Fibrocystic Breast Changes: Imaging and Pathological Correlational Study of a Sample in The Kurdistan Region of Iraq

Background and objectives: Fibrocystic changes of the breast are the most common breast changes observed globally. The study aimed to assess these changes using ultrasound and correlate the imaging findings with histopathological changes to determine accuracy. Methods: A prospective cross-sectional study included 240 women who were diagnosed with fibrocystic breasts between January 2022 and July 2023 at a specialized medical center in Duhok city. Ultrasound was performed to evaluate changes in the breast. Imaging results were classified according to the guidelines of the American College of Radiology's Breast Imaging Reporting and Data System. Women with moderate imaging findings underwent ultrasound guided needle aspiration. The samples obtained were sent for cytological and histopathological evaluation. A correlation was conducted between the results of both of these modalities. Results: The age group most affected was 29-49 years. Bilateral breast involvement was the most prevalent, accounting for 78% of the cases. 74% of the affected women complained of cyclical mastalgia. Ultrasound findings mainly show simple cysts, clustered cysts, and duct ectasia, accounting for 29%, 30%, and 15% respectively. BI-RAD 2, followed by 3, and then 4A were the most common imaging categories. Simple cyst (36%), ducts with apocrine metaplasia (23%), and epithelial hyperplasia without atypia (18%) were the most commonly observed histopathological findings. Statistically significant accuracy was observed regarding the imaging and cytological correlations in BI-RAD 3and 4A. Conclusion: A strong correlation was observed between the ultrasound findings of breast fibrocystic changes and the histopathological evaluation.