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Fibrocystic Breasts

  1. What are fibrocystic breasts?
  2. Symptoms
  3. Causes
  4. Diagnosis
  5. Treatment
  6. Complications
  7. FAQs
  8. Other names

What are fibrocystic breasts?

Fibrocystic breasts are breasts which have undergone changes in the structure of their tissue, causing them to feel lumpy, uncomfortable, or even painful.

Also known as fibrocystic change or fibrocystic breast disease, tissue changes that may occur when a person is affected by the condition, include:[1]

  • Fibrosis: a large amount of irregularly-arranged connective tissues that are found in areas of the body where stress occurs, known as fibrous tissue
  • Cysts: fluid-filled sacs

Fibrocystic breast change is very common, with some figures showing that it may occur in up to half of all women.[2] When fibrocystic change occurs, it usually develops between the age of 30 to 50 years.[3] In most cases, treatment is not required.

Fibrocystic change in tissue may complicate the process of screening for breast cancer, and in some cases, the condition may slightly increase the risk of developing breast cancer. However, fibrocystic breasts are not cancerous. It is important to keep track of any changes to the breasts, especially if symptoms worsen or persist.

Symptoms

The symptoms of fibrocystic breasts can differ between people. Usually, they are most intense about one week before menstruation and decrease in intensity shortly after menstruation has started. Breast symptoms are usually symmetrical, occurring in both breasts.

Some women who are affected by fibrocystic breasts may not notice any symptoms at all. If symptoms are experienced, they may include:[4][5]

  • Painful or tender breasts before menstruation
  • Watery or milky nipple discharge
  • Lumps or nodules in the breasts
  • Change in breast size
  • Changes to menstrual cycle, if not yet past menopause

Wondering if you are experiencing symptoms of fibrocystic breasts? Try the Ada app for a personal health assessment.

Causes

Fibrocystic changes refer to two conditions:

  • Fibrosis
  • Cysts

Fibrosis refers to the thickening and scarring of the breast tissue, leading to areas that feel rubbery, firm or hard to the touch.

Cysts develop when fluid builds up inside the breast glands and is encapsulated. These begin with microcysts, which are too small to feel and only visible under a microscope. If fluid continues to build up, larger macrocysts may form, which can be felt easily and may be up to one or two inches in diameter.[1]

Fibrocystic changes occur in women of childbearing age, usually subsiding with menopause. The tissue alters over the course of the menstrual cycle and also significantly during periods of pregnancy and breastfeeding. These changes are a reaction to the fluctuating levels of the hormones estrogen and progesterone in the body. Changes in hormone levels are also believed to increase the likelihood of developing fibrocystic breasts, often making the condition more noticeable just before the menstrual period.[6]

Taking the contraceptive pill may reduce the likelihood of developing fibrocystic breasts.[7] Taking hormonal replacement therapy (HRT) after the menopause can cause women to develop fibrocystic breasts.[8]

Diagnosis

Fibrocystic breasts will often be suspected by a doctor on the basis of the symptoms and a physical examination. If there is unusual nipple discharge and/or a mass found during breast examination, ultrasound or mammography scans may then be carried out to confirm diagnosis.

The foremost concern is not the fibrocystic breast condition itself, which is typically not serious, but the possibility that it may mask breast cancer, which has similar symptoms.

In order to rule out a cancer diagnosis, a biopsy may be done. A biopsy is a test that removes tissue or sometimes fluid from an area. Local anesthetic may be administered, depending on the type of biopsy used.

If you are experiencing symptoms of fibrocystic breasts, try using the Ada app to find out more about your symptoms.

Ultrasound

An ultrasound scan may be used to produce an image of the internal breast. This will allow doctors to identify different types of cyst which may be present:[1]

Simple cyst: This type of cyst appears on the ultrasound scan as a lump which is just filled with fluid. It is non-cancerous.

Complex cyst: This type of cyst appears on the ultrasound scan as a lump that is solid, or which has both fluid and solid components. When detected, a biopsy may be done to check whether there are any cancerous cells.

Mammogram

A mammogram is an X-ray of the breasts. Sometimes a person may have both an ultrasound and a mammogram, as each shows different detail of the breast tissue. A magnetic resonance imaging (MRI) scan may also be used.

Women under the age of 40 do not often have a mammogram, as it is difficult to obtain a clear picture of younger women’s breasts, which are denser, using a mammogram.[5]

Biopsy

A biopsy is a test that removes tissue or sometimes fluid from an area. Cells are then examined under a microscope and further tested to check for the presence of breast cancer.

Good to know: About 80 percent of women who have breast biopsies do not have breast cancer.[9]

There are three types of biopsies that may be used:[10][11]

Fine needle aspiration

If the lump is easily accessible or is likely to be filled with the fluid, a doctor may perform a fine needle aspiration (FNA), in which fluid is drawn through a needle. The lump should collapse once the fluid inside has been drawn and discarded.

If the lump persists, another sample may be taken with a similar method for a biopsy, to examine the cells.

Core needle biopsy

This involves using a larger needle through which a small amount of tissue can be removed. Local anesthetic will be used.

Surgical biopsy

A surgical biopsy is done with local anesthesia. This involves removal of all or part of an abnormal lump.

If cancerous or precancerous cells are detected during a biopsy, then further treatment may be required, such as surgery or chemotherapy.

Treatment

Most people with fibrocystic breasts do not require specific treatment. People with fibrocystic breasts may find that over-the-counter pain relief such as paracetamol, also known as acetaminophen, may help with the pain and tenderness at times. Many people also find supportive bras and warm compresses helpful for reducing pain. People with distressing or severe symptoms may benefit from:[1][4]

  • Hormonal therapy
  • Draining cysts of fluids
  • Surgery to remove cysts

Complications

Fibrocystic change does not correlate with an increased risk of breast cancer. However, women with fibrocystic breasts may be more difficult to examine for breast cancer.[3] It is important to keep track of any changes to the breasts, especially if symptoms worsen or persist. Carrying out regular breast checks oneself as well as check-ups with a GP is advisable in order to identify new lumps early.

If you think you may have a health condition, try using the Ada app to find out more about your symptoms.

FAQs

Q: Is there a link between fibrocystic breasts and caffeine?
A: Many women report an improvement in symptoms when they eliminate caffeine from their diet, and some studies have suggested a connection. However, there is not yet enough evidence to show whether there is a significant connection.[1]

Q: Is it possible to have fibrocystic breasts after menopause?
A: A person is less likely to develop new lumps due to fibrocystic breasts after menopause, though pre-menopausal fibrocystic changes that have persisted may still be discovered at this time. This is due to the decrease in estrogen, which is associated with fibrocystic changes. Some women, who take hormones to treat problems related to menopause, may develop breast lumps. All women, no matter what age, should seek a doctor’s advice for any change or irregularity in their breasts.[12]

Q: Fibrocystic breasts and breastfeeding – are there any associated problems?
A: Any fibrocystic breast change should not complicate breastfeeding, though it can be associated with a bloody discharge from the nipple during pregnancy and lactation.[13] Fibrocystic breast change also tends to improve during pregnancy and breastfeeding. It is best to seek advice if lumps or bloody discharge do appear during breastfeeding, since this can be caused by other medical conditions, such as mastitis, which can lead to complications.

Q: Does vitamin E reduce fibrocystic breasts pain?
A: Many women report an improvement in symptoms when they take vitamin E supplements and some studies have shown a connection. However, there is not yet enough evidence to show that vitamin E makes a significant difference to breast pain. Vitamin E deficiency is considered to be rare, as vitamin E is sufficiently present in average nutritional intake.[14]

Q: Do breast cysts go away?
A: Yes, a cyst may go away on its own or, if causing discomfort, may be drained by a doctor. Many women have cysts that come back.[15]

Q: How long do breast cysts last?**
A: Breasts cysts may remain for many years or may resolve spontaneously. They usually disappear after menopause, but in some women, they can last throughout life.[16]

Q: What does breast cancer feel like?
A: Early signs of breast cancer include a painless lump or mass in the breast. However, many people with early breast cancer will have no symptoms at all. Most breast lumps are not cancerous. However, it is important to see a doctor as soon as possible if a person suspects they may have breast cancer.

Read more about the symptoms of breast cancer »

Q: What do fibrocystic breasts feel like?**
A: The tissue may enlarge, causing a feeling of heaviness, discomfort, tenderness to the touch or a burning pain. Some women have described the breasts as feeling tender, lumpy or ropy. Try using the Ada app to find out more about your symptoms.

Read more about the symptoms of fibrocystic breasts »

Other names for fibrocystic breasts

  • Benign breast lumps
  • Fibroadenosis
  • Mammary dysplasia
  • Chronic cystic mastitis
  • Hyperplastic cystic disease
  • Fibrocystic change
  • Fibrocystic breast disease
  • Diffuse cystic mastopathy
  • Fibrosclerosis of breast
  • Fibrocystic mastopathy
  • Glandular breast changes
  • Cystic changes
  • Cystic breasts
  • Fibrocystic breast tissue
  • Fibrous breasts

  1. American Cancer Society. "Fibrosis and Simple Cysts in the Breast." 20 September 2017. Accessed 23 July 2018.

  2. BMJ Best Practice. "Fibrocystic breasts - Epidemiology." Accessed 6 September 2018.

  3. BMJ Best Practice. "Fibrocystic breasts." Accessed 23 July 2018.

  4. AMBOSS. "Benign breast conditions." Accessed 24 July 2018.

  5. Patient.info. "Benign Breast Disease. Non cancerous breast conditions." 23 September 2016. Accessed 24 July 2018.

  6. Science Direct. "A Review of Mastalgia in Patients with Fibrocystic Breast Changes." Accessed 15 December 2018.

  7. MedlinePlus Medical Encyclopedia. "Fibrocystic breast disease." 11 November 2016. Accessed 15 December 2018.

  8. Breastcancer.org. "Hormone Replacement Therapy Ups Risk of Benign Breast Disease." 8 April 2008. Accessed 15 December 2018.

  9. National Breast Cancer Foundation. "Biopsy." Accessed 15 December 2018.

  10. National Breast Cancer Foundation. "Biopsy." Accessed 25 July 2018.

  11. NHS.UK. "Breast cancer in women - Diagnosis." Accessed 25 July 2018.

  12. Harvard Health. "Breast pain: Not just a premenopausal complaint." 19 June 2018. Accessed 15 December 2018.

  13. Breastfeeding Support. "Breast Lumps." 23 June 2018. Accessed 16 December 2018.

  14. Natural Medicine Journal. "The Research Behind Vitamin E." Accessed 16 December 2018.

  15. Westmead BCI. "Breast Cyst Fact Sheet." Accessed 15 December 2018.

  16. Diagnostic Radiology: Musculoskeletal and Breast Imaging."(https://books.google.com/books/about/Diagnostic_Radiology_Musculoskeletal_and.html?id=LcVpWb4DJBoC) 31 August 2012. Accessed 15 December 2018.