Fibrocystic Breast Disease

What Is Fibrocystic Breast Disease?  Fibrocystic breast disease is not breast cancer and is not associated with an increased risk for developing breast cancer in general.  However, if you have fibrocystic changes in your breasts and develop a new or persistent breast lump which remains after your next menstrual cycle, you need to have it evaluated by your provider.  Consider any new lump a potential cancer until proven otherwise!  It is the most common of non-cancerous breast diseases of women.  The term, "FCBD" actually covers a broad range of conditions from painful breasts with solid, lumpy patches, thickened areas, to cysts (lumps filled with fluid).  Pain from FCBD can occur at any time of your cycle.  The breast lumps may become larger or tender near the time of your period.  Fibrocystic breast changes can also occur after menopause in women taking hormone replacement therapy. 

How common is FCBD? Many women of childbearing age --about 20 to 45 years of age--have FCBD.  Physicians find evidence of FCBD in about one third of women of that age.

Who is most likely to get FCBD? Women who have a family history of benign breast disorders, particularly in a mother or a sister, are most likely to develop FCBD.  It is also more common among women who have not had children, who are Jewish, Caucasian, or who have experienced severe PMS.

How will I know if I have FCBD? Most breast lumps are discovered by the patients themselves through breast self-examination (BSE) and awareness of symptoms.  Women of childbearing age should examine their breasts at least once a month.  Women with FCBD may develop lumps in both breasts at the same time.  Your breasts may feel painful, tender, or feel dull, heavy, and full.  You may feel a burning sensation in your breasts, or find them extremely sensitive to touch.  Fibrocystic breast disease may also develop without pain.   In some kinds of FCBD, a clear, pinkish, watery fluid may be discharged from the nipples.  Symptoms of fibrocystic breast disease may be more noticeable a week or a few days before your period and may diminish or disappear as soon as your period starts.

How is FCBD diagnosed? Your physician may be able to make a diagnosis by examination of the lumps in your breast.  Usually the lumps of FCBD feel different from lumps that signal cancer.  Other methods of diagnosing FCBD include mammography and/or ultrasound.  Another frequently used technique is fine needle aspiration, in which a needle is inserted into the lump and any fluid it may contain is withdrawn and analyzed by a laboratory. 

Do pregnancy, breast feeding, and menopause affect FCBD? Thanks to changes caused by various hormones in a woman's body, FCBD tends to improve during breast feeding and pregnancy.  The disease also tends to resolve a year or two after menopause because the body begins to lose estrogen. This may not happen after menopause if the woman is on hormone replacement therapy. 

How is FCBD treated? There are many ways to treat FCBD depending on the character of the lumps, the amount of discomfort, and your family history.  A few, small, painless lumps that come and go with your menstrual cycle may require treatment.  Your physician will want you to follow these areas closely with self breast examination and may want you to follow up with breast examinations in the office at regular intervals.  If you are troubled by breast pain or tenderness, your provider may advise you to wear a well-fitting, supportive bra.  Ice packs and/or warm compresses may be applied to painful areas.  You may take over-the-counter non steroidal inflammatory drugs, such as AdvilŽ or MotrinŽ to relieve the pain.  Reducing the amount of salt in your diet the week prior to your period may help.  You may be asked to reduce or eliminate caffeine in your diet.  Foods that are high in caffeine include coffee, tea, cola and chocolate.  Taking Vitamin E (600 IU per day) may also alleviate the symptoms.  Your provider may prescribe hormone therapy in the form of birth control pills to help decrease the occurrence of the symptoms.  Surgery is performed only if FCBD is severe.

Is there a connection between FCBD and breast cancer? Most benign breast changes do not increase a women's risk for getting breast cancer.  Recent studies show that only very specific types of microscopic breast changes increase a woman's risk for cancer and that these changes are not fibrocystic changes.