Fibrocystic Breast Condition (cont.)
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What causes fibrocystic breasts?
Fibrocystic breast condition involves the glandular breast tissue. The sole
known biologic function of these glands is the production, or secretion, of
milk. Occupying a major portion of the breast, the glandular tissue is
surrounded by fatty tissue and support elements. The glandular tissue is
composed of different types of cells: (1) clusters of secretory cells (cells
that produce milk) that are connected to the milk ducts (tiny tubes); and (2)
the cells that line the surfaces of the secretory cells, called the epithelial
cells.
The most significant contributing factor to fibrocystic breast condition is a
woman's normal hormonal variation during her monthly cycle. Many hormonal
changes occur as a woman's body prepares each month for a possible pregnancy.
The most important of these hormones are estrogen and progesterone. These two
hormones directly affect the breast tissues by causing cells to grow and
multiply.
Many hormones aside from estrogen and progesterone also play an important
role in causing fibrocystic breasts. Prolactin, growth factor, insulin, and
thyroid hormone are some of the other major hormones that are produced outside
of the breast tissue, yet act in important ways on the breast. In addition, the
breast itself produces hormonal products from its glandular and fat cells.
Signals that are released from these hormonal products are sent to neighboring
breast cells. The signals from these hormone-like factors may, in fact, be the
key contributors to the symptoms of fibrocystic breast condition. These substances
may also enhance the effects of estrogen and progesterone and vice versa.
The same cyclical hormones that prepare the glandular tissue in the breast
for the possibility of milk production (lactation) are also responsible for a
woman's menstrual period. However, there is a major difference between what
happens in the breast and uterus.
In the uterus (the womb), these hormones promote the growth and
multiplication of the cells lining the uterus. If pregnancy does not occur, this
uterine lining is sloughed off and discharged from a woman's body during
menstruation.
In the breast, these same hormones stimulate the growth of breast glandular
tissue and increase the activity of blood vessels, cell metabolism, and
supporting tissue. All this activity may contribute to the feeling of breast
fullness and fluid retention that women commonly experience before their
menstrual period.
When the monthly cycle is over, however, these stimulated breast cells cannot
simply slough away and pass out of the body like the lining of the uterus.
Instead, many of these breast cells undergo a process of programmed cell death,
called apoptosis. During apoptosis, enzymes are activated that start digesting
cells from within. These cells break down and the resulting cellular fragments
are then further broken down by scavenger cells (inflammatory cells) and nearby
glandular cells.
During this process, the fragments of broken cells and the inflammation may
lead to scarring (fibrosis) that damages the ducts and the clusters (lobules) of
glandular tissue within the breast. The inflammatory cells and some of the
breakdown fragments may release hormone-like substances that in turn act on the
nearby glandular, ductal, and structural support cells.
The amount of cellular breakdown products, the degree of inflammation, and
the efficiency of the cellular cleanup process in the breast vary from woman to
woman. These factors may also fluctuate from month to month in an individual
woman. They may even vary in different areas of the same breast in a woman.
Next: Which women are more likely to develop fibrocystic breast condition? »
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