Fibrocystic breast disease is not a "harmless nondisease" but a distinct clinical entity that requires treatment to bring about relief to the patient, to reduce the incidence of breast surgical procedures, and to diminish the risk of breast cancer. Patients at high risk of breast cancer (breast cancer in mother and/or sister) should have clinical examinations at 4- to 6-month intervals and mammography every 1 to 2 years needle aspiration should be performed when the slightest suspicion arises. Needle aspiration biopsy should be performed in patients with macrocysts and whenever clinical, ultrasonic, and/or mammographic examinations are suspicious for carcinoma. ![]() With thorough diagnostic evaluation, appropriate medication, and close follow-up, treatment success can be achieved in almost every patient. Adjuvant therapy of fibrocystic breast disease with vitamin E is of value in patients with borderline or abnormal lipid profiles (low plasma levels of high-density lipoprotein and high plasma levels of low-density lipoprotein). These treatment modalities are equally as effective as or superior to danazol therapy, which entails side effects in the majority of patients. Medical treatment of fibrocystic disease is accomplished: by suppression of ovarian estrogen secretion with a low-estrogen oral contraceptive, whereby the action of estrogen on breast tissues is opposed by the oral contraceptive's progestin component (19-nortestosterone derivatives), or by cyclic administration of a progestogen (progesterone, medroxyprogesterone acetate) that modulates the mammary effects of estrogen. Fibrocystic changes regress during the postmenopausal period. The disease progresses with advancing premenopausal age and is most pronounced in women during their 40s. The clinical correlate of fibrocystic disease is reflected by breast and axillary pain or tenderness in response to development of fibrocystic plaques, nodularity, macrocysts, and fibrocystic lumps. In conclusion, this study finds significant associations between iron (stored and dietary) and fibrocystic disease and breast cancer.The pathophysiology of fibrocystic breast disease is determined by estrogen predominance and progesterone deficiency that result in hyperproliferation of connective tissue (fibrosis), which is followed by facultative epithelial proliferation the risk of breast cancer is increased twofold to fourfold in these patients. However, the risk of subsequent breast cancer associated with the presence of CCL in a benign breast biopsy is poorly understood. This protocol describes the signs and symptoms of fibrocystic breast changes and provides. Between 50 and 90 of women will experience benign changes in their breast tissue during their lifetime, with the 30s and 40s being the most common age of occurrence. Risk of breast cancer relative to the risk of fibrocystic changes was associated with dietary iron intake in women with nonproliferative fibrocystic changes (OR: 2.63, 95% CI: 1.04-6.68, p = 0.02). Histologic and genetic evidence suggests that at least some columnar cell lesions (CCL) of the breast represent precursor lesions in the low-grade breast neoplasia pathway. Fibrocystic breast changes are noncancerous lumps or abnormalities in the breast tissue. Similar, but weaker, trends were observed for proliferative changes and for breast cancer. Increasing ferritin levels were significantly associated with increasing risk of nonproliferative fibrocystic changes (OR: 2.51, 95% CI: 1.16-5.45, p trend = 0.04). Plasma ferritin levels and reported dietary iron intake were compared in 346 women with fibrocystic changes, 248 breast cancer cases and 1,040 controls. A case-control study nested in a cohort of women in Shanghai, China, was conducted to evaluate possible associations between risk of proliferative and nonproliferative fibrocystic changes as well as breast cancer and dietary iron intake and plasma ferritin levels. Iron overload, which was previously uncommon, has become more common in the United States than iron deficiency and may be increasing in China concurrently with dramatic increases in meat consumption. Iron, an essential element necessary for cell function, has also been demonstrated to have potential carcinogenic and co-carcinogenic activities. Case-control and cohort studies have provided evidence that at least some of these factors may be dietary. ![]() ![]() ![]() Increases in risk of breast cancer in successive generations of migrants to the United States from China and rapid temporal changes in incidence rates in China following social and economic changes clearly implicate environmental factors in the etiology of this disease.
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