Nonproliferative Changes

Nonproliferative Changes

Simple cysts are often aspirated to completion and do not need further evaluation. Cysts containing debris or blood image may appear solid and require biopsy to exclude the possibility of carcinoma.

Calcifications image are often found within clusters of apocrine cysts image. When detected on mammographic screening, biopsy is warranted as DCIS is also frequently associated with multiple calcifications.



  • Benign breast disease (BBD) with nonproliferative changes


  • Fibrocystic breast disease

  • Fibrocystic changes


  • Commonly encountered constellation of benign breast changes including cysts, apocrine metaplasia, stromal fibrosis, and adenosis


Hormonal Effects

  • Responsiveness of breast tissues to monthly changes of estrogen and progesterone levels plays an important role in pathogenesis of BBD

    • May be related to excess hormonal stimulation &/or hypersensitivity of breast tissue

  • Clinical factors associated with increased risk of BBD

    • Late age at menopause, estrogen replacement therapy, nulliparity, low body mass index, and family history of breast cancer

  • Clinical factors associated with decreased risk of BBD

    • High parity, oral contraceptives, physical activity

    • Tamoxifen, when used for breast cancer prevention, is associated with 28% reduction in prevalence of BBD (relative risk 0.72)



  • Incidence

    • Very common

      • Some elements of BBD are evident in up to 50-60% of women of reproductive age

    • Increased incidence of BBD seen in postmenopausal women receiving estrogens ± progestins for > 8 years (relative risk increased by 1.70)


  • Mammographic screening

    • May present with densities or calcifications

  • Palpable lumps

    • Diffuse symmetrical lumpiness is commonly found on physical examination

    • Size and symptoms may fluctuate over course of menstrual cycle

  • Cyclic breast pain may occur during late luteal phase of menstrual cycle

Natural History

  • BBD with nonproliferative changes does not increase risk of breast cancer

Jul 6, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Nonproliferative Changes

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