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Fibrocystic changes rarely forecast cancer.

Fibrocystic changes rarely forecast cancer

The majority of women with chronic "lumpy breasts" are at no greater risk of developing breast cancer than other women, according to the College of American Pathologists (CAP). Prompted by women concerned about the diagnosis of "fibrocystic disease" and about increasing health insurance premiums, the Skokie, Ill.-based College held a consensus meeting to define the relationship between fibrocystic changes and breast cancer.

Both conditions occur relatively frequently in the United States -- about 9 percent of women get breast cancer, and 50 to 80 percent of women undergo breast tissue changes that range from unnoticeable to painful during the menstrual cycle. But whether "fibrocystic disease" is precancerous depends on its exact nature, the 40 pathologists, oncologists, surgeons and gynecologists conclude in their report, which appears in the March ARCHIVES OF PATHOLOGY AND LABORATORY MEDICINE.

There are more than a dozen types of tissue changes that fall under the moniker "fibrocystic disease," and because most of them are not diseases, the group prefers the name "fibrocystic changes" or "fibrocystic conditions."

Among the evidence considered by the committee was a study reported last year by researchers from Nashville's Vanderbilt University. Looking at biopsy tissue from 3,303 women with benign breast changes, they found that 70 percent of the women had cell types that put them at no greater risk than normal of breast cancer, another 26 percent had changes relating to a 1.5-to-2-times-higher risk, and only 4 percent were in the 5-times-higher-risk group.

Because the statistics were based on women whose breasts were biopsied, the percentage of women with fibrocystic changes in the general population who are in the no-increased-risk group is probably higher than 70 percent, notes CAP spokesperson Kay H. Woodruff, a pathologist at Brookside Hospital in San Pablo, Calif. Unless the physician notices suspicious changes, most women with fibrocystic changes are not biopsied.

"A lot of people assume a lump equals cancer, but there are many types of lumps," Woodruff says. "Most are not cancer."

While lumps can make doing a breast self-examination more difficult, the practice is just as important in women with fibrocystic changes as in other women, notes consensus head Robert V.P. Hutter, a pathologist at St. Barnabas Medical Center in Livingston, N.J.

As for problems with getting individual health insurance, an Aetna spokesperson says that depending on the examining physician's recommendation, the company offers women with fibrocystic changes a standard policy, a policy with a higher premium, or one that excludes breast-related problems. A Mutual of Omaha spokesperson says his company offers a policy that excludes the breast, but may change its approach after reviewing the current report.
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Author:Silberner, Joanne
Publication:Science News
Date:Mar 8, 1986
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