Fibrocystic Breasts: Normal or Cause for Concern?

(WASHINGTON, DC-3/21/02) - At least half of all women experience lumpy, painful, swollen breasts at some point in their lives, according to the American Cancer Society. This benign condition is properly called "fibrocystic breasts" or "fibrocystic change"; it is sometimes mistakenly referred to as "fibrocystic disease. In 95 percent of cases, fibrocystic breast changes do not increase a woman's risk of breast cancer. They do, however, lead to thicker and denser breast tissue, which can mask cancerous changes or make them more difficult to detect. This condition can make breast exams and mammograms difficult to interpret, and make early breast cancer detection more challenging.

Fibrocystic breasts are most common in women ages 30 to 50, but these changes can occur at any age. In fact, fibrocystic changes occur in varying degrees in almost all women over 30; they are just clinically apparent in about half of them.  Fibrocystic breast changes include variations in tissue that occur during the menstrual cycle, as well as benign lumps and fluid filled sacs or cysts. 

"Eight out of 10 lumps I evaluate are benign and most of these are due to fibrocystic breast changes," said George N. Peters, MD, Executive Director of the UT Southwestern Center for Breast Care in Dallas. "This does not mean women who know or suspect they have fibrocystic breasts should ignore lumps. Instead, if they are premenopausal and they find a lump, they should wait one menstrual cycle; in 60-70 percent of cases, the lump will go away. If it doesn't go away, she should see her doctor immediately," said Dr. Peters, who notes that women have to learn to recognize changes via consistent monthly breast self exams (BSE).

"Although the condition is benign, fibrocystic breasts affect quality of life and accuracy of screening," noted Sherry Marts, PhD, Scientific Director of the Society for Women's Health Research. "More attention should be paid to conditions unique to women like this one."

What Causes this Condition?
Experts aren't completely clear about what causes fibrocystic breasts but know hormones play an important role. During each menstrual cycle, fluctuations in the levels of estrogen and progesterone cause breast tissue to swell and then return to normal. Towards the end of the cycle, milk glands and ducts enlarge leaving breasts tender and lumpy. These symptoms usually subside after the start of the menstrual period.

Continual hormonal stimulation can cause tissue to harden and pockets of fluid or cysts to form. Cysts are round, moveable lumps that vary in size and are usually present in both breasts. Some cysts are too small to be felt while others can be several inches across. While large cysts are more often painful, they do not necessarily signal a problem. Recurring or multiple cysts do not increase the risk of breast cancer.

How to Minimize Pain and Swelling
There are several treatments for the pain and swelling of fibrocystic changes.  Most women benefit from a supportive bra in the week before their menses.  While there is little scientific evidence to back them up, a number of dietary recommendations also exist. Eliminating caffeine, reducing salt intake and taking vitamin E (400-800 IU daily) and A (150,000 IU daily) may help some women. Using diuretics during the week before the menstrual period can help ease uncomfortable, swollen breasts. Birth control pills can alleviate symptoms for some women, and in severe cases, doctors may suggest an antihormone treatment called danazol.  Large painful cysts can be drained with a needle, and if they do not disappear they may require surgical removal.

The Society for Women's Health Research is the nation's only not-for-profit organization whose sole mission is to improve the health of women through research. Founded in 1990, the Society brought to national attention the need for the appropriate inclusion of women in major medical research studies and the resulting need for more information about conditions affecting women. The Society advocates increased funding for research on women's health, encourages the study of sex differences that may affect the prevention, diagnosis and treatment of disease, and promotes the inclusion of women in medical research studies. Dr. Donnica Moore has been a member of the Society since 1990 and is a past member of its Board of Directors.

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Created: 3/27/2002  -  Donnica Moore, M.D.