Fibrocystic changes are the most common cause of breast lumps in women from 30 to 50 years of age. Fibrocystic changes may also be called fibrocystic disease, cystic disease, or chronic cystic mastitis. Fibrocystic changes are not cancer.
Diagnosing Fibrocystic Changes
Fibrocystic changes may be found by physical examination, mammography or ultrasound. Fibrocystic changes may also be diagnosed with a breast biopsy. Very few women who have a breast biopsy for a fibrocystic condition have the type of change that would be considered a risk factor for breast cancer.
Cause of Fibrocystic Changes
Fibrocystic changes are related to the way breast tissue responds to the female hormones, estrogen and progesterone.
Fibrocystic changes are most often found in both breasts and commonly found in the upper outer part of the breast and the underside of the breast. When the breast tissue is stimulated by the hormones during the menstrual cycle, swelling occurs in the blood vessels of the breast. The milk glands and milk ducts become larger and the breasts retain fluid. The breasts may feel swollen, tender and lumpy. Some women may have tenderness while others may have severe pain. Each month after a woman has her period, the swelling in the breast decreases and the breasts feel less tender and lumpy.
After repeated stimulation by the hormones, the breast may have an increase in firmness. Pockets of fluid called “cysts” may form in the milk ducts. After menopause, the breasts may be less sensitive. However, fibrocystic changes may continue for women who choose hormone replacement.
Cysts are fluid filled pockets in the breast. Large cysts usually feel firm, smooth, moveable and tender. Smaller cysts may feel like tiny beads in the breast. The tenderness and the size of the cysts usually increase the week before the menstrual period and decrease the week after the menstrual period. Simple cysts can be drained with a syringe and needle in a doctor’s office. Surgical removal (biopsy) is usually not necessary.
Lumps versus Fibrocystic Changes
Not all women who have breast lumps have fibrocystic changes. The normal structures of the breasts, the milk glands, the ducts and the fibrous tissue make the breasts feel lumpy. By doing Breast Self Examination (BSE) each month, a woman will learn what is normal for her. When she feels a change, she will know to consult her health care provider who may recommend a mammogram or an ultrasound of the breast.
Treatment of Fibrocystic Condition
Women who have painful breasts may find some relief with local heat application and a good support bra. Avoiding food and drink that contain caffeine may relieve symptoms. A health care provider may recommend aspirin or other pain relievers. Some lumps may need to be removed surgically. This is the type of lump that fails to disappear after observation and attempts by a doctor to remove fluid.
Source: American Cancer Society [http://www.cancer.org] & printed with their permission