Fibrocystic Breast Condition Fibrocystic Changes

  • Medical Author:
    Melissa Conrad Stöppler, MD

    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.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    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.

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Is there more than one type of fibrocystic breast condition?

Yes. When biopsies (samples) of breast tissue are studied under the microscope, it is possible to identify different types of fibrocystic breast condition. Some cases of fibrocystic breast condition show little disturbance of the breast tissue. Other cases involve a large number of cysts, along with fibrous (scar) tissue, in the breast tissue. Additionally, in some cases of fibrocystic breast condition, the breast cells do not have a normal appearance.

Cysts and fibrosis: Usually, even when the breast is not stimulated to produce milk, some secretions are produced by the secretory glandular cells. These secretions are normally reabsorbed "downstream" in the ducts. However, when there has been tissue damage and scarring (fibrosis) in the breast, these secretions may be trapped in the glandular portions of the breasts, thereby leading to the formation of fluid-filled sacs called cysts. In some areas of the breasts, there may be excessive fluid secretions due to stimulation by hormone-like substances. The resulting cysts may remain microscopic or enlarge until they contain several teaspoons or even tablespoons of fluid. These larger cysts may be felt as palpable (capable of being detected by touching) breast lumps. Even microscopic cysts may sometimes be felt as palpable lumps if many cysts are clustered together and there is a buildup of fibrous (scar) tissue around the cysts.

Hyperplasia and atypical hyperplasia of breast cells: With repeated stimulation from normal hormones, and possibly the effects of many of the hormone-like substances produced in the breast, a few of the epithelial cells (cells that line the ducts in the breast) may eventually lose some of their genetic controls, which normally limit their multiplication (cell division). When this happens, cells may proliferate, leading to an abnormal architectural pattern of the epithelial cells. This over-proliferation of cells is termed hyperplasia. Sometimes these proliferating cells begin to appear abnormal and to look different from one another. They are now described as "atypical." As other more normal cells continue to cycle, die and break down, these atypical cells can move in, spread out, and accumulate. This extensive overgrowth and accumulation of atypical cells is called atypical hyperplasia.

Medically Reviewed by a Doctor on 11/2/2015

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