Fibrocystic disease

It is the most common benign lesion.
It is observed between 20-50 years of age usually premenopausal.
Cause
Altered oestrogen and progesterone ratio or relative decrease progesterone.
Strees factor.
Types
Localised
Diffuse
Risk factor
Nulliparity
Delayed menopausa
Symptoms
Breast pain-present throughout the cycle but aggravated premenstrually (cycle)
Pain is either dull continuous or intermittent severe.
Examination
Coarsely nodular areas resembling ill-difined lumps either localised or duffused.
These are prominent in premenstrual phase.
  Diagnosis
Careful palpation, mammography, ultrasound and aspirations biopsy        Treatment                               
Assurance.
Diuretics and tranquilizers in the second half of the cycle.
Reduce intake of coffee,tea , chocolates, caffeinated soda,tobacco.
Vitamin E400 mg daily.
In fefractory cases any of the following may be tried:
Cyclic combine oestrogen-progestrogen preparation.
Danazol 200 mg daily in divided doses.
Bromocriptine-2.5-5mg daily at bed time .
Surgery-rarely indicated.

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