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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
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
Related Anatomy
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Related Differential Diagnoses
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References
Tables
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
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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