Mammary hyperplasia (fibrocystic change or benign proliferative breast disease) encompasses a spectrum of hormonally responsive stromal and epithelial alterations. Symptoms fluctuate with the menstrual cycle and often regress spontaneously; however, pronounced changes require exclusion of malignancy.

1. Cyclic mastalgia
   Bilateral, dull or heavy pain most prominent in the upper outer quadrants, beginning 3–7 days before menses and resolving with menstruation. Pain may radiate to the axilla or medial arm.
2. Nodular or glandular thickening
   Multiple, small, mobile “lumps” with ill-defined borders create a cobble-stone or granular consistency that merges with surrounding tissue.
3. Premenstrual breast swelling and heaviness
   Diffuse enlargement of one or both breasts, accompanied by tightness of brassiere and mild nipple hypersensitivity.
4. Cystic fluctuation
   Large cysts produce discrete, well-circumscribed, resilient masses that may transilluminate; aspiration yields straw-coloured or greenish fluid.
5. Nipple discharge
   Multiduct, serous or green-brown discharge is common; frank blood or persistent single-duct discharge mandates cytological evaluation.
6. Axillary discomfort
   Tender, mobile lymph nodes < 1 cm accompany cyclic inflammation; firm or fixed nodes require biopsy.
7. Post-menopausal regression
   Symptoms diminish spontaneously after ovarian failure; new palpable masses in post-menopausal women are considered malignant until proven otherwise.
8. Psychological impact
   Fear of cancer amplifies symptom perception; reassurance following negative imaging and clinical follow-up often reduces pain scores.