Fibrocystic Breast Condition (cont.)
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Why can fibrocystic breast condition be associated with an increased risk of breast cancer?
Fibrocystic breast condition that involves hyperplasia is associated with a
slightly elevated risk of breast cancer, and atypical hyperplasia is associated
with a moderately increased risk of breast cancer when compared to women without
fibrocystic changes. This is because genetic errors (mutations) have begun to
accumulate in cells that no longer respond normally to the signals that usually
control cell growth and division. These cells may also have an impaired ability
to repair any genetic damage. As the atypical cells increase in number, they
accumulate additional genetic errors.
Environmental, dietary, and metabolic toxins may also interact with a woman's
complex hormonal system to increase the risk of mutations and thus increase the
risk of breast cancer. It has been demonstrated that individuals differ
significantly in their ability to break down and remove toxins from the body.
Some of this varied response to toxins may be due to inherited differences. The
potential for DNA damage (leading to genetic errors or mutations), which can be
caused by a variety of damaging agents combined with the stimulation of cell
division, is what ultimately leads to the risk of breast cancer that is
associated with some cases of fibrocystic breast condition; the ability to
recognize and repair DNA damage, a process that cells must continuously perform,
varies from person to person.
Why don't all women with fibrocystic breast condition have breast biopsies?
One reason to undergo a breast biopsy is to diagnose breast cancer. Another
reason is to identify those women with fibrocystic breast condition who are at an
increased risk of developing breast cancer in the future. However, the severity
of a woman's symptoms and clinical signs of fibrocystic breast condition (pain and
lumpiness) do not necessarily correlate with the cellular findings under the
microscope. Therefore, it is difficult to single out every woman with
fibrocystic breast condition for whom a breast biopsy would be useful.
Additional reasons why breast biopsies are not done on every woman with
fibrocystic breast condition include: (1) the invasive nature of the biopsy
procedure; (2) the necessity of anesthesia; and (3) cost-benefit considerations.
Instead, most women with fibrocystic breast condition are followed over time as if
they all are at an increased risk for developing breast cancer. The woman
herself must ensure that her clinician is appropriately monitoring her on a
regular basis.
Next: What is the recommended follow-up for women with fibrocystic breast condition? »
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