The Fibrocystic Breast

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Fibrocystic breasts – those containing lumpy nodular tissue – used to be regarded as a “disease.” But somewhere along the way, “fibrocystic breast disease” got downgraded to merely “fibrocystic breast changes,” probably because more than half of all women experience these changes at one point in their lives.

In fact, many women with fibrocystic breasts are asymptomatic. Those who aren’t will experience some or all of the following:

  • Generalized breast pain or tenderness
  • Breast lumps or areas of thickening that tend to blend into the surrounding breast tissue
  • Green or dark brown non-bloody nipple discharge that tends to leak without pressure or squeezing
  • Breast lumps that fluctuate in size with the menstrual cycle
  • Monthly increase in breast pain or lumpiness from ovulation to just before your period
  • Breast changes that are similar in both breasts

Fibrocystic breast changes are usually normal, or at least not problematic. You should see a doctor only if:

  • Your doctor evaluated a breast lump but now it seems to be bigger or otherwise changed
  • You find a new breast lump or area of prominent thickening
  • Breast changes persist after your period
  • You have specific areas of continuous or worsening breast pain

Your doctor will likely begin her diagnosis with a clinical breast examination, visually and manually examining your breasts and the lymph nodes located in your lower neck and underarm area. Depending upon your medical history, this may be the extent of the testing. If, however, your doctor detects a new lump and suspects fibrocystic changes, and these changes persist after a second examination following your menstrual period, she will likely invite you back for a mammogram or an ultrasound scan.

If all the other tests check out okay, your doctor will likely schedule you for a breast biopsy. In this procedure a small sample of your breast tissue is removed for analysis.

Should your breast lump feel like a cyst to your doctor, she may schedule you for a fine-needle aspiration. If it is a cyst, the withdrawal of the fluid by this procedure will cause it to collapse.

Only in rare circumstances will a doctor recommend the surgical removal of cyst-like lumps which do not resolve after repeated aspiration and careful monitoring. More likely she will recommend over-the counter pain relievers such as NSAIDs and acetaminophen to relieve the symptoms.

 

Sources: The Mayo Clinic