00:01 Our first topic here will be fibrocystic change, extremely important. 00:05 Understand that we do not call this a disease and this definitely not a cancer. 00:10 So two things that I’ve said here that is of utmost importance. 00:13 Number one, it’s not a disease. 00:15 It’s a change. 00:17 Number two, it is not cancer. 00:19 Learn that first. 00:21 Why am I not calling it a disease? Approximately 50% of females in the reproductive age have this going on. 00:28 Fibrocystic change. 00:30 Thank goodness this isn’t breast cancer. 00:32 In fact, the chance of going on to breast cancer are quite slim. 00:36 Okay, it’s a change, not a disease. 00:39 I’m not going to call this a tumor 50% of population. 00:43 Young and we’ll talk about different histologic manifestations. 00:49 Know this really well and, as a point of reference, you need to compare this with an important differential called an actual benign tumor and that will be a fibroadenoma. 01:02 Clinical features: It produces a palpable lump. 01:05 You can actually feel it. 01:07 It may produce mammographic densities or calcifications. 01:10 Stop here. 01:12 Fibrocystic change. 01:13 Is this a disease? No. 01:14 Is this a cancer? No. 01:17 If you find calcification, yes, you’re concerned about cancer. 01:22 But the history so far, reproductive age, young estrogen sensitive they’ll have to give you something about histology, which I have not touched yet, but I need to in greater detail. 01:33 It may produce nipple discharge and that nipple discharge, well, it could be clear, very rarely would it be bloody, but just keep that in mind. 01:42 Some type of fluid coming out of the nipple and I’ll talk to you more about nipple discharges. 01:47 Could it be bloody? Could it be milk? Galactorrhea, okay? Or could it be just fluid? Or could it be purulent. 01:53 Remember, acute mastitis? The baby biting on the nipple, introducing organism, acute mastitis. 02:01 There, you would have a purulent type of discharge. 02:03 That discharge from the nipple tells you quite a bit. 02:07 Discharge in general. 02:08 Firbrocystic change and morphology. 02:11 Now here, I’ll walk you through a table which will give you the details, but allow the name to speak to you. 02:18 Fibrocystic change. 02:21 Right off the bat, it gives you two major differentials, fibrosis or cystic. 02:29 I’ll talk to you more about the cystic. 02:31 A cyst. 02:32 What’s the definition of a cyst? Fluid accumulation. 02:37 You’re never going to find this in fibroadenoma. 02:40 And fibroadema is a tumor. It’s solid. 02:43 And, well, fibroadenoma will be located way back in the stroma. 02:47 Epithelial changes especially -- now, this cyst in which it’s accumulating fluid, you must know the details. 02:55 Meaning to say that within the cyst and epithelial cells, remember this is a true cyst. 03:00 What’s the definition of a true cyst? It’s a structure that is lined by epithelium. 03:06 In this case, it’s going to secrete fluid. 03:09 So what type of epithelium is then here going to secrete fluid? This is called apocrine metaplasia. 03:16 Commit that to memory. 03:18 Apocrine or those type of cells that are responsible for secreting the fluid here in the cystic type of histology of fibrocystic change.
The lecture Fibrocystic Breast Change by Carlo Raj, MD is from the course Reproductive Pathology: Breast Disease with Carlo Raj. It contains the following chapters:
Which of the following is NOT associated with fibrocystic breast changes?
Which of the following statements about fibrocystic breast changes is TRUE?
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he doesn't go into details of the topic. For a beginner, I would never recommend this lecture