Mammary hyperplasia is an abnormality of normal mammary gland development and recuperation (ANDI) rather than a disease, but this type of lesion is often categorized as mammary hyperplasia in our country.ANDI occurs in the 2nd~3rd stage of the life cycle, with cyclic activity when normal at the age of 25~40 years, and cyclic breast pain and cyclic nodes in the case of abnormality; and lobular, stromal, and ductal recuperation when normal at the age of 35~55 years, and cysts, sclerosis, and ductal dilatation in the case of abnormality. The management focuses on clinical breast examination and management of the breast. Its management focuses on the triple examination of breast clinical examination, breast imaging and percutaneous biopsy to exclude early breast cancer and to prevent and control precancerous lesions such as breast atypical hyperplasia. Clinical manifestations of breast hyperplasia Most of the breast hyperplasia has no clinical manifestations, and periodic breast pain is often the physiological manifestation. There is no pathological evidence as to whether non-periodic pain is diagnostic of breast hyperplasia. Diffuse thickening of the mammary glands and breast lumps may be manifestations of breast hyperplasia, which may or may not be accompanied by mastalgia. In the case of nipple discharge, the discharge is usually clear, plasma or yellow, and blood is rare. Diagnosis and differential diagnosis Breast pain is divided into periodic and non-periodic, the latter needs to be differentiated from non-genuine breast pain secondary to other diseases, such as non-specific costochondritis (Tietze’s syndrome), the pain is often located in the inner quadrant of the breast, and the pain is aggravated when the lesion of costochondral cartilage is pressed, and the effect of injection of steroid hormones and local anesthesia is better; gallstones or angina can also cause breast tenderness, which may be accompanied or not accompanied with breast enlargement. Gallstones or angina pectoris can also cause breast tenderness. Breast lumps or cysts may be the manifestation of breast hyperplasia, or more often, lumps or glandular thickening, which may be characterized by periodic or non-periodic pain, and manifested as clearly palpable lumps or nodules, with or without tenderness. Breast ultrasonography may show only glandular thickening, or a slightly hypoechoic mass with clear boundaries and regular morphology, or a cyst, or no echogenic abnormality, with a BI-RADS grade of 1 to 3. Mammograms show dense glands, or masses with regular morphology and clear boundaries, or slightly dense masses and ring-shaped halos, with a BI-RADS grade of 0, 2-3, and often require percutaneous biopsy or magnetic resonance imaging (MRI) when differentiating from breast cancer. When the BI-RADS grade is 4 or 5, percutaneous biopsy is needed to identify breast cancer and other diseases. Nipple overflow Nipple overflow may be accompanied by dilatation of the milk ducts, and is mostly watery or milky, appearing as a plasma or yellow overflow, with blood being rare. When bloody fluid is present, mammography or imaging is needed to rule out intraductal papilloma, ductal carcinoma in situ, or breast cancer. Some cases need to be differentiated from periductal mastitis. Treatment Principles Symptomatic treatment is recommended, i.e., treatment of breast pain, breast cysts or breast lumps as the corresponding symptoms. Adequate individualized psychological and pharmacological interventions combined with appropriate biopsy and surgical excision are effective treatment modalities. In most patients, the symptoms of breast pain improved significantly after explanation, dietary modification, and wearing appropriate bras, and no treatment was needed. If the symptoms of breast pain persist and affect normal life and workers, appropriate drug intervention can be given. In China, traditional Chinese medicines are mostly used to treat breast pain, and some patients can get relief from the symptoms. For those with lumps, percutaneous biopsy should be performed according to the BI-RADS classification in order to avoid missed diagnosis and misdiagnosis of breast cancer. When breast hyperplasia with ductal epithelial atypical hyperplasia (ADH), lobular atypical hyperplasia (ALH), or papillomatosis is identified, it suggests a high risk of breast cancer and surgical treatment or chemoprevention is recommended.