It is a common breast disease in women. The nomenclature of this condition is quite confusing, also known as lobular hyperplasia, mammary dysplasia, fibrocystic sexually transmitted disease, etc. It was previously referred to as chronic cystic mastitis, but in reality, there are no inflammatory changes in this disease, making the term inappropriate. The characteristic of this condition is the hyperplasia of breast components, exhibiting abnormalities in structure, quantity, and histomorphology, hence it is called cystic hyperplasia or mammary dysplasia.

bubble_chart Etiology

Disease cause

This disease is commonly seen in women aged 30 to 50 and is related to ovarian dysfunction. During the menstruation cycle, the breasts also undergo cyclical changes. When the hormonal balance in the body is disrupted, with elevated estrogen levels and an imbalance in progesterone, the mammary glands fail to fully regress after hyperplasia, leading to mammary tissue proliferation.

Pathological changes

The excised specimen often appears yellowish-white, firm in texture, and lacks a membrane. The cut surface may reveal numerous scattered small cysts, which are actually dilated ducts of varying sizes. Most cyst walls are smooth and contain yellowish-green or brown viscous fluid. Sometimes, yellowish-white cheese-like material may ooze from the duct openings. If it is a diffuse cystic sexually transmitted disease, it is referred to as Schimmelbusche disease. A single, tense, bluish cyst is called a blue-domed cyst.

bubble_chart Diagnosis

Clinical manifestations: Patients often experience distending pain in one or both breasts, which may be mild and needle-like, sometimes radiating to the shoulders, arms, or chest and back. The pain typically worsens before menstruation and subsides or disappears after menstruation begins. Upon examination, scattered round nodules of varying sizes can be felt in the breast tissue, which are firm and sometimes tender. These nodules have indistinct borders with the surrounding breast tissue and do not adhere to the skin or chest muscles. In some cases, they may present as poorly defined thickened areas. The lesions are most commonly located in the upper outer quadrant of the breast but can also affect the entire breast. A small number of patients may experience nipple discharge, often brown, serous, or bloody. The condition can persist for a long time, but symptoms usually resolve or improve after menopause.

Treatment measures: The vast majority of cystic hyperplasia can be treated non-surgically. Supporting the breasts with a bra, using Chinese medicinals to soothe the liver and regulate qi, as well as harmonizing methods can alleviate pain. When pain is significant during the premenopausal period, methyltestosterone can be taken before menstruation, 3 times a day, 5mg each time; progesterone can also be taken orally, 5-10mg daily, for 7-10 days before menstruation. In recent years, vitamin E has been used for treatment, which also has a pain-relieving effect. For cases where the lesion is limited to a part of the breast and a distinct mass remains after menstruation, surgical treatment may also be considered.