Dr. M.J. Bazos, MD
Patient Handout
FIBROCYSTIC BREAST
CHANGES
About Your
Diagnosis
Breasts that are “fibrocystic” have
an exaggerated response to the hormonal fluctuations of the menstrual cycle.
After ovulation, 1–2 weeks before the period, the breasts develop cysts,
retain fluid, and enlarge. They may also become tender and sometimes very
painful. The pain can radiate into the axilla (the armpit) or even into the
shoulder area. After the period, the breasts will shrink in size, and become
less lumpy and less tender. Fibrocystic breasts are diagnosed by the symptoms
that occur before the period and by examination. Many women with fibrocystic
breasts have cysts that can be felt by examination. If you are undergoing
mammograms, the mammogram findings may also indicate fibrocystic changes. It is
estimated that 50% of all women have some degree of fibrocystic changes of the
breast. Fibrocystic breasts are usually symptomatic between the ages of 20 and
50 years. Once a woman has gone through menopause, the fibrocystic changes are
less symptomatic or not symptomatic at all. However, if the woman starts on
hormone replacement therapy, sometimes the fibrocystic breasts will continue to
be symptomatic because of the hormonal
stimulation.
Living With Your
Diagnosis
The most common symptoms are
that both breasts become tender or painful and engorged 1– 2 weeks before
the period. The tenderness or pain is often in the outer, upper sides of the
breasts (toward the armpit). However, sometimes the tenderness or pain can occur
in other areas of the breast as well. If the breasts are examined, they may feel
thicker and lumpy as if examining a mound of peas clumped together.
Occasionally, a breast cyst will
grow
larger than usual, up to 2.5 inches, and will cause pain in one particular spot
and can be felt as a distinct lump. The tenderness and/or pain can range from
very mild to very severe. However, most of the time pain medication is not
necessary. If you have fibrocystic changes, try not to examine your breasts
before your period. Do your self-breast examination as recommended, only after
your periods. Otherwise, you may feel “lumps” and become
unnecessarily alarmed. However, despite your best efforts, you may find that you
visit your doctor more often than someone who doesn’t have fibrocystic
breasts to get a lump checked
out.
Treatment
Most
women will not need medication to treat their fibrocystic breast symptoms. If
some medication is needed, often over-the-counter ibuprofen can be effective in
relieving some of the symptoms. If more relief is needed, your doctor may
prescribe a mild diuretic to start with. If your symptoms do not respond to
ibuprofen or a diuretic, your doctor may refer you to a breast surgeon or
gynecologist for further medical treatment. Sometimes birth control pills are
prescribed. Other medications that may be prescribed are danazol, bromocriptine
or tamoxifen. Decreasing the amount of caffeine and nicotine (if you are a
smoker) may decrease the severity of the symptoms. One study of women with
fibrocystic changes demonstrated that 92% had less severe symptoms when they
decreased their caffeine and/ or nicotine intake. Although, other studies have
not confirmed this finding, it may be worthwhile to decrease caffeine and
nicotine intake to see whether your symptoms lessen. Evening Primrose Oil
capsules may also lessen symptoms from fibrocystic breasts. In a study looking
at premenstrual symptoms, it was observed that women receiving Evening Primrose
Oil capsules had milder breast symptoms than women not taking Evening Primrose
Oil. The amount recommended is 1.5–2.0 grams of Evening Primrose Oil twice
each day 10–14 days before each period. Usually, it can be purchased at a
health food store. No side effects have been
reported.
The
DOs
• Take as directed any
recommended or prescribed
medication.
• Wear a good supportive
bra.
• Have a yearly breast
examination, and have mammograms performed when
recommended.
The
DON’Ts
• Don’t take
in excessive caffeine or
nicotine.
When to Call Your
Doctor
• If your symptoms are not
relieved by the recommended treatment, another medication may be
prescribed.
• If you feel a lump in
your breast.