Therapy of patients at risk
Skidmore, F.D.
Annals of the new York Academy of Sciences 586: 284-287
1990
ISSN/ISBN: 0077-8923 PMID: 2357009 DOI: 10.1111/j.1749-6632.1990.tb17818.xDocument Number: 371460
This is an informal discussion of how the author manages fibrocystic breast disease. Cystic disease of the breast is common in premenopausal women, peaking at age 48. It usually follows a cyclic pattern, increasing premenstrually, and often developing during missed periods before menopause. Sometimes iatrogenic causes, such as premenopausal estrogen replacement or cimetidine, are responsible. 6% of women with cystic disease will progress to breast cancer by the age of 52. Patients are treated with excisional biopsy, and are followed up every 6 months. Disease can manifest on the range from benign fibroadenoma, to epitheliosis, to carcinoma in situ. It is advisable to discontinue birth control pills immediately in women with cyst disease. Estrogen replacement is especially contraindicated for these women because it will cause fibroadenosis in the upper outer quadrant, retard the process of fatty degeneration of breast tissue, and increase the woman's chances of more cysts, more biopsies, and more anxiety as future mammograms become increasingly difficult to interpret.