F

Family history: a strong history of breast cancer may attribute an increased risk of breast cancer to unaffected relatives. Breast cancer is common and clustering of cases can by chance lead to cancers occurring within a family. The incidence of true genetic breast cancers is very small - under 5% of all breast cancers. Family history in either the maternal or paternal arm is equally significant. The higher the number of affected relatives, the younger the age of onset, and the presence of associated cancers (eg ovarian), increase the familial risk of breast cancer. The following constitutes an elevation of risk to justify special screening over and above that offered by (general) screening programmes (see entry). A family history of breast cancer affecting the following groups on the same side of the family: (i) One first degree relative* diagnosed with breast cancer under 40; (ii) Two or more first or second degree relatives on same side of the family, under 60 years or ovarian cancer at any age; (iii) One or more first degree relatives with bilateral breast cancer under age of 60; (iv) Three family members on the same side of the family with breast cancer under 70 years; (iv) Four family members on the same side of the family with breast cancer; (v) Close relatives of Ashkenazi Jewish women affected with breast cancer under 40 years old or ovarian cancer; (vi) Family members of rare high risk cancer syndromes e.g. Li-Fraumeni; (vii) Family history of male breast cancer in first or second degree relatives.

*A first degree relative can be a mother, father, sister or daughter and a second-degree relative can be an aunt, cousin, grandmother or granddaughter

Fibroadenoma: a common benign breast lump in younger women. There are two pathological classifications, pericanalicular and intracanalicular, which are merely microscopic descriptions and have no implication on management. Fibroadenomas can be single or multiple. Smaller fibroadenomas sometimes regress spontaneoulsy. Fibroadenomas confirmed to be benign on triple assessment (see entry) in women under the age of 35 years and in the absence of a family history might be treated conservatively. Indications for surgical removal of a fibroadenoma in younger women include large size or an increase in size, indeterminate triple assessment, or patient preference. New fibroadenomas that develop in women over the age of 40 years are usually recommended to be removed.

Fibrocystic change: a common condition that affects women in her later reproductive and perimenopausal years. It is best viewed as a variant of normal breast involution rather than a disease. The microscopic appearances are: proliferation of normal breast cells within the ducts, cyst formation, fibrosis of the surrounding supporting tissue, and an influx of lymphocytes. It can present as a thickening, a lump as a result of proliferation of breast and supporting tissue, or the formation of cysts. Fibrocystic breast change can also cause breast pain and tenderness.

Fine needle aspiration cytology (FNAC): a needle and syringe used to obtain cells by suction on the barrel, to examine cells on a glass slide after staining. (see cytology entry).