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.