FIBROCYSTIC BREAST DISEASE

General Information

DEFINITION--A disorder of the female breast characterized by non-malignant lumps. This condition is quite prevalent in women. The majority of these benign lesions are not associated with an increased risk of breast cancer.

BODY PARTS INVOLVED--Breasts.

SEX OR AGE MOST AFFECTED--Females from puberty to old age. This condition affects about 50-80% of women to some degree. It usually disappears after menopause unless estrogen-replacement therapy is used.

SIGNS & SYMPTOMS--

Lumps in the breasts with the following characteristics:

• Lumps are usually on both sides. Solitary lumps may occur, but multiple lumps are common.
• Lumps offer resistance when pressed with fingertips; they may be tender.
• Lumps may be accompanied by generalized breast pain, especially before menstrual periods.
• Lumps often enlarge before menstrual periods and shrink afterward.
• Lumps come in different sizes. When the lumps are relatively large and near the surface, they can be moved freely within the breast.
• Nipple discharge.

CAUSES--Unknown, but probably related to estrogen and other hormones produced by the ovaries and possibly to dietary fat intake. Family history of cysts is common.

RISK INCREASES WITH

• Unknown.
• Some studies indicate that drinking coffee and smoking cigarettes are associated with a higher incidence and greater extent of fibrocystic breasts. Other studies have failed to show them as risk factors.

HOW TO PREVENT

• Until research is conclusive, avoid smoking and drinking coffee.
• Monthly breast self-examination to check breasts for lumps and changes in lumps after diagnosis. Report any changes to your doctor.
• Routine mammogram studies as recommended for your age group.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Diagnostic tests including mammogram, ultrasound (useful for distinguishing cystic from solid lesion) and surgical diagnostic procedures such as biopsy or cyst aspiration (sometimes). (See Breast Biopsy by Incision and Breast Biopsy by Needle Aspiration in Surgery section.)

APPROPRIATE HEALTH CARE

• Monthly breast self-examination (see Appendix).
• Doctor's supervision.

POSSIBLE COMPLICATIONS--Some lumps appear benign but are cancerous. Diagnostic studies, including biopsy, are often necessary to rule out malignancy.

PROBABLE OUTCOME--Women with fibrocystic breast disease continue to have breast lumps that appear and dissolve; some remain permanently. The disorder is presently incurable, but it normally does not jeopardize health.

How To Treat

GENERAL MEASURES--

• Examine your breasts carefully each month just prior to or at the onset of menstruation. Report any changes in lumps that have been diagnosed previously.
• Visit your doctor regularly (usually twice a year) for a breast exam or other studies, especially if you have a family history of cancer.

MEDICATION--Your doctor may prescribe:

• For pain, spironolactone and vitamin B-6 or iodine (kelp tablets).
• For more severe disease, danazol or bromocriptine.
• Vitamin E (there is some evidence that it is beneficial).

ACTIVITY--No restrictions. Regular exercise is important, but avoid activities that may cause trauma to the breasts.

DIET--

• No special diet, but avoid smoking, caffeine, chocolate and other sweets, cola drinks.
• Control your weight (see Weight-Loss Diet in Appendix).

Call Your Doctor If

• You have undiagnosed lumps in the breast.
• You detect a change in a lump or new lumps appear.
• Nipple discharge appears.
• You have not had a breast exam in 2 years.
• New, unexplained symptoms develop. Hormones used in treatment may produce side effects.