Fibrocystic changes are the most common cause of breast lumps in women under the age of fifty. The condition is not cancerous. At least 50% of the women in their reproductive years have lumpy breasts as a result of fibrocystic changes.
Diagnosing Fibrocystic Changes
Usually fibrocystic changes can be diagnosed by physical examination. Mammography, ultrasound, needle aspiration, or biopsy may also be helpful in diagnosing fibrocystic lumps and ruling out cancer.
Causes of Fibrocystic Changes
The cause of fibrocystic changes is related to the way breast tissue responds to fluctuations in the levels of estrogen and progesterone, the female hormones produced by the ovaries during a woman’s reproductive years. Each month during a menstrual cycle, the breast tissue alternately swells and returns to normal. Hormonal stimulation of the breast tissue causes the blood vessels to swell, the milk glands and ducts to enlarge, and the breast to retain water. The breasts frequently feel swollen, painful, tender, and lumpy at this time. After menstruation, swelling decreases and the breasts feel less tender and lumpy. That is why the best time to examine the breast is right after the menstrual period.
As a result of repeated hormone stimulation, there is an increase in firmness of breast tissue. Pockets of fluid called cysts may form in obstructed or enlarged milk ducts. The breast tissue may feel like an irregularly shaped area of thicker tissue with a lumpy or ridge-like surface. Fibrocystic tissue may feel like tiny beads scattered through the breast.
Generally, fibrocystic changes are found in both breasts and most frequently are found in the upper-outer quadrant and the underside of the breast. Pre-menopausal women with a fibrocystic condition may experience an increase in size of lumpy areas in the breast, as well as discomfort ranging from a feeling of fullness or heaviness to a dull ache, extreme sensitivity to touch, or burning sensation. The condition tends to subside after menopause.
Removal of Cysts
Cysts are fluid filled sacs that are usually smooth, firm, movable, and tender. The tenderness and lump size generally increase the week before the menstrual period and subside somewhat the week following. Large cysts feel round and similar to what you feel when you press.
Screening for Breast Cancer
Monthly Breast Self Exam (BSE) can help women distinguish the difference between “normal” lumpy breast tissue and lumps that must be evaluated by a surgeon. Particular attention must be paid to any limp that is new, persistent, especially prominent, hard, or enlarging.
Breast cancer screening includes the following
- Monthly Breast Self Exam (BSE) beginning at age 20.
- Yearly exam by your physician.
- Yearly mammogram beginning at age 40.
Finding a New Lump
The discovery of a lump in your breast can cause a great deal of concern because of the possibility of breast cancer. It is important to discuss any new lump that you notice with your physician.
The Best Time for Breast Self Examination (BSE)
The American Cancer Society urges women to perform BSE once a month, about a week after the menstrual period. Post-menopausal women should choose a set day, such as the first of the month, to practice self-examination. For further information, ask for our brochure on BSE.
The treatment of a fibrocystic condition may include the following
- Needle aspiration of a cyst.
- Surgical removal (biopsy) of lumps that are concerning for the possibility of cancer.
- Avoidance of caffeine in coffee, tea, and colas.
- Non-steroidal anti-inflammatory drugs such as aspirin or ibuprofen.
- Local ice or heat applications.
- A good support bra.
- Vitamins A, B complex, and E.
- Evening Primrose.