Locate a Hospital or Clinic 24 hour a day, 7 day a week nurse telephone advice Find doctor accepting new patients
Fibrocystic Breast Changes

 
   
 

Fibrocystic Breast Changes (FBC)

FBC is a general term that had been used by health professionals to describe a number of non-cancerous conditions occurring in the breast. The term, fibrocystic breast disease, is still used by many health professionals however, increasingly breast specialists are moving away from this generic term and describing this group of conditions more specifically. If you have been diagnosed with FBC, there were likely one or more of the following changes found in your breasts.

CYSTS

Refer to a closed sac within tissue that has a definite wall and contains fluid. If large, cysts may be felt as a painful lump.  Multiple smaller cysts may feel like a “grainy” nodularity in the breast.  Microscopic cysts may be detected by ultrasound or in biopsied tissue.

BREAST LUMPINESS

The lobular and ductal gland structure in the breast is constantly changing because of the stimulation of estrogen and progesterone hormones. The breasts respond to this stimulation by filling with fluid.  Each breast will produce and store 15-30 ml of fluid in the ducts during the month.

Also the hormone stimulation causes extra layers of cells to be produced in the lobules and ducts. The combination of these two changes can cause an increase in the size of the breast, increased lumpiness.

BREAST PAIN

Pain in the breast (also called mastalgia ) is a common condition that can affect up to 70% of women in their lifetime. It can originate from a number of causes including cysts and large lumps. There can be a pattern to the pain that occurs with hormonal changes in a woman’s monthly cycle or pain may be constant.  Breast pain is often not indicative of serious breast disease such as cancer however, it should be evaluated by a physician or breast specialist to rule out more serious disease or treatable causes of pain. The Society of Obstetricians and Gynaecologists of Canada (SOGC) have just released practise guidelines in Jan 2006 which may impact the way breast pain has been evaluated and treated.

NIPPLE DISCHARGE

Some women experience a yellowy-greenish discharge from there nipples.  The discharge may be from fluid which has collected in the ducts or from cysts near the nipple.  This discharge may occur right before the beginning of their monthly cycle, after sexual stimulation, or when a women begins taking estrogen supplements. 

WHO IS AT RISK?

At least 50 percent of all women have irregular feeling, lumpy breasts.

Studies have shown that as many as 90 percent of women have microscopic, cystic changes. Changes occur at any age after the onset of menstruation but are more common between the age of 30 and menopause.  Fibrocystic breast changes can occur after menopause, especially in women on hormone replacement therapy.

WHAT CAUSES FBC?

Changes that occur in glandular tissue are thought to be the body's overreaction to the normal female sex hormones estrogen and progesterone. Some drugs routinely prescribed by a physician can cause women to also experience lumpiness, fullness, and tenderness. If cysts have become large enough they may begin pressing on surrounding nerves and become painful.

WHAT IS THE TREATMENT?

There is no specific treatment for fibrocystic breast change as treatment depends upon what is thought to be the cause of the change. If you have sought help for pain, tenderness or a lump that you found during breast self-examination, your doctor will take a thorough breast health and family history and then examine your breasts.  Tests such as mammogram and/or breast ultrasound may be ordered.  In some cases, a fine needle aspiration may be necessary to confirm a cyst or to take a biopsy on a lumpy area.  If there is any question about diagnosis, removing a lump completely may be advised.

Larger, more painful, cysts can be aspirated (have the fluid removed) for comfort. Many women have reported symptom improvement by following guidelines for management of breast pain.  These guidelines can include being fitted for a good support bra, getting regular exercise and seeking medical advice on changes in hormonal treatment. The Society of Gynaecological Obstetricians of Canada Guidelines (2006) recommend getting 25 gm. of ground flaxseed daily in a muffin as a first line treatment for severe breast pain that is cyclical (related to monthly hormone changes).

Often the best treatment is the education and reassurance by your physician or breast health professional that your ‘lumpiness’ is normal and that you have done what you can and in some cases, undergone testing to rule out more serious disease like breast cancer.

To find out more information on breast health the following web sites may be of assistance.