Fibrocystic Breast Change

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.