benign changes characterized by the formation of fibrotic and/or cystic tissue

<aside> 💡 no increased risk of breast cancer

</aside>

Demographics / Risk factors

• Most common benign lesion of the breast
• Primarily in premenopausal women 20–50 years of age
• Up to 50% of women are affected during their lifetime.

Aetiology and pathophysiology

• unknown - Although it has not been fully established, an excess of estrogen coupled with a progesterone deficiency seems to play an important role.

Clinical features

• Premenstrual bilateral multifocal breast pain
• Tender or nontender breast nodules
• Clear or slightly milky nipple discharge
• breast pain, focal areas of nodularity or cysts often in the upper outer quadrant, frequently bilateral, mobile, varies with menstrual cycle, and nipple discharge (straw-like, brown, or green)

Ix findings

• Ultrasound and mammography (first-line)
  • Ultrasound
    • Findings range from normal appearance to focal regions of thick parenchyma.
    • Сysts may be present.
  • Mammography (not recommended for women < 30 years)
    • Round or oval masses with clear borders
    • In some cases, dispersed calcifications
• Fine-needle aspiration (after imaging confirms a cystic lesion): indicated if the patient is symptomatic and/or requests the procedure
• Biopsy: confirms diagnosis if imaging is inconclusive