Fibrocystic Breast Changes

Overview

What are fibrocystic breast changes?

Fibrocystic breast change is a common noncancerous condition that affects mostly premenopausal women. The condition results in "lumpy" cystic changes in the breast tissue. It can be constant or cyclical (every month). It was formerly known as fibrocystic breast disease, but as there is no real disease or disorder, it is now called fibrocystic breast changes.

Who experiences fibrocystic breast changes?

Fibrocystic breast changes are most common in women ages 20 to 50. It is extremely rare in women past menopause not receiving hormonal replacement. It affects an estimated 50% of women between the ages of 20 and 50. Fibrocystic changes are the most frequent lesion of the breast.

Drinking alcohol may increase the risk of fibrocystic breast changes, especially in young women between 18 and 22 years of age. Caffeine is also thought to contribute to the severity of fibrocystic breast changes and pain, but this is still up for debate in the medical community.

Symptoms and Causes

What causes fibrocystic breast changes?

While the exact mechanism is unclear, fibrocystic breast changes are believed to be caused by fluctuating levels of hormones, especially estrogen, during the menstrual cycle.

What are the symptoms of fibrocystic breast changes?

Fibrocystic breast changes encompass a wide variety of symptoms, including:

  • Breast tenderness or discomfort, which can worsen during the immediate premenstrual period.
  • The sudden appearance or disappearance of palpable benign masses in the breast.
  • Lumpy, free-moving masses in the breast, often near the armpit. These are often asymptomatic (cause no pain) and are discovered by accident or during breast self-exams.

Symptoms can worsen after age 30, and intensify again after age 35.

Diagnosis and Tests

How are fibrocystic breast changes diagnosed?

Any changes or masses found in the breast should be brought to the attention of your doctor as soon as possible. He or she will first want to see if the growth is cancerous or benign. The first steps in doing this are often mammograms or ultrasound scans. Ultrasounds alone may be used for young women, as their breast tissue is often too dense to evaluate with mammography.

Your doctor may be able to determine if the mass is benign based on the density, shape, and other imaging characteristics.

However, he or she may not be able to make such determination based solely on the images. They may also need to perform a biopsy to get a sample of the tissue. This can usually be done with a needle in the breast center, although sometimes surgery is necessary. With a biopsy, your doctor can determine if a lump is solid or a cyst, and whether or not it is cancerous.

Management and Treatment

How are fibrocystic breast changes treated?

In the majority of cases, no treatment is needed once your doctor has determined that your breast changes are not due to cancer.

Those suffering pain or discomfort due to fibrocystic breast changes are advised to wear a good, supportive bra both day and night when symptoms are worse. It is also advised to avoid contact sports and other activities which could cause injury to the breasts. It is also advised to avoid caffeine consumption: coffee, tea, soda, and chocolate can all contribute to the pain.

Sometimes, the cyst can be completely aspirated through the needle during the biopsy, but future masses can occur in patients with fibrocystic breast changes. Future masses should be brought to the attention of your doctor as future masses can develop in areas of fibrocystic breast changes.

Outlook / Prognosis

What is the outlook for fibrocystic breast changes?

Fibrocystic breast changes are benign and not harmful to the patient. However, it is very important than any growth in the breasts is evaluated immediately to determine if it is cancerous. Women with some kinds of fibrocystic breast changes are at higher risk of cancer. Your doctor can advise and monitor you if this is the case.

Any woman who has new growths appear in the breast should have them evaluated by a doctor as soon as possible.

Last reviewed by a Cleveland Clinic medical professional on 04/09/2014.

References

  • Ferri FF. Ferri's Clinical Advisor 2012, 5 Books in 1, Expert Consult - Online and Print. Elsevier Health Sciences; 2011.
  • McPhee SJ, Papadakis M, Rabow MW. CURRENT Medical Diagnosis and Treatment 2012, Fifty-First Edition. McGraw Hill Professional; 2011.
  • American Cancer Society. Types of non-cancerous breast conditions Accessed 4/10/14.

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