Fibrocystic Breasts

Topic Overview

What are fibrocystic breast changes?

Many women have breasts that feel lumpy, thick, and tender, especially right before their periods. These symptoms are called fibrocystic breast changes. They may also be called cyclic breast changes, because they come and go with your menstrual cycle.

Fibrocystic breast changes are normal and harmless. They aren't cancer, and they don't increase your chance of getting breast cancer.

But having fibrocystic breast changes can make it harder to find a lump that could be cancer. This is a special concern if you also have a higher-than-normal risk for breast cancer. So if you or a close family member has had breast cancer or if you have had radiation treatment or a breast biopsy showing atypical ductal hyperplasia (ADH), talk to your doctor about how often you need a breast checkup.

What causes fibrocystic breast changes?

Experts think that fibrocystic breast changes are linked to the hormone changes that happen during a woman's menstrual cycle. Each month, a woman's body gets ready for a possible pregnancy. It releases hormones that signal the breasts to make milk. The milk (or mammary) glands get bigger, which may make some women's breasts feel lumpy and tender. These symptoms go away after a woman starts her period.

You are more likely to have fibrocystic breasts if your mother or sisters have them.

What are the symptoms?

If you have fibrocystic breasts, you may notice the symptoms right before your menstrual period. You may find that:

• Your breasts are swollen.
• They feel tender or painful. Women often describe this as a dull or aching pain, heaviness, or soreness.
• Your breasts feel lumpy. Your doctor may call this "generalized breast lumpiness." Lumpy (cystic) areas feel thick. You may have one or more lumps that are always in the same area and that grow and shrink with each menstrual cycle. The lumps move if you push on them.
• Your symptoms get better by the time your period ends.

Symptoms can be on one or both sides and can occur up toward and under the armpit.

Many women first notice fibrocystic breast changes when they are in their 30s. At this age, your hormone levels start to vary more than before.

How are fibrocystic breast changes diagnosed?

If you notice a new breast lump, wait through one menstrual cycle. If it's still there after your period, see your doctor for a breast exam. If you aren't having menstrual periods, see your doctor for a breast exam as soon as you notice a new lump.

To diagnose fibrocystic breast changes, your doctor will do a breast exam and ask when you had your last period. Further exams and tests usually aren't needed. But if your doctor needs more information or you want reassurance, you may have other tests, such as a mammogram or a breast ultrasound.

How are they treated?

You don't need to do anything about fibrocystic breast changes. They are normal, and they don't lead to cancer.

If breast pain bothers you:

• Take an over-the-counter pain medicine like acetaminophen (such as Tylenol) or ibuprofen (such as Advil). If this doesn't help, ask your doctor about using a nonsteroidal anti-inflammatory drug (NSAID)skin cream. Stronger medicines are available, but they may have more side effects. Be safe with medicines. Read and follow all instructions on the label.
• Wear a bra that gives your breasts good support.
• Ask your doctor about low-dose birth control pills. For some women, these help reduce breast soreness and swelling before periods. They may be a good choice if your symptoms bother youand you want to prevent pregnancy.

Although there is no evidence that any of these help with breast pain, some women report that they feel better when they give up caffeine; eat a very low-fat diet; or take certain vitamin, mineral, or herbal supplements. Be sure your doctor knows about any supplements you're taking. And talk with your doctor before you make any major changes to your diet.