The most important thing to understand about fibrocystic breast is that this condition is not the same as breast cancer, though both tend to cause lumpiness in the breast. So what are the differences? Breast cancer or carcinoma of the breast is a dangerous pathology in which a cancerous tumor forms in the breast. This tumor can spread locally by contiguous spread, to the more virulent (highly malignant) types, which can spread to all parts of the body, i.e. metastasize to the liver, lungs, bone and brain etc. In its highly malignant form, it (breast cancer) can be lethal within months to years if left untreated. Unlike breast cancer, fibrocystic breast disease is a benign condition, almost considered physiological or a normal change in the breast of pre-menopausal women. Unlike breast cancer, fibrocystic breast disease will never be lethal and does not spread to other parts of the body. On self examination, the main differences are that the patient of breast cancer will usually have symptoms of weight loss and unusually severe pain in the breast. The woman may be able to feel a new lump or growth in the breast that was previously not seen. This lump may be adherent to the underlying chest wall or the overlying skin. Mammography and breast ultrasound is usually sufficient in suspecting breast cancer. Finally MR and CT imaging may also help along with FNAC or fine needle aspiration cytology or biopsy of the suspected breast tumor.
However, despite the differences, there is a small minority of women who have long term fibrocystic breast condition, who will also develop hyperplasia with atypical cells in the breast. Atypical cells are partially mutated cells in the breast which have appearances different from that of the other normal cells in the breast (on microscopic examination). How do atypical cells form in the breast? Due to chronic and repeated changes taking place in the breast during every menstrual cycle, over a long period before menopause, the woman’s breast undergoes repeated injury due to the hormonal effects and those from dietary and metabolic as well as environmental factors. There are also cells that destroy these atypical cells in a self regulatory mechanism in the body. However, repeated insults due to the causes mentioned above can upset the balance that maintains normalcy in the breast tissues. The result is that there is proliferation of atypical cells in the breast, called hyperplasia. Some of these atypical cells can undergo a cancerous change (the step towards cancer formation). This is more likely to occur if the woman has a history of breast cancer in the family or among close relations. Such women are advised to undergo detailed follow up and monitoring for breast cancer including needle biopsy and imaging. In case atypical cells are present on needle biopsy, the patient has to be followed up regularly for cancerous changes in these cells. It must be noted that the severity of fibrocystic breast disease has no direct relation to breast cancer formation.
For further information see Fibrocystic Breast Disease.
