Aberations in the Normal Development and Involution of the breast (ANDI)

Last reviewed 01/2018

Aberations in the Normal Development and Involution of the breast (ANDI)

ANDI is a term used to describe most benign breast diseases

  • based on the fact that most benign breast disorders are relatively minor aberrations of the normal processes of development, cyclical hormonal response and involution

  • benign breast conditions are practically a universal phenomenon among women
    • benign pathological states account for approximately 90% of the clinical presentations related to the breast
    • these diseases are more common in females 30-50 years old, thus it is hormonal in nature
    • previously there was a tendency to include all benign breast disorders and pathology under the designation of 'fibrocystic disease'
      • this term, when applied to a biopsy or a palpable breast mass, is nonspecific and often includes normal physiologic and morphologic changes in the breast along with specific benign disease process.
    • another term used in this regard is 'mammary dysplasia'
    • purpose of the term ANDI is to refrain from calling normal changes a disease and to eliminate confusion

ANDI CLassification of benign breast disorders:

  • disorders of development
    • Polymastia and polythelia (exposed to the same scope of disease as normal breast tissue)
    • Accessory axillary breast tissue
    • Congenital inversion of nipples
    • Macromastia
    • Fibroadenoma
    • Phylloides tumor
    • Adolescent hypertrophy - gross stromal hyperplasia at time of development, of unknown origin

  • disorders of cyclical change
    • Mastalgia and nodularity

  • disorders of involution
    • Fibrocystic breast disease /fibrocystic change /chronic cystic mastitis /mammary dysphasia
      • includes a variety of changes in the glandular and stromal tissue in response to the levels of oestrogen and prrogesterone and often presents with cyclical breast pain (mastalgia)
    • Fibrocystic changes:
      • Cysts
      • Fibrosis
      • Sclerosing adenosis
      • Duct ectasia with periductal mastitis