Learn about this condition that's common in women, including symptoms, possible causes and testing to determine when breast cysts might need treatment.
Fibrocystic breasts are composed of tissue that feels lumpy or ropelike in texture. Doctors call this nodular or glandular breast tissue.
It's not at all uncommon to have fibrocystic breasts or experience fibrocystic breast changes. In fact, medical professionals have stopped using the term "fibrocystic breast disease" and now simply refer to "fibrocystic breasts" or "fibrocystic breast changes" because having fibrocystic breasts isn't a disease. Breast changes that fluctuate with the menstrual cycle and have a ropelike texture are considered normal.
Fibrocystic breast changes don't always cause symptoms. Some people experience breast pain, tenderness and lumpiness — especially in the upper, outer area of the breasts. Breast symptoms tend to be most bothersome just before menstruation and get better afterward. Simple self-care measures can usually relieve discomfort associated with fibrocystic breasts.
Signs and symptoms of fibrocystic breasts may include:
Fibrocystic breast changes occur most often between 30 and 50 years of age. These changes happen rarely after menopause unless you're taking hormone replacement medicine such as estrogen or progesterone.
Most fibrocystic breast changes are normal. However, make an appointment with your doctor if:
The exact cause of fibrocystic breast changes isn't known, but experts suspect that reproductive hormones — especially estrogen — play a role.
Fluctuating hormone levels during the menstrual cycle can cause breast discomfort and areas of lumpy breast tissue that feel tender, sore and swollen. Fibrocystic breast changes tend to be more bothersome before your menstrual period and ease up after your period begins.
When examined under a microscope, fibrocystic breast tissue includes distinct components such as:
Having fibrocystic breasts doesn't increase your risk of breast cancer.
Tests to evaluate your condition may include:
Clinical breast exam. Your doctor feels (palpates) your breasts and the lymph nodes located in your lower neck and underarm area checking for unusual breast tissue. If the breast exam — along with your medical history — suggests you have normal breast changes, you may not need additional tests.
But if your doctor finds a new lump or suspicious breast tissue, you may need to come back a few weeks later, after your period, for another clinical breast exam. If the changes persist or the breast exam is concerning, you may need additional tests, such as a diagnostic mammogram or ultrasound.
Breast biopsy. If a diagnostic mammogram and ultrasound are normal, but your doctor still has concerns about a breast lump, you may be referred to a breast surgeon to determine whether you need a surgical breast biopsy.
A breast biopsy is a procedure to remove a small sample of breast tissue for microscopic analysis. If a suspicious area is detected during an imaging exam, your radiologist may recommend an ultrasound-guided breast biopsy or a sterotactic biopsy, which uses mammography to pinpoint the exact location for the biopsy.
It's important to report any new or persistent breast changes to your doctor, even if you've had a normal mammogram within the last year. You may need a diagnostic mammogram or ultrasound to evaluate the changes.
If you don't experience symptoms, or your symptoms are mild, no treatment is needed for fibrocystic breasts. Severe pain or large, painful cysts associated with fibrocystic breasts may warrant treatment.
Treatment options for breast cysts include:
Examples of treatment options for breast pain include:
You might find relief from symptoms of fibrocystic breasts through one of these home remedies:
Vitamins and dietary supplements may lessen breast pain symptoms and severity for some people. Ask your doctor if one of these might help you — and ask about doses and any possible side effects:
Vitamin E. Early studies showed a possible beneficial effect of vitamin E on breast pain in people who experience breast pain that fluctuates during the menstrual cycle. In one study, 200 international units (IU) of vitamin E taken twice daily for two months improved symptoms. There was no additional benefit after four months.
For people older than 18 years, pregnant and breastfeeding, the maximum dose of vitamin E is 1,000 milligrams daily (or 1,500 IU).
If you try a supplement for breast pain, stop taking it if you don't notice any improvement in your breast pain after a few months. Try just one supplement at a time so that you can clearly determine which one helps alleviate the pain — or not.
You're likely to start by seeing your family doctor, nurse practitioner or physician assistant. In some cases, based on a clinical breast exam or findings on an imaging test, you may be referred to a breast-health specialist.
The initial evaluation focuses on your medical history. Your health care provider will want to discuss your symptoms, their relation to your menstrual cycle and any other relevant information.
To prepare for your appointment, make a list of:
Basic questions to ask your doctor include:
Don't hesitate to ask questions anytime you don't understand something.
Your doctor may ask you questions, such as:
June 23rd, 2021