Fibrocystic Breast Disease

Definition
Fibrocystic changes in the breast refer to a variety of irregularities in the breast tissue. These changes are benign, or noncancerous.

What is going on in the body?
Fibrocystic changes occur when there is an imbalance of the female hormones produced by the ovaries. These hormones are estrogen and progesterone. The imbalance changes breast tissue to produce lumps. This condition is very common and is not cancer.

What are the signs and symptoms of the condition?
The classic symptom of fibrocystic changes is pain in both breasts. The pain is usually worse right before menstruation. The woman may have other symptoms, including:

� Susan M. Lark M.D.

(Excerpted from The Women's Health Companion)

Thirty percent of American women have fibrocystic breast disease, a benign (noncancerous) condition characterized by round lumps that move freely within the breast tissue. This lumps are usually tender to the touch. In contrast, a cancerous growth in the breast is often not tender or freely movable when touched. The texture of the lumps can vary from soft to firm. For many women, the tenderness may increase as menstruation approaches. Often the cysts fill with fluid and can enlarge premenstrually in response to the increase in hormonal levels during this time.

The main hormones implicated in the worsening of breast symptoms premenstrually include estrogen, the main female hormone, and prolactin, the milk release hormone secreted by the pituitary gland. Dietary factors have also been implicated. These include caffeine intake from coffee, black teas, colas, and chocolate, as well as excessive saturated fat and salt. Usually the symptoms of pain and swelling do not persist once menstruation begins, and most women notice significant relief at this time. The difference in the breast swelling can be so marked between the first and second half of the menstrual cycle that some women actually change bra size.

With repeated cycles of hormonal stimulation, the breast cysts may become chronically inflamed and surrounded by fibrous tissue which can harden and thicken the cysts. It is then more difficult for the fluid trapped in the cysts to escape and be reabsorbed by the body. This condition occurs most frequently in women in their late thirties and forties. To distinguish these hardened cysts from cancer, physicians often perform a simple office procedure called a needle aspiration. In this procedure, a needle is used to remove fluid from the cyst. This helps relieve pressure from the cyst on the surrounding tissue if it is causing pain, as well as rule out breast cancer. A mammogram will also help distinguish a breast cyst from breast cancer.

However, if there is a lingering concern about making an accurate diagnosis, a surgical biopsy might be performed. This is done under a local anesthetic in a physician's office or clinic or under general anesthesia in a hospital setting. A biopsy allows the physician to remove the entire breast mass so that the cells can be examined microscopically for any cancerous changes. Fortunately, most masses are benign.

Besides eliminating certain foods from the diet (caffeine, saturated fats, and salt), a high-fiber diet, including many plant-based foods, fruits and vegetables, beans and peas, raw seeds and nuts, and whole grains may help prevent cyclical fluctuations in cyst size and tenderness. The addition of seafood to the diet, particularly fish, may be useful in preventing breast cysts due to the iodine content and healthy oils contained in certain fish. The best fish for female health include those high in the Omega-3 fatty acids like salmon, trout, and mackerel.

Vitamins and Minerals for Breast Cysts
The following vitamins and minerals can be helpful in reducing and preventing breast cysts:

Vitamin A
Vitamin A has been found to be useful in reducing both the pain symptoms and the size of the breast lesions in women with fibrocystic breast disease. At the University of Montreal Medical School, where high doses of vitamin A were administered (150,000 IU daily) to a small research group of volunteer women. The women studied had documented benign breast disease with moderate to severe pain symptoms. Their breast tenderness had not previously responded to mild analgesic medication (painkillers) or cessation of caffeine use. Eighty percent of the women tested had beneficial results with vitamin A and a dramatic reduction in the level of pain. The lessening of breast pain was still evident eight months after the study ended. Forty percent of the women had at least a 50 percent decrease in the size of their breast lumps. One drawback, though, is that vitamin A in high doses can cause toxic symptoms. Vitamin A derived from fish sources is an oil-based product which can accumulate to high levels in the liver, where it is stored. Several women in this study had severe headaches from the high dosage of vitamin A taken, and several other women had more mild side effects.

To avoid the risk of side effects from fish oil-based vitamin A, it is safer for most women to use the provitamin A, beta carotene. Beta carotene is found abundantly in many yellow, orange, red, and dark green fruits and vegetables. It is converted to vitamin A by the liver and intestines as needed by the body. In fact, many women who eat a plant-based diet can easily ingest 50,000 to 100,000 IU of beta carotene on a daily basis. (One cup of carrot juice or one sweet potato contains 20,000 IU of beta carotene). Supplements of beta carotene are also readily available in health food stores and pharmacies.

Vitamin E
In several controlled studies, vitamin E was found to be quite helpful in reducing the pain and tenderness, as well as the size, of breast lumps. In one study, where subjects were given 600 IU of vitamin E for two menstrual cycles, 80 percent showed a positive response. Another study of 29 women with fibrocystic breast lumps, which worsen premenstrually, showed again a good response to vitamin E treatments. At doses of 500 or 600 IU per day, 16 women had moderate to total symptom relief. The other 13 women had reduction of cyst size or complete disappearance of the cysts.

Iodine
In animal studies, iodine deficient rats were found to develop breast changes similar to human fibrocystic disease. Human studies have also suggested that women who are iodine deficient may have a predisposition towards developing breast cysts. Iodine is needed by the body for the production of the thyroid hormone. Lack of adequate thyroid hormone also affects the menstrual cycle.

Sea vegetables such as nori, kelp, and dulse, found in the produce section of health food stores, are good sources of iodine. Dulse is also available in liquid drops, while kelp is available in tablets. Kelp also comes in powdered form and can be used in cooking as a good salt substitute.

Essential Fatty Acids
Several studies have looked at the beneficial effects of evening primrose oil on fibrocystic breast disease. Evening primrose oil is an excellent source of the essential fatty acid, linoleic acid, and its chemical derivative, gamma linolenic acid (GLA). In one study of 291 women with severe breast pain, 45 percent of the women had symptom relief with the use of evening primrose oil. Another study of 41 women showed equally good symptom relief. The beneficial results were maintained in women who continued to use evening primrose oil after the study ended. Typical dosages used were 1500 mg twice a day. (This would amount to taking 6 of the 500 mg capsules commonly available.) In my experience, some women need to go as high as 9 to 12 capsules per day for relief of severe symptoms. Borage oil and black currant oil are more concentrated sources of GLA, so the number of capsules necessary is reduced. For example, 3 or 4 capsules per day of borage oil may be sufficient.

I am a 20 year old female who has had bilateral breast "cysts" since I was 11 years old. I went to the doctor for this condition 2-3 years ago and again this past August. My doctor claimed I had some type of fibrocystic disease. They have definitely gotten bigger over the years ... almost like it's a big clump of cysts. Lately (over the past week or so) they've really begun to hurt and feel like they might have gotten even larger. Do you have any idea what this might be? Could it be anything more than just cysts at my age?

Kenneth Blank, MD and John Han-Chih Chang, MD, Editorial Assistants for Oncolink, respond:

The condition you describe is likely fibrocystic condition of the breast. Fibrocystic condition is diagnosed upon palpation (feeling) rubbery and cystic areas in a single area or multiple regions in one or both breasts. Fibrocystic condition is the most common lesion affecting the female breast. In fact, the majority of women are likely to have some manifestation of fibrocystic condition sometime in their lifetime. The condition is most commonly seen in women ages 30-50, but is reported to occur in younger women

In addition to feeling cysts and rubbery areas, fibrocystic condition can cause monthly cyclic pain and tenderness. The symptoms often occur one week before the menses and subsides one week later. Treatment is symptomatic and includes analgesics and limiting caffeine intake. Occasionally vitamin E may help relieve pain as may abstinence from alcohol.

Fibrocystic Breasts

Fibrocystic breast condition is a common, non-cancerous condition that affects more than 50% of women at some point in their lives. The most common signs of fibrocystic breasts include lumpiness, tenderness, cysts (packets of fluid), areas of thickening, fibrosis (scar-like connective tissue), and breast pain. Having fibrocystic breasts, in and of itself, is not a risk factor for breast cancer. However, fibrocystic breast condition can sometimes make it more difficult to detect a hidden breast cancer with standard examination and imaging techniques.

Fibrocystic breast condition is most common among women between the ages of 30 and 50, although women younger than 30 may also have fibrocystic breasts. Because the condition is related to the menstrual cycle, the symptoms will usually cease after menopause unless a woman is taking hormone replacement therapy. In some cases, fibrocystic breast symptoms may continue past menopause.

The degree to which women experience these symptoms varies significantly. Some women with fibrocystic breasts only experience mild breast pain and may not be able to feel any breast lumps when performing breast self-exams. Other women with fibrocystic breasts may experience more severe breast pain or tenderness and may feel multiple lumps in their breasts. Most fibrocystic breast lumps are found in the upper, outer quadrant of the breasts (near the axilla, armpit, region), although these lumps can occur anywhere in the breasts. Fibrocystic breast lumps tend to be smooth, rounded, and mobile (not attached to other breast tissue), though some fibrocystic tissue may have a thickened, irregular feel. The lumps or irregularities associated with fibrocystic breasts are often tender to touch and may increase or decrease in size during the menstrual cycle.

In the past, many physicians have referred to fibrocystic breasts, or lumpy breasts, as "fibrocystic breast disease." This term is misleading because fibrocystic breast condition is not a disease at all. Rather, it is a common, non-cancerous breast condition that affects over half of all women at some point in their lives. Today, most physicians refer to this condition as "fibrocystic breast condition" or "fibrocystic breast change." Other terms that may be used to describe the condition include "cystic disease," "chronic cystic mastitis," or "mammary dysplasia."

In fact, since fibrocystic breasts are so common among women during their reproductive years, some physicians do not even like to label the symptoms as a "condition." They believe that these women simply have lumpier and more tender breasts than others.

Fibrocystic breasts occur from changes in the glandular and stromal (connective) tissues of the breast. These changes are related to a woman�s menstrual cycle and the hormones, estrogen and progesterone. Women with fibrocystic breasts often have bilateral cyclic breast pain or tenderness that coincides with their menstrual cycles.

During each menstrual cycle, normal hormonal stimulation causes the breasts� milk glands and ducts to enlarge, and in turn, the breasts may retain water. Before or during menstruation, the breasts may feel swollen, painful, tender, or lumpy. The severity of these symptoms varies significantly from woman to woman. Some women only experience mild breast swelling during menstruation, while others experience constant breast tenderness. Because the condition is hormone-related, it will usually affect both breasts (bilaterally). Symptoms of fibrocystic breasts usually stop after menopause but may be prolonged if a woman takes hormone replacement therapy.

Fibrocystic breasts are often first noticed by the woman, and further investigated by her physician. Breast tenderness, pain, and/or lumpiness are common indicators of fibrocystic breasts, especially when they coincide with menstruation. Often, fibrocystic breasts will be diagnosed with a physician-performed clinical breast exam alone.

While having fibrocystic breasts is usually not a risk factor for breast cancer, the condition can sometimes make breast cancer more difficult to detect. Therefore, in some cases, breast imaging exams, such as mammography or ultrasound, will need to be performed on women who show symptoms of fibrocystic breasts. However, screening mammography may be more difficult to perform on women with fibrocystic breasts because the breast density associated with fibrocystic breasts may eclipse breast cancer on the mammogram film. In some cases, additional mammography or ultrasound imaging, followed by fine needle aspiration or biopsy, will be performed on women with fibrocystic breasts to determine whether breast cancer is present. Fine needle aspiration (to drain large, painful cysts) may also be performed by a physician help relieve some of the more severe symptoms of fibrocystic breast condition.

Often, physicians may recommend that the symptoms of fibrocystic breasts be treated with self-care. Depending on the individual situation, several measures may be recommended to relieve the symptoms of fibrocystic breasts. For instance, women may wish to wear extra support (athletic type) bras to help hold the breasts closer to the chest wall, which may provide some symptomatic relief. Extra support bras are especially important for large breasted women and may provide relief when breasts are full and tense with fluid. Physicians will often recommend that a support bra be worn both during the day and at night, especially during times of the woman�s menstrual cycle when the breasts are most tender.

In addition, certain vitamins (particularly vitamin E, vitamin B6, or niacin) or herbal supplements such as evening primrose oil may help alleviate the symptoms of fibrocystic breasts by reducing inflammation and fluid retention. It is important that these supplements be used according to directions and that women avoid megadoses since serious side effects may occur from incorrect use.

Some women also find that reducing their caffeine intake by avoiding coffee, tea, chocolate, and soft drinks decreases water retention and breast discomfort. However, this is a controversial topic among healthcare professionals because studies linking breast pain and caffeine have been inconsistent.

In 1978, a study revealed that patients who took oral contraceptives were less likely to have fibrocystic breasts. The study has since been reconfirmed several times, though some health care professionals (and women) do not believe oral contraception has any significant effect on treating fibrocystic breasts.

If fibrocystic breast pain is severe and interferes with a woman�s daily activities, further treatment may be necessary. Diuretics, substances that encourage the excretion of excess fluid from the body in the form of urine (which may in turn reduce tissue swelling and pain) are usually reserved for women who experience non-cyclical breast pain, but may be used to alleviate the symptoms of fibrocystic breast condition in some cases. The release of fluid in the body can help decrease breast pain and swelling.

Bromocriptine and danazol both relieve cyclical breast pain by blocking estrogen and progesterone. However, these drugs may cause serious side effects in some women. Bromocriptine is poorly tolerated by many patients; side effects include nausea, dizziness, and fertility problems. Side effects of danazol may include weight gain, amenorrhea (absence of menstruation), and masculinization (such as extra facial hair) when given high doses. Other drugs, such as tamoxifen (brand name, Nolvadex) or goserelin (brand name, Zoladex) have been shown to have some effect on cyclical breast pain; however, these drugs are currently only approved for use in the United Kingdom for treating severe fibrocystic breast pain.

The earlier breast cancer is detected, the greater the chances of survival. Women with fibrocystic breasts should follow the same breast health guidelines as other women. These guidelines include breast self-exams, clinical breast exams, and screening mammography (beginning at age 40). Having fibrocystic breasts is not a risk factor for breast cancer. However, fibrocystic breasts can sometimes mask the appearance of breast cancer on a mammogram. Therefore, it is very important that women with fibrocystic breasts become familiar with the normal lumpiness and tenderness associated with the condition so that they can readily identify atypical symptoms that may indicate breast cancer. Click here to learn about the warning signs of breast cancer.

In some cases, density associated with fibrocystic breasts can mask breast cancer on a mammogram film. Therefore, some women with fibrocystic breasts may be referred for additional breast imaging with ultrasound or may be referred for breast biopsies if breast cancer is suspected.

What is fibrocystic breast disease?

Not being a vain person, I never gave a real thought to my breasts. They are a part of me that fed my two youngest children which I have always taken for granted. That is until the day I started having pain in my right one.

I am an active woman who thinks nothing of carrying lumber, sacks of concrete, hanging doors or even building walls so I took it for granted the pain was a result of straining a muscle. The problem is the pain didn't disappear for several weeks. I finally started checking the breast and thought I felt something funny. Again I waited. I kept telling myself it was in my head and nothing was really wrong. Then my husband found out he insisted I go to the doctor to be checked.

bodyOffer(28863) I made my appointment for the next week and kept assuring him and myself that it was just in my head. Convincing myself that nothing was there. Setting myself up to be broadsided when the doctor said that something was there.

From there, tests were scheduled and for two weeks I worried over my breast. I never really considered them much until the thought of losing one. I thought of how I would feel about having one breast and how it might affect my husband; a self admitted breast man. Over and over he assured me it would make no difference. Over and over I would dwell on possible outcomes.

When the results came back, it was found I had Fibrocystic Breast Disease (FBD). FBD is also known as cystic mastitis causes abnormal benign (non-cancerous) tissue in breasts. As an adoptive child with no family medical history, I began researching this disease to find out more about it.

1. Fibrocystic Breast Disease is a condition that is most common in pre-menopausal women.

3. Symptoms can vary from mildly uncomfortable to extremely painful swelling of the breast tissue.

4. Fibrocystic Breast Disease is not cancerous but the conditions that create it are considered a 5% risk factor for cancer.

5. It is believed high estrogen to progesterone ratios is one of the causes of the disease.

bodyOffer2() 6. Women with high levels of the hormone Prolactin also seem to have a higher occurrence of FBC

7. The conditions often seem to go in cycles and usually occur right before a menstrual period.

9. Women who have 3 or fewer bowel movements run a 4.5% higher risk when compared to those who have a daily bowel movement.

10. Hypothyroidism and/or Iodine deficiencies have been shown to cause fibrocystic breast disease and should be ruled out before treatment of FBD is begun.

11. Certain liver dysfunctions, which affect the clearance or filtering of estrogen, can be a cause of FBD and should be investigated. Some vitamin deficiencies such as B6 and folic acid will also affect the way the estrogen is bonded to glucoronic acid to be turned into bile.

When Fibrocystic Breast Disease has been diagnosed, doctors often recommend a decrease in the intake of caffeinated products such as coffee, tea, certain soft drinks and chocolate. Medications such as aspirin should be checked to see if caffeine in an additive.

The doctor may also recommend some of the following supplements to lower diet risks, occurrences or symptoms of FBD.

1. Evening Primrose to increase the production of prostaglandins so breast tenderness will be decreased.

bodyOffer3() 3. Lactobacillus Acidophilus to also help in the excretion of estrogen.

4. Iodine supplementation may also be recommended to reduce the inflammation and fibrosis but these can often have side effects.

5. Vitamin E to level certain high pituitary hormones that are often seen in patients with FBD.

These are just a few of the options your doctor may discuss with if Fibrocystic Breast Disease is diagnosed. He or she is the only one who will be able to diagnose the problem and rule out other, more serious problems.

I personally can�t describe the relief I felt at finding out it was a non-cancerous condition. I can say it never leaves my mind as how my delay in visiting my doctor could have made everything turn out differently including the prognosis.

Every woman regardless of age should get their yearly check ups, pelvic exams and do their monthly breast exams. For those in their late thirties, get a baseline mammogram and for those over forty, put up with that blasted mammogram even if you feel fine. Temporary discomfort isn�t worth the risks to not only your overall health but to your very life as well.

Title: What is fibrocystic breast disease?
Description: Theories as to cause, treatments, symptoms of fibrocystic breast disease.

Fibrocystic Breast Disease - Women Health Information Page

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Fibrocystic Breasts

What is fibrocystic breast disease?