Fibrocystic breast changes cause noncancerous growths in the breasts, most often in premenopausal women. The condition is quite common, affecting more than one-half of women at some point in their lives. While the condition was once known as fibrocystic breast disease, the medical profession has stopped calling it that because the changes seen with fibrocystic breasts are not indicative of disease.
Fibrocystic breast changes can be asymptomatic. In women who do feel the effects, signs and symptoms can be constant or cyclical (monthly) in nature. Lumps or areas of thickened tissue develop, which fluctuate in size throughout the menstrual cycle. The benign masses may be free-moving within the breast and can appear and disappear suddenly. Generalized breast tenderness and pain, and a dark brown or green discharge may occur. Symptoms tend to be most severe right before menstruation. Fibrocystic breast changes occur most frequently in women between the ages of 20 and 50. It's rare for postmenopausal women to have fibrocystic breast changes unless they are using hormone therapy.
While the lumps associated with fibrocystic breast changes are benign, women should consult their physicians in the following circumstances:
Researchers do not know what causes fibrocystic breast changes, but they believe fluctuating hormones, especially estrogen, during a woman's menstrual cycle play a significant role. As mentioned earlier, symptoms associated with fibrocystic breasts tend to be worst right before menstruation and disappear or lessen as soon as the period begins. Fibrocystic breasts contain certain characteristics when viewed under a microscope. They contain round or oval fluid-filled cysts, prominent scar-like tissue, and enlarged breast lobules, as well as an overgrowth of cells lining the milk-producing tissues or milk ducts.
A physician will check for lumps and other breast changes with a visual and manual breast examination. If she determines the changes are normal, a woman may not need any further diagnostic tests. If the doctor finds a new lump and suspects it is associated with fibrocystic breast changes, she may have a woman come back after her menstrual period for another examination. Changes that remain after a woman's menstrual period may call for further diagnostic testing.
If a doctor is unsure whether a woman's lump is due to fibrocystic breast changes or something more serious, she may order an ultrasound or a mammogram to examine the lump more closely. In an ultrasound, sound waves produce images of the breast. This test is most effective for women under the age of 30 because it best shows the dense breast tissue common to younger women. An ultrasound can help determine whether a lump is a solid mass or a fluid-filled cyst. The woman may also require a mammogram, an x-ray that focuses on a specific area of the breast.
Some women may require a fine-needle aspiration or breast biopsy to determine if a breast lump is fibrous or cancerous. In the former test, a physician uses a thin, hollow needle to extract a small sample of tissue from the breast lump for testing. In a breast biopsy, a small portion of the lump is surgically removed.
Over-the-counter pain relievers, such as non-steroid anti-inflammatory drugs (NSAIDs) can be used to treat the pain or discomfort associated with fibrocystic breast changes. A physician may also prescribe oral contraceptives (birth control pills), as these lower menstrual cycle hormone levels, thus reducing symptoms.
If cysts are causing a lot of discomfort or pain or if they are large, women can undergo fine-needle aspiration or surgical removal. The procedures are similar for both testing and removal. Draining the cyst with aspiration may relieve pressure and pain in that area of the breast. If a cyst recurs after repeated fine-needle aspirations, surgery can remove it, though it is rare for a woman to require this method of treatment.
Some women find their symptoms ease if they wear a firm support bra during the day and at night. Doctors recommend women with fibrocystic breast changes wear sports bras during exercise with any impact. A heating pad may help relieve breast discomfort, and some women benefit from avoiding coffee and other caffeine-containing foods and drinks. Reducing fat in the diet may also help with fibrocystic breasts. If the affected woman is postmenopausal and takes hormone therapy, she may choose to discuss with her doctor reducing or stopping the treatment.
Having fibrocystic breasts does not raise a woman's risk of getting breast cancer later on. However, it is important to monitor any lumps, and have a physician examine any new growths. Monthly self-exams are the best way to identify new lumps right away.
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