Fibrocystic changes in the breast refer to a variety of irregularities in the breast tissue. These changes are benign, or noncancerous.
Fibrocystic changes occur when there is an imbalance of the female hormones produced by the ovaries. These hormones are estrogen and progesterone. The imbalance changes breast tissue to produce lumps. This condition is very common and is not cancer.
The classic symptom of fibrocystic changes is pain in both breasts. The pain is usually worse right before menstruation. The woman may have other symptoms, including: breast tendernesscysts, which are fluid-filled sacs within the breast tissuegeneralized lumpiness of the breastsnipple discharge
Fibrocystic changes are caused by a hormonal imbalance. This imbalance usually involves estrogen and progesterone. An increase in another hormone, prolactin, may also be responsible for some of the changes. Over half of all women experience fibrocystic changes at some time in their lives. The changes are most common in women between the ages of 20 and 50. The condition is uncommon after menopause unless the woman is taking hormone replacement therapy.
Fibrocystic changes are so common they are considered normal in most cases. There is no known prevention.
Diagnosis of fibrocystic changes begins with a medical history and physical exam. The woman can also feel the changes during a breast self-examination. The changes have been compared to manipulating a plateful of peas. There are usually areas of lumpiness.
Larger cysts often feel like small balloons filled with water. A health care provider will feel the breast to evaluate these changes.
A mammogram and or ultrasound may be ordered. Drainage of a breast cyst with a needle or breast biopsy is sometimes done but is often not required for diagnosis.
Women with certain fibrocystic changes have an increased risk of developing breast cancer in the future. This risk of breast cancer can be about five times greater than the risk in women who do not have such changes. Notably, most women with fibrocystic disease do not have these unusual changes.
Fibrocystic changes are not contagious and pose no risk to others.
Initial therapy consists of having the woman wear a support bra, both night and day. Limiting or eliminating caffeine often helps.
Some women get relief from taking Vitamin E while others are helped by taking vitamin A - although it often takes three or more months before benefits can be seen. Also, the Natural Medications Comprehensive Database rates iodine as "possibly effective" for fibrocystic breast discomfort.
Diuretics, or water pills, such as spironolactone (i.e., Aldactone), may help the discomfort.
Some women find it helpful to stop smoking. Oral contraceptives can also reduce symptoms.
Bromocriptine (i.e., Parlodel) or danazol (i.e., Danocrine) may be prescribed for severe symptoms. These medicines relieve breast symptoms and decrease breast lumps in about 90% of women.
On rare occasions, surgical treatment with removal of the breast is used. Surgery is usually only considered if the woman has severe pain or an abnormal biopsy.
Diuretics can pull out potassium from the body which may lead to weakness and heart irregularities. Bromocriptine may cause nausea and dizziness. Danazol can cause weight gain, acne, and excess body hair.
A woman with fibrocystic breast changes may need treatment intermittently.
A woman with fibrocystic breast changes will be asked to do regular breast self-examinations. She will have periodic visits with the healthcare provider and regular mammograms. If certain changes occur, the provider may recommend a breast biopsy. Any new or worsening symptoms should be reported to the healthcare provider.
"Comprehensive Gynecology" William Dregemueller, Third edition, 1997.
"Breast Disease, diagnosis and treatment" Schwartz GF and Marchant DJ. 1980.
"Breast Disease" Marchant DJ, et al. New York 1986
"Fibrocystic Disease of the Breast, non-disease?" New England Journal of Medicine 307:1010. Lowe SM et al.
