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

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

Reference:

• Hughes LE. Classification of benign breast disorders. The ANDI classification based on physiological processes within the normal breast. Br Med Bull. 1991 Apr;47(2):251-7.