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, manifesting abnormalities in structure, quantity, and tissue morphology, hence it is called cystic hyperplasia or mammary dysplasia.

bubble_chart Epidemiology

The relationship between cystic hyperplasia and breast cancer remains unclear. Epidemiological studies suggest that patients with cystic hyperplasia have a 2 to 4 times higher chance of developing breast cancer compared to the normal population. Whether cystic Bingben hyperplasia itself will become malignant is related to the degree of ductal epithelial hyperplasia. Simple cystic hyperplasia rarely becomes malignant, but if accompanied by atypical epithelial hyperplasia, especially grade III, the likelihood of malignancy increases significantly, classifying it as a precancerous condition.

bubble_chart Etiology

This disease is commonly seen in women aged 30 to 50 and is related to ovarian dysfunction. During the menstrual cycle, the breasts also undergo periodic changes. When the balance of hormones 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 gland hyperplasia.

bubble_chart Pathological Changes

The resected specimen often appears yellowish-white, firm in texture, and lacks a capsule. The cut surface sometimes reveals numerous scattered small cysts, which are actually cystic dilations of ducts of varying sizes. The cyst walls are mostly smooth and contain thick, yellowish-green or brown viscous fluid. Occasionally, yellowish-white, cheese-like material may exude from the duct openings. If it presents as a diffuse cystic sexually transmitted disease, it is referred to as Schimmelbusche disease. A solitary, tense, bluish cyst is called a blue-dome cyst.

Patients often experience distending pain in one or both breasts, which may feel like needle pricks and can radiate to the shoulders, arms, or chest and back. The pain is typically more pronounced before menstruation and subsides or disappears after menstruation begins. Upon examination, scattered round nodules of varying sizes can be felt in the breasts, which are firm and sometimes tender. These nodules have indistinct borders with the surrounding breast tissue and are not adherent to the skin or chest muscles. In some cases, they may present as poorly defined thickened areas. The lesions are more 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.

bubble_chart 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 other harmonizing methods can alleviate pain. For significant pain during premenopause, methyltestosterone can be taken three times a day, 5mg each time, before menstruation begins; alternatively, progesterone can be taken orally at 5–10mg daily for 7–10 days before menstruation. In recent years, vitamin E therapy has also been used to relieve pain. For cases where the lesion is confined to a specific part of the breast and a distinct mass remains after menstruation, surgical treatment may also be considered.