Chronic cystic mastitis
| Chronic cystic mastitis | |
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| Cross section of the breast of an adult female. |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Fibrocystic disease; diffuse cystic mastopathy; mammary dysplasia; fibrocystic disease of the breast; fibrocystic mastopathy; fibroadenosis
Overview
Chronic cystic mastitis is a condition rather than a disease. It is a common condition marked by benign (noncancerous) changes in breast tissue. These changes may include irregular lumps or cysts, breast discomfort, sensitive nipples, and itching. These symptoms may change throughout the menstrual cycle and usually stop after menopause.
Causes
The causes of the condition are not fully understood, though it is known that they are tied to ovarian hormone levels, as the condition usually subsides after menopause. It is also related to the menstrual cycle and to dietary conditions. The incidence is lower in women taking birth control, possibly because of the regulation of hormone levels. Dietary fat levels and caffeine intake may have an effect on the onset of the condition, as may family history.
Drug side effect - Clomifene.
Epidemiology and Demographics
An estimated 30-60% of women suffer from this condition. It is characterized by noncancerous lumps in the breast.
Natural History, Complications and Prognosis
There are usually no adverse side effects to this condition. In almost all cases it subsides after menopause. A possible complication arises through the fact that cancerous tumors may be more difficult to detect in women with CCM.
Diagnosis
History and Symptoms
Symptoms include breast discomfort, sensitive nipples and itching. Symptoms follow a periodic trend tied closely to the menstrual cycle. Symptoms tend to peak immediately before each period and decrease afterwards. At peak, breasts may feel full and swollen. No complications related to breastfeeding have been found.
Physical Examination
Chronic cystic mastitis is characterized by the appearance of fibrous tissue and a lumpy, cobblestone texture in the breasts. These lumps are smooth with defined edges, and are usually free-moving in regard to adjacent structures. The bumps can sometimes be obscured by irregularities in the breast that are associated with the condition. The lumps are most often found in the upper, outer sections of the breast (nearest to the armpit). Women with chronic cystic mastitis may experience a persistent or intermittent aching in their breasts related to periodic swelling. Breasts and nipples may be tender or itchy.
Other Imaging Findings
Mammography does not often work for diagnosis of CCM, as the breast tissue is often too dense to allow for thorough examination.
Other Diagnostic Studies
This condition is often easily diagnosed by a doctor, though it may require a biopsy of the affected area.
Treatment
Medical Therapy
There is no cure for the condition, but symptoms may be reduced by monitoring caffeine and fat intake and wearing a well fitting bra. In severe cases a synthetic androgen may be prescribed.
Surgery
Aspiration with a very fine needle is used to drain fluid from larger cysts.