As experts in obstetrics and gynecology, Atlanta Women's Specialists believes that an informed patient is an empowered patient. So we have made patient education a top priority. Look here for your guide to the most accurate information available on- and offline.

Fibrocystic Breast Changes

What are fibrocystic breast changes?
First of all, being diagnosed with fibrocystic breast changes does not mean you have cancer. It is the most common nonmalignant breast disorder of women. Other names for it are "benign breast disease," "mammary dysplasia," and "chronic cystic mastitis." The term, "fibrocystic breast changes," actually covers a broad range of conditions from painful breasts with solid, lumpy patches to cysts (lumps filled with fluid). It is estimated that 80% to 90% of breast lumps are not cancerous, however, fibrocystic breast changes requires a physician's care and you should always, and immediately, seek medical advice for any breast lump or irregularity. Fortunately, fibrocystic breast disease can be treated.

How common is fibrocystic breast changes?
Many women of childbearing age, about 20-45 years of age, have it. Physicians find evidence of fibrocystic breast changes in about one-third of women in this age range.

Who is most likely to get fibrocystic breast changes?
Women who have a family history of breast cancer or benign breast disorders, particularly in a mother or sister, are those most likely to develop fibrocystic breast changes. It is also more likely among women who have no children, who are Jewish, white, well-to-do, who have severe premenstrual syndrome (PMS) or menstrual irregularities, and women who have had miscarriages.

How will I know if I have fibrocystic breast changes?
Most breast lumps are discovered by the patients themselves through breast self-examination (BSE) and awareness of symptoms. Women of childbearing age should examine their breasts at least once a month. Several lumps may develop in both breasts at the same time. Your breasts may feel painful or tender, or feel dull, heavy, and full. You may feel a burning sensation in your breasts, or may find them extremely sensitive to touch. Fibrocystic breast changes may also develop without pain.

The lumps you find will probably be tender, firm, and slightly movable under your fingertips. Pain and lumps are sometimes more obvious in the left breast. In some cases of fibrocystic breast changes, a clear or pinkish water fluid may be discharged from the nipples. Symptoms of fibrocystic breast changes may be more noticeable a week or a few days before your period and may diminish or disappear as soon as your period starts.

How do I perform a breast self-examination?
Every woman over the age of 20 should learn BSE and do it once a month. The best place for it is in your bathtub or shower because lumps are easier to detect with wet hands on soapy skin. Examine each breast with the fingers of the opposite hand in slow, circular motion. If you do find a lump or notice any other irregularity on BSE, make an appointment with your doctor immediately. Many physicians say the best time of month to perform BSE is five to seven days after the end of your period, because this is the time when hormonal changes make symptoms and lumps easiest to detect.

In addition to feeling for lumps, you should also stand or sit in front of a mirror and look for changes in the contour or appearance of each breast. If your physician has already diagnosed fibrocystic breast changes and you have lumps in your breast remember where they are and how they feel so you can immediately recognize a new lump. If you have any of the symptoms, if you notice a change in contour or appearance of one or both breasts in the mirror, or if you are in one of the risk groups, see your physician.

How is fibrocystic breast changes diagnosed?
Your physician may be able to make a diagnosis by feeling the lumps. Usually the lumps of fibrocystic breast changes feel definitely different from lumps that signal cancer.

Other methods of diagnosing fibrocystic breast changes include mammography, which is an x-ray of the breast, and ultrasound, which uses sound waves to make a picture of structures inside the body. Another frequently used technique is needle aspiration, in which a hollow needle is inserted into the lump and any fluid it may contain is withdrawn and analyzed by laboratory. Some of these procedures may be performed in your physician's office; others may require a visit to a larger medical facility.

Mammography and ultrasound are safe and painless. The tiny amount of radiation used in mammography is very small and its benefits completely outweigh any possible risks. Needle aspiration can barely be felt.

Do pregnancy, breast-feeding, and menopause affect fibrocystic breast changes?
Thanks to changes caused by various hormones in a women's body, fibrocystic breast change tends to improve during pregnancy and breast-feeding. The changes also tend to resolve a year or two after menopause because the body begins to lose estrogen. Some women who take hormones to treat problems related to menopause may develop breast lumps. Other women after menopause may develop another benign breast changes called "ductal estasia," with symptoms of redness, pain, and swelling. Again, any woman, no matter what age, should seek her physician's advice for any change or irregularity in her breast.

How is fibrocystic breast changes treated?
There are many ways to treated fibrocystic breast changes depending on the character of the lumps, amount of discomfort, and your family history. A few, small painless lumps that come and go with your menstrual cycle may not require treatment although your physician will probably ask you to continue to examine your breast once a month and come in for a breast examination every six months to one year. If you are troubled by breast pain or tenderness, your physician may advise you to wear a well-fitting, supportive bra and lightweight, loose fitting clothing. Ice packs or warm compressed applied to tender areas may give some relief.

Reducing the amount of fluid your body retains before your period can also ease discomfort. One way to do this is to limit your intake of salt. Another way is to take a diuretic medication or "water pills" prescribed by your physician. You may also be asked to reduce or eliminate caffeine, which comes in coffee, tea, cola, and chocolate. Reducing the amount of fat you eat in dairy products and red meat will help your liver process hormones more efficiently. Drinking less alcohol may allow the various hormones to work together better. Stop smoking. Taking vitamins E (600 IU per day) and B vitamins may also alleviate symptoms.

Some authorities say stress may make symptoms worse. Techniques that reduce stress, such as medication, physical exercise, and biofeedback, may provide some relief of pain and ease anxiety. If you have constant pain and none of these treatments seem to help, your physician may prescribe hormones. Progesterone, progestin, and oral contraceptives (birth control pills) are some hormone medications that work well. You may notice spotting between periods, if you take these hormones but probably won't have any other side effects. Your physician may prescribe danazol, another hormonal drug. It is effective but a small percentage of women who take it complain of menstrual irregularities, weight gain, swelling and rash. If you are pregnant or planning to become pregnant consult your physician before taking any of these medications.

Surgery is performed only if fibrocystic breast changes are severe. A surgeon can, however, remove the lumps without disfiguring the breast or leaving large scars. Sometimes even large cysts-lumps containing fluid-can be drained by needle aspiration.

Is there a connection between fibrocystic breast changes and breast cancer?
This is still unknown, and it may turn out that there is no connection. Some researchers estimated that women with fibrocystic breast changes are 2 1/2 times more likely to develop breast cancer than other women are, but this figure is controversial. Remember that being diagnosed with fibrocystic breast changes does not mean you have cancer, and it does not necessarily lead to breast cancer. It is easily discovered, usually by the woman herself, and it can be treated.

Some women with fibrocystic breast change may be more likely to develop breast cancer because of other factors, such as having a mother or sister with breast cancer, having cancer in another organ, or eating a diet high in fat. If you are in this risk group, you should have regular checkups from your physician. You may need to have mammograms on a regular basis.

Can fibrocystic breast changes be avoided?
Limiting salt, caffeine, and fat helps to reduce severity of symptoms in some women, and may even prevent the changes altogether. The most important way to avoid problems that may result from the condition is diligent, monthly breast self-examination and an immediate visit to your physician if you find any irregularities.