Fibrocystic Breast Changes

Fibrocystic breast changes is a non-cancerous(benign) condition that about half of all women have at some time in their life. It is also called benign breast disease and mammary dysplasia. It may also be called fibrocystic breast disease, but it is not really a disease. It is a common condition that occurs when women go through the hormonal changes during their menstrual cycle, between the ages of 20 to 50. Menopausal women do not have this problem, unless they are on hormone therapy. It can affect one or both breasts. This is not a sign that you will later get cancer.

CAUSES

Overgrowth of cells lining the milk ducts, or enlarged lobules in the breast, cause the breast duct to become blocked. The duct then fills up with fluid. This is like a small balloon filled with water. It is called a cyst. Over time, with repeated inflammation there is a tendency to form scar tissue. This scar tissue becomes the fibrous part of fibrocystic disease. The exact cause of this happening is not known, but it may be related to the female hormones, estrogen and progesterone. Heredity (genetics) may also be a factor in some cases.

SYMPTOMS

  • Tenderness.

  • Swelling.

  • Rope-like feeling.

  • Lumpy breast, one or both sides.

  • Changes in the size of the breasts, before and after the menstrual period (larger before, smaller after).

  • Green or dark brown nipple discharge (not blood).

Symptoms are usually worse before periods (menstrual cycle) and get better toward the end of menstruation. Usually, it is temporary minor discomfort. But some women have severe pain.

DIAGNOSIS

Check your breasts monthly. The best time to check your breasts is after your period. If you check them during your period, you are more likely to feel the normal glands enlarged, as a result of the hormonal changes that happen right before your period. If you do not have menstrual periods, check your breasts the first day of every month. Become familiar with the way your own breasts feel. It is then easier to notice if there are changes, such as more tenderness, a new growth, change in breast size, or a change in a lump that has always been there. All breasts lumps need to be investigated, to rule out breast cancer. See your caregiver as soon as possible, if you find a lump. Most breast lumps are not cancerous. Excellent treatment is available for ones that are.

To make a diagnosis, your caregiver will examine your breasts and may recommend other tests, such as:

  • Mammogram (breast X-ray).

  • Ultrasound.

  • MRI (magnetic resonance imaging).

  • Removing fluid from the cyst with a fine needle, under local anesthesia (aspiration).

  • Taking a breast tissue sample (breast biopsy).

Some questions your caregiver will ask are:

  • What was the date of your last period?

  • When did the lump show up?

  • Is there any discharge from your breast?

  • Is the breast tender or painful?

  • Are the symptoms in one or both breasts?

  • Has the lump changed in size from month-to-month? How long has it been present?

  • Any family history of breast problems?

  • Any past breast problems?

  • Any history of breast surgery?

  • Are you taking any medications?

  • When was your last mammogram, and where was it done?

TREATMENT

  • Dietary changes help to prevent or reduce the symptoms of fibrocystic breast changes.

  • You may need to stop consuming all foods that contain caffeine, such as chocolate, sodas, coffee, and tea.

  • Reducing sugar and fat in your diet may also help.

  • Decrease estrogen in your diet. Some sources include commercially raised meats which contain estrogen. Eliminate other natural estrogens.

  • Birth control pills can also make symptoms worse.

  • Natural progesterone cream, applied at a dose of 15 to 20 milligrams per day, from ovulation until a day or two before your period returns, may help with returning to normal breast tissue over several months. Seek advice from your caregiver.

  • Over-the-counter pain pills may help, as recommended by your caregiver.

  • Danazol hormone (male-like hormone) is sometimes used. It may cause hair growth and acne.

  • Needle aspiration can be used, to remove fluid from the cyst.

  • Surgery may be needed, to remove a large, persistent, and tender cyst.

  • Evening primrose oil may help with the tenderness and pain. It has linolenic acid that women may not have enough of.

HOME CARE INSTRUCTIONS

  • Examine your breasts after every menstrual period.

  • If you do not have menstrual periods, examine your breasts the first day of every month.

  • Wear a firm support bra, especially when exercising.

  • Decrease or avoid caffeine in your diet.

  • Decrease the fat and sugar in your diet.

  • Eat a balanced diet.

  • Try to see your caregiver after you have a menstrual period.

  • Before seeing your caregiver, make notes about:

  • When you have the symptoms.

  • What types of symptoms you are having.

  • Medications you are taking.

  • When and where your last mammogram was taken.

  • Past breast problems or breast surgery.

SEEK MEDICAL CARE IF:

  • You have been diagnosed with fibrocystic breast changes, and you develop changes in your breast:

  • Discharge from the nipple, especially bloody discharge.

  • Pain in the breast that does not go away after your menstrual period.

  • New lumps or bumps in the breast.

  • Lumps in your armpit.

  • Your breast or breasts become enlarged, red, and painful.

  • You find an isolated lump, even if it is not tender.

  • You have questions about this condition that have not been answered.