may undergo regressive       changes       such       as. adenofibrosis, srlerosing adenosis, duct dilation, cyst formation, and calcification. Loss of parenchymal elements (ductules, alveoli) with intra-lobular and periductal fibrosis is encountered in chronic disease..


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