Fibrocystic Breast Disease

woman having pain in breasts

Fibrocystic Breast Disease

Fibrocystic breast disease, commonly known as fibrocystic breasts or fibrocystic change, is a noncancerous condition in which the female’s breasts feel lumpy. The condition is not harmful or dangerous but is generally very troubling or uncomfortable for women. Fibrocystic breasts are made of tissue that feels lumpy or has a rope-like texture. Doctors have named this “nodular or glandular breast tissue”.

It is common to have fibrocystic breasts. A huge majority of females suffer from fibrocystic breast changes at one point during their lives.  Doctors and other medical professionals now call this condition “fibrocystic breasts” or “fibrocystic breast changes” because the condition of having fibrocystic breasts is not really a disease. Breast changes such as fibrocystic are considered normal and of no harm.

Fibrocystic breast changes occur are generally observed among women during their 20s to 50s. It is rarely observed in the postmenopausal stage unless the female is on hormone therapy. Many females with fibrocystic breasts do not show symptoms, but some females experience breast pain, tenderness, and lumpiness, especially in the upper and outer area of the breasts. The symptoms of breast changes are the most troubling just before menstruation. Safe and basic self-care measures can generally give relief from discomfort due to fibrocystic breasts.

Symptoms

  • Lumps or areas of thick mass which tends to blend into the breast tissues and area around it.
  • Breast pain.
  • Tend breasts.
  • Breast lumps with fluctuating size as per the menstrual cycle.
  • Green or dark brown nipple discharge, not blood, which tends to leak even with no pressure exerted or squeezing.
  • Similar breast changes on both of the breasts.
  • A gradual increase in breast pain or lumpiness, generally monthly, changing from mid of the period cycle (ovulation period) to just before the onset of the period.

When to visit a doctor

Generally, the fibrocystic breast changes are normal and not harmful. But, it is suggested to visit your doctor in the following cases mentioned below:

  • There is a new breast lump or area of prominent thickening.
  • There are specific areas of continuous or severe breast pain which increases.
  • Strange breast changes after the period cycle end.
  • The doctor had evaluated a breast lump which now seems to be bigger in size or has changed. 

Causes

The accurate cause behind fibrocystic breast changes is not known yet, but it is suspected that reproductive hormones, especially estrogen play an important role.

Fluctuation in hormone levels during the menstrual cycle can lead to breast discomfort and cause lumpy breast tissue which feels tender, sore and swollen. Fibrocystic breast changes are more bothering before the period cycle. The pain and lumpiness generally clear up or is reduced once the menstrual cycle begins.

Upon examination under a microscope, fibrocystic breast tissue appears as distinct components such as:

  • Round or oval cysts filled with fluid
  • A prominence of scar-like fibrous tissue
  • Overgrowth of cells which line the milk ducts or around the milk-producing tissues of the breast
  • Enlargement of breast lobules

 

Risk factors- Fibrocystic breasts and Breast cancer

Having fibrocystic breasts has no link with breast cancer. This condition does not increase the risk of breast cancer or have any impact on it.

 

Diagnosis

breast diagnosis with a magnifying glass

Tests to evaluate the condition may include:

  • Clinical breast exam- The doctor examines and checks for unusual lumps or areas by visually and manually examining the breasts and the lymph nodes located in your lower neck and the area around the underarms, on both sides. If the patient’s medical history and the clinical breast exam indicates normal changes in the breasts, additional tests might not be required. If the doctor finds a new lump during the examination and suspects it to be fibrocystic changes, the patient may be suggested come back a few weeks later after her menstrual period for further examination and have another clinical breast exam. If the changes persist, the patient is most likely to require a mammogram or ultrasound test for further evaluation.
  • Mammogram- If the doctor detects or finds a breast lump or eminent thickening in the breast tissues, the patient would need a diagnostic mammogram test. It is an X-ray exam which focuses on a particular area of concern in the breast. At the time of the test, the radiologist is required to closely examine the area of concern while interpreting the mammogram.
  • Ultrasound- An ultrasound is an examination which uses sound waves to produce images of the breasts ( in this case ). It is often performed along with a mammogram. If the patient under the age of 30, she be suggested to have an ultrasound instead of the mammogram. Ultrasound is a better test for evaluating the dense breast tissue, tightly packed tissues with lobules or ducts and connective tissue in a younger woman’s case. Ultrasound can also help the doctor differentiate between cysts filled with fluids and solid masses.
  • Fine-needle aspiration- In case of a breast lump which feels like a cyst, the doctor might try fine-needle aspiration test to see if any fluid comes out from the lump. This procedure is helpful and can be performed in the doctor’s clinic itself. During the test, the thin, fine-needle used in the aspiration procedure may collapse the cyst and resolve the discomfort.
  • Breast biopsy- If the diagnostic mammogram and ultrasound tests are normal, but the doctor still has worries about the breast lump, the patient may be suggested to visit a breast surgeon to determine if she needs a surgical breast biopsy or not. A breast biopsy is a procedure used to remove a small sample of breast tissue. This is performed for microscopic analysis. If a suspicious area is detected during the imaging exam, the radiologist may suggest an ultrasound-guided breast biopsy or a stereotactic biopsy, in which the mammography is used to point the exact location for the biopsy.

Treatment

If you do not experience any symptoms, or the symptoms are mild, no treatment is required for fibrocystic breasts. In case of severe pain or if there are large, painful cysts associated to fibrocystic breasts, there may be further treatment required.

Surgical excision

In rare cases, surgery may be required to remove the persistent lump which does not resolve even after repeated aspiration and carefully monitoring.

Examples of treatment options for breast pain include:

  • Over-the-counter pain relievers, like acetaminophen or non-steroidal, anti-inflammatory drugs.
  • Oral contraceptives, which can lower the levels of hormones related to period cycle, linked to fibrocystic breast changes.

Alternative medicine options

Vitamins and dietary supplements can reduce breast pain symptoms and the severity in the case of some women. Consult the doctor if one of such medication might help the condition in your case and also ask about the number of doses suggested to you. Although such options are considered safe in some cases, there may be some side effects as mentioned below:

  • Evening primrose oil – This supplement can help change the balance of fatty acids in the patient’s cells,  which can help reduce breast pain.
  • Vitamin E – There are some studies that show a possible beneficial effect of vitamin E on breast pain in case of premenstrual women who experience breast pain which fluctuates during the period cycle. If a supplement is being taken to reduce breast pain, it is suggested to discontinue the use if no improvement is observed in the breast pain after a few months of consumption. Try taking just one supplement at one time so that the female can clearly determine if there is any relief from the pain or not.

Have a breast examination

You could start off by seeing your regular doctor, or medical practitioner. Sometimes, on the basis of the breast exam and imaging tests, you might be referred to a specialist. The initial judgment is based on your medical history. Your doctor or physician would want to discuss your symptoms, your menstrual cycle, and other information as may be deemed necessary. Even the thought of breast cancer can make any woman worry. And this is rather natural as this disease has become fairly common these days.

Preventive Measures

But now, with the development of medical science, the treatment for breast cancer keeps getting better. There are a number of ways that help in the prevention of the disease. The given steps are quite simple, but they can be a big help in preventing the risk of breast cancer. If practiced properly, these ways can be a big help.

  • Watching your weight- Achieving a healthy weight should be a goal for everyone. Being overweight can increase the risk of many diseases, including cancer, especially after menopause.
  • Being physically active- Exercise is one way that can help to ward off the risk of many diseases. Women who remain physically active for around 30 minutes a day have a lower risk of developing breast cancer. Working out on a regular basis can also have a huge impact.
  • Avoiding excess alcohol and eating fruits and vegetables- Eating healthy helps to lower the risk of breast cancer. Adding fruits and vegetables to your regular diet is a big help. Along with it, the consumption of alcohol must be lowered. Mindful drinking can have some benefits in older adults. Having a drink a day, or drinking moderately is not dangerous. But if you feel like its getting too much, put a stop to it.
  • Quit smoking- Regardless of the fact that whether a person smoke or not, everyone knows how hazardous smoking is. It increases the risk of heart diseases, strokes, and cancer tremendously, and it can be a potent cause for breast cancer as well. Apart from this, it causes bad breath, bad teeth, and makes your skin unhealthy. So it’s better to keep your distance from tobacco and cigarettes.
  • Prefer breastfeeding if possible- Breastfeeding for a year and above in total for all children lowers the risk of breast cancer. It is also very helpful for the kids.
  • Avoid contraceptive pills, especially if you’re over 35, or if you smoke- Contraceptive or birth control pills have their own benefits and risks. For a younger woman, the risks are lower, and they elevate as the age of the woman increases. Women using birth control pills are at a slightly higher risk of breast cancer. But the risk continues only till the time the pill is used. It can also increase the risk of heart diseases and strokes, especially if the woman smokes. However, long term use of contraceptive pills might have its own benefits too. It helps to prevent ovarian cancer, colon cancer, uterine cancer and avoids unwanted pregnancies. But if you are concerned about breast cancer, avoiding contraceptive pills is one way to lower this risk.
  • Steer away from post-menopausal hormones- The usage of postmenopausal hormones to prevent chronic diseases like osteoporosis and heart diseases should not be preferred. It has a mixed effect on the health of a woman, and sometimes increases the risk of diseases while decreasing that of others. Estrogen hormones and estrogen-plus-progestin hormones elevate the risk of breast cancer. If post-menopausal hormones are used by a woman, they should not be for long. One must consult the doctor about the usage of these.
  • Raloxifene and Tamoxifen for women at high risk of breast cancer- This might not be considered a healthy option, but taking prescription drugs of raloxifene and tamoxifen can remarkably lower the peril of breast cancer, especially in women who are at a higher risk. These drugs have been approved by the FDA for the prevention of breast cancer. But they might have some side effects too, so they should not be taken without proper consultation. A woman at a high risk of breast cancer should discuss tamoxifen and raloxifene with her doctor as a way to avoid this risk.

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