What are fibrocystic changes?
HealthGate.Com for the use of their article!
by Elaine Gottlieb
Do your breasts feel lumpy? In most cases, you're probably experiencing fibrocystic
breast change a benign condition that occurs in at least 60 percent of all women of
It sounds very unglamorous, but the human breast is no more than a lumpy gland made up
of milk glands and ducts and the tissues that separate and support them. Most breasts have
at least a lump or two; however, if your breast feels especially lumpy and uncomfortable,
you're probably experiencing fibrocystic breast changes.
"The vast majority of women have [fibrocystic changes]...and are no worse for
it," reports Dr. Carolyn Kaelin, a gynecologist and director of the breast clinic at
Brigham & Women's Hospital in Boston.
Fibrocystic changes are benign breast changes. The medical literature used to refer to
them as "fibrocystic disease," but that was before fibrocystic changes were
found to be no more a disease than menstruation or menopause. The breast tissue may feel dense
with an irregular area of thicker tissue with a lumpy or ridge-like surface. You might
also feel tiny bead-like masses scattered throughout the breasts.
Why does this happen?
Your breasts may feel tender, swollen and full with a dull, heavy pain. They may be
sensitive to touch with a burning sensation. This discomfort is normal and does not
indicate the presence of disease. For some women the pain is so severe that they cannot
exercise or lie on their stomachs. Fibrocystic changes usually occur in both breasts, most
often in the upper outer quadrant and the underside of the breast where most of the
milk-producing glands are located.
Fibrocystic changes are associated with hormonal shifts in estrogen and progesterone,
which affect the breast tissue. During the menstrual cycle, the breasts swell as the milk
glands and ducts enlarge and the breasts retain water. After menstruation the breast
swelling goes down and the breasts return to normal.
Fibrocystic changes generally begin when women are in their twenties or thirties and
usually last until menopause. For a small number of women, the condition worsens over the
years, causing constant pain and lumpiness. In general, some of the lumps become permanent
and may or may not shrink after menopause.
Some women with fibrocystic changes develop cysts in their breasts. A cyst is a
fluid-filled sac that is usually smooth, firm, movable and sometimes tender like a
water balloon without the water. The cyst will generally increase in size before the
menstrual period and decrease afterwards. A large cyst may be round and feel a bit like an
eyeball when pressed with the eyelid closed.
If you are concerned about a lump, your health care provider can determine whether or
not it warrants further attention. Determining whether a lump is a cyst or something more
serious can be determined by a simple office procedure known as fine needle aspiration. A
fine-gauge needle is inserted into the lump and fluid is withdrawn.
If the lump is a cyst, as is the case 95% of the time, it will collapse once the fluid
is removed. If it's a complex cyst, the next step is an ultrasound-guided fine needle
aspiration that would likely cause the cyst wall to collapse. "If we were concerned
that there was something in the cyst wall, we would proceed with a biopsy," says
While there is no definitive, medically proven treatment for breast pain caused by
fibrocystic changes, there are various remedies that can be helpful.
Fibrocystic changes and breast cancer
Foods and supplements
"Finding out what works for individual women is a trial and error process. If
there was one good way to treat the discomfort, everyone would be treated that way. Not
every remedy works for everyone but hopefully, at least something works for
everyone," Kaelin observes.
Avoiding foods and beverages containing caffeine,
such as coffee, tea, chocolate and soft drinks, can decrease water retention and may help
to alleviate the discomfort. Reducing fat in
the diet may also be helpful. Various herbs, vitamins and natural preparations, such as
evening primrose oil and vitamins B6 and E, are sometimes effective. Women who stop
smoking sometimes notice that their lumps decrease.
Aspirin and other pain relievers, as well as the application of heat can relieve
uncomfortable symptoms, as does wearing a bra that provides firm support. In worse case
scenarios, oral contraceptives which change the hormonal balance can lessen
fibrocystic changes. For severe cases, Danazol, a synthetic form of the hormone androgen,
may be prescribed. However, many women find that the side effects of Danazol, including
weight gain, hair growth and voice changes, are more distressing than the fibrocystic
There is no correlation between fibrocystic changes and breast cancer. There are some variations in
breast tissue that create a predisposition to breast cancer, but this is rare. The best
way to alleviate concerns about these cyclic changes is to examine your breasts every
month seven days after your period when hormone levels are lowest and there is less
texture. That way you'll know what degree of texture and lumpiness is normal for your
breasts and be able to detect changes. It's also a good idea to keep a diagram of the
textured areas, says Kaelin.
Kaelin strongly advises women to have a clinician examine their breasts once a year;
this should be done in addition to mammograms since 10%-15% of lumps elude detection by
mammogram. Any woman who is concerned about the texture of her breasts need only talk with
other women, says Kaelin, to find out just how common lumpiness and texture are.
|How to examine your breasts It
is normal to have some lumpiness or thickening in the breasts. By examining your breasts
once each month, you will learn what is normal for you and notice when any changes do
occur. Some women find that doing a weekly self-exam works better for them. They learn how
their breasts feel at all phases of their menstrual cycles. The more you can examine your
breasts, the better you can learn what is normal for you. Your job isn't just to find
lumps, but to notice if there are any changes.
|In the shower
||With your fingers flat, move gently over every part of each
breast. Use your right hand to examine the left breast and your left hand to examine the
right breast. Check for any thickening, hard lump or knot.
|In front of a mirror
||Check your breasts with your arms at your sides. Then raise
your arms overhead. Look for any changes in the shape of each breast, swelling, dimpling
or changes in the nipples.
||To examine your right breast, put a pillow under your right
shoulder. Place your right hand behind your head. Then with the flat fingers of your left
hand, press gently in small circular motions around an imaginary clock face. Begin at the
outermost top of your right breast for 12 o'clock, then move to 10 o'clock, etc. until you
get back to 12 o'clock. Each breast will have a normal ridge of firm tissue. Then move in
one inch toward the nipple, including the nipple. Keep circling to examine every part of
your breast including the nipple. Repeat the procedure on the left breast with a pillow
under the left shoulder and your left hand behind your head. Finally, squeeze the nipple
of each breast gently between the thumb and index finger. Any clear or bloody discharge
should be reported to your physician immediately.
Boston Women's Health Collective. The New Bodies Ourselves. Econo-Clad Books, 1999.
Understanding Fibrocystic Changes of the Breast
College of American Pathologists
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