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Fibrocystic disease of the breast (FBD) is a condition that is seen in a large percentage of women from ages 30 to 50, in which the breast becomes painful and lumpy, especially during menses. Other names that have been applied to FBD include mammary dysplasia, chronic cystic mastitis, diffuse cystic mastopathy, benign breast disease (a term that includes other benign breast disorders, including infections) and FibroCystic breast Condition (FCC). Although many names and acronyms, the condition is no longer considered a “disease”.
What is the Cause and How Does this Condition Develop?
To understand the etiology (cause/s) and the pathology of FBD, one must first understand the structure of the normal female breast. The breast consists of mainly three types of tissues. These are the glandular tissue which secretes milk after child birth, the connective tissue which forms the framework of the breast and fatty or adipose tissue. The glandular tissue consists of secretor cells (whose primary function is to release milk), epithelial cells and tiny ducts (lactiferous ducts) that lead to the nipple.
The breast is controlled and influenced by various chemicals (hormones) released into the blood from several organs. These include estrogen and progesterone from the ovary, as well as hormones like thyroxin from the thyroid, and growth hormone, prolactin and insulin. A complex interaction between these various hormones controls breast tissue and function. During the menstrual cycle, these hormones (notably estrogen and progesterone) cause both uterine and breast changes preparing the woman for possible pregnancy. However, when pregnancy does not occur, the uterus undergoes menstrual bleeding with resultant sloughing off or shedding of its inner lining.
Similarly in the breast, the glandular and fatty tissues as well as blood vessels multiply in preparation for pregnancy. This causes a feeling of fullness in the breasts. When menstruation takes place, these tissues undergo destruction of the excess cells that have accumulated within the breast. Certain scavenger cells then remove this dead material from the breast. This process of cell death and the inflammatory responses that follow is repeated during each menstrual cycle causing repeated collection of unneeded tissue and material within the breast resulting in both fibrous (scar tissue formation) and cystic (fluid filled spaces) changes within the breast. This spectrum of changes is called fibrocystic breast disease or fibrocystic breast condition. The degree of cellular damage, necrosis of tissue and scar or cystic formation can vary widely from one woman to another and also from one menstrual cycle to another.
What are the Types of Fibrocystic Breast Disease?
Fibrocystic breast conditions vary from primarily cystic changes and scar tissue (fibrosis) build up to the formation of atypical cells. Usually the changes .seen are a combination of the first two (scar tissue and cystic changes). However, many women show no significant changes on histo-pathological study (microscopic examination of biopsy tissue). Cystic changes vary from microscopic cysts (fluid collections within the glands) to large macroscopic collections (larger visible or palpable cysts). However, it must be emphasized that as minute cysts multiply, they may form a larger mass or lump consisting completely of these microscopic cysts and can be felt on palpation (physical examination of the breast). Formation of atypical or abnormal cells within the glandular tissue or the ducts of the breast are the result of long standing FBD. Here, there is proliferation of abnormal cells resulting in breast lumpiness.
See more detail about Firbrocystic Breast Disease here.
