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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Definitions
- Fibrocystic change (FCC): Spectrum of histopathologic changes, including cysts, fibrosis, apocrine metaplasia (AM), Ca⁺⁺, chronic inflammation, sclerosing adenosis (SA), and epithelial hyperplasia
- Cysts can be gross or microscopic
- AM: Epithelial cells demonstrating secretory changes with abundant eosinophilic cytoplasm
- Adenosis: Enlarged lobules with ↑ number of acini (tubules)
- Usual ductal hyperplasia (UDH): > 1 layer of epithelial cells of variable morphology, no secondary spaces
- Fibrosis: Densely collagenized stroma
- SA: Adenosis around central duct with stromal sclerosis compressing duct lumina
- Avoid term fibrocystic disease, as FCC is within spectrum of normal variation
- Fibrocystic change (FCC): Spectrum of histopathologic changes, including cysts, fibrosis, apocrine metaplasia (AM), Ca⁺⁺, chronic inflammation, sclerosing adenosis (SA), and epithelial hyperplasia
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Image-Guided Biopsy
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Demirdover C et al: Is histological evaluation of reduction mammaplasty specimens worthwhile? Aesthet Surg J. ePub, 2018
- Oligane HC et al: Grouped amorphous calcifications at mammography: frequently atypical but rarely associated with aggressive malignancy. Radiology. 288(3):671-679, 2018
- Milosevic ZC et al: Breast dynamic contrast enhanced mri: fibrocystic changes presenting as a non-mass enhancement mimicking malignancy. Radiol Oncol. 51(2):130-6, 2017
- Berg WA et al: Quantitative maximum shear-wave stiffness of breast masses as a predictor of histopathologic severity. AJR Am J Roentgenol. 205(2):448-55, 2015
- diFlorio-Alexander RM et al: Breast MRI-detected cystic apocrine metaplasia: imaging features with microvessel analysis and histologic correlation. AJR Am J Roentgenol. 204(1):211-8, 2015
- Ochi M et al: Diffusion-weighted imaging (b value = 1500 s/mm(2)) is useful to decrease false-positive breast cancer cases due to fibrocystic changes. Breast Cancer. 20(2):137-44, 2013
- Lee SJ et al: MRI features of stromal fibrosis of the breast with histopathologic correlation. AJR Am J Roentgenol. 197(3):755-62, 2011
- Berg WA et al: Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am. 48(5):931-87, 2010
- Chen JH et al: Magnetic resonance imaging features of fibrocystic change of the breast. Magn Reson Imaging. 26(9):1207-1314, 2008
- Daly CP et al: Complicated breast cysts on sonography: is aspiration necessary to exclude malignancy? Acad Radiol. 15(5):610-7, 2008
- Chang YW et al: Sonographic differentiation of benign and malignant cystic lesions of the breast. J Ultrasound Med. 26(1):47-53, 2007
- Collins LC et al: The influence of family history on breast cancer risk in women with biopsy-confirmed benign breast disease: results from the Nurses' Health Study. Cancer. 107(6):1240-7, 2006
- Liberman L et al: Does size matter? Positive predictive value of MRI-detected breast lesions as a function of lesion size. AJR Am J Roentgenol. 186(2):426-30, 2006
- Berg WA: Sonographically depicted breast clustered microcysts: is follow-up appropriate? AJR Am J Roentgenol. 185(4):952-9, 2005
- Berg WA et al: Cystic lesions of the breast: sonographic-pathologic correlation. Radiology. 227(1):183-91, 2003
- Leung JW et al: Utility of targeted sonography in the evaluation of focal breast pain. J Ultrasound Med. 21(5):521-6; quiz 528-9, 2002
- Shetty MK et al: Sonographic findings in focal fibrocystic changes of the breast. Ultrasound Q. 18(1):35-40, 2002
- Berg WA et al: Biopsy of amorphous breast calcifications: pathologic outcome and yield at stereotactic biopsy. Radiology. 221(2):495-503, 2001
- Leung JW et al: Multiple bilateral masses detected on screening mammography: assessment of need for recall imaging. AJR Am J Roentgenol. 175(1):23-9, 2000
- Dupont WD et al: Breast cancer risk associated with proliferative breast disease and atypical hyperplasia. Cancer. 71(4):1258-65, 1993
- Nomura A et al: Epidemiologic characteristics of benign breast disease. Am J Epidemiol. 105(6):505-12, 1977
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References
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Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Definitions
- Fibrocystic change (FCC): Spectrum of histopathologic changes, including cysts, fibrosis, apocrine metaplasia (AM), Ca⁺⁺, chronic inflammation, sclerosing adenosis (SA), and epithelial hyperplasia
- Cysts can be gross or microscopic
- AM: Epithelial cells demonstrating secretory changes with abundant eosinophilic cytoplasm
- Adenosis: Enlarged lobules with ↑ number of acini (tubules)
- Usual ductal hyperplasia (UDH): > 1 layer of epithelial cells of variable morphology, no secondary spaces
- Fibrosis: Densely collagenized stroma
- SA: Adenosis around central duct with stromal sclerosis compressing duct lumina
- Avoid term fibrocystic disease, as FCC is within spectrum of normal variation
- Fibrocystic change (FCC): Spectrum of histopathologic changes, including cysts, fibrosis, apocrine metaplasia (AM), Ca⁺⁺, chronic inflammation, sclerosing adenosis (SA), and epithelial hyperplasia
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Image-Guided Biopsy
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Demirdover C et al: Is histological evaluation of reduction mammaplasty specimens worthwhile? Aesthet Surg J. ePub, 2018
- Oligane HC et al: Grouped amorphous calcifications at mammography: frequently atypical but rarely associated with aggressive malignancy. Radiology. 288(3):671-679, 2018
- Milosevic ZC et al: Breast dynamic contrast enhanced mri: fibrocystic changes presenting as a non-mass enhancement mimicking malignancy. Radiol Oncol. 51(2):130-6, 2017
- Berg WA et al: Quantitative maximum shear-wave stiffness of breast masses as a predictor of histopathologic severity. AJR Am J Roentgenol. 205(2):448-55, 2015
- diFlorio-Alexander RM et al: Breast MRI-detected cystic apocrine metaplasia: imaging features with microvessel analysis and histologic correlation. AJR Am J Roentgenol. 204(1):211-8, 2015
- Ochi M et al: Diffusion-weighted imaging (b value = 1500 s/mm(2)) is useful to decrease false-positive breast cancer cases due to fibrocystic changes. Breast Cancer. 20(2):137-44, 2013
- Lee SJ et al: MRI features of stromal fibrosis of the breast with histopathologic correlation. AJR Am J Roentgenol. 197(3):755-62, 2011
- Berg WA et al: Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am. 48(5):931-87, 2010
- Chen JH et al: Magnetic resonance imaging features of fibrocystic change of the breast. Magn Reson Imaging. 26(9):1207-1314, 2008
- Daly CP et al: Complicated breast cysts on sonography: is aspiration necessary to exclude malignancy? Acad Radiol. 15(5):610-7, 2008
- Chang YW et al: Sonographic differentiation of benign and malignant cystic lesions of the breast. J Ultrasound Med. 26(1):47-53, 2007
- Collins LC et al: The influence of family history on breast cancer risk in women with biopsy-confirmed benign breast disease: results from the Nurses' Health Study. Cancer. 107(6):1240-7, 2006
- Liberman L et al: Does size matter? Positive predictive value of MRI-detected breast lesions as a function of lesion size. AJR Am J Roentgenol. 186(2):426-30, 2006
- Berg WA: Sonographically depicted breast clustered microcysts: is follow-up appropriate? AJR Am J Roentgenol. 185(4):952-9, 2005
- Berg WA et al: Cystic lesions of the breast: sonographic-pathologic correlation. Radiology. 227(1):183-91, 2003
- Leung JW et al: Utility of targeted sonography in the evaluation of focal breast pain. J Ultrasound Med. 21(5):521-6; quiz 528-9, 2002
- Shetty MK et al: Sonographic findings in focal fibrocystic changes of the breast. Ultrasound Q. 18(1):35-40, 2002
- Berg WA et al: Biopsy of amorphous breast calcifications: pathologic outcome and yield at stereotactic biopsy. Radiology. 221(2):495-503, 2001
- Leung JW et al: Multiple bilateral masses detected on screening mammography: assessment of need for recall imaging. AJR Am J Roentgenol. 175(1):23-9, 2000
- Dupont WD et al: Breast cancer risk associated with proliferative breast disease and atypical hyperplasia. Cancer. 71(4):1258-65, 1993
- Nomura A et al: Epidemiologic characteristics of benign breast disease. Am J Epidemiol. 105(6):505-12, 1977
