Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
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.
Cysts are saclike structures that can occur throughout the body and usually contain a semisolid, liquid, or gaseous substance. Infections, tumors, genetic conditions, chronic inflammatory conditions, and wear and tear can cause cysts. Though some cysts may be palpable, others may not produce any symptoms. Treatment depends upon the location and cause of the cyst.
Breast cancer is the most common cancer in women and the second most common cause of cancer death in women in the U.S. Symptoms include a lump in the breast or underarm area, nipple pain, change in breast size or shape, an inverted nipple, nipple discharge, and breast skin changes. Treatment may involve chemotherapy, radiation therapy, biological therapy, hormone therapy, or surgery.
The breast generally refers to the chest, however, more specifically, to the mammary gland. The mammary gland is a milk producing gland comprised largely of fat. Within the mammary gland is a complex network of branching ducts. The ducts exit from sac-like structures called lobules, which can produce milk in females. The darkened area around the nipple is called the areola. Common medical concerns in regard to the breast include breast lumps, breast cysts, breast cancer, and breast infections.
Women's health is an important topic area to guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur. Educating yourself so that the transitions into different phases of life is key to a healthy, happy, and productive life.
Lifestyle changes, a healthy antioxidant-rich diet, exercise, and weight reduction can help reduce a woman's risk of developing breast cancer. It's important to be aware of how risk factors such as family history, lifestyle factors, breast conditions, radiation therapy, and hormonal factors may influence your chances of developing breast cancer. Mammography and breast self-examinations are crucial steps in breast cancer prevention.
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