Fibrocystic Breast Disease

General Illness Information

Medical Term:
FIBROCYSTIC BREAST DISEASE

Common Name: Benign breast disease

Description: Fibrocystic breast disease is a generalized term for non- malignant lumps in breasts, causing pain. Although it is called a disease, it is not really a disease. Therefore the term benign breast  disease or fibrocystic condition would be more appropriate. The benign lumps are usually smooth, regular and mobile.

At least 50% of women  have benign breast disease during their lifetime. Affects women in childbearing years, more common age 30-50. Rare in menopausal women not receiving hormone replacement therapy.

Fibrocystic breast disease is the most frequent cause of lumps in the breast.

Causes: Causes of benign breast disease are unknown, but lumps are probably sustained by estrogen and possibly also related to dietary fat and caffeine intake. In some cases may be associated with increased levels of prolactin ( a hormone secreted by pituitary gland).

Very little is known about genetic aspects of fibrocystic breast disease, but family history of cysts is common.

Prevention:

  • Until research is conclusive, avoid smoking and caffeine;
  • Practice monthly breast self-examination to check breasts for lumps and changes in lumps after diagnosis. Report any changes to your doctor;
  • Routine mammogram studies, to screen for cancer.

Signs & Symptoms

  • May not have any symptoms;
  • Painful tender breast lump, either solitary or more commonly multiple tender lumps, usually in upper outer quadrants of the breast. These lumps  have a tendency to resolve spontaneously, often after menses;
  • Pain usually worse before menstrual periods;
  • May be indistinguishable from cancerous tumor of the breast;
  • Breast engorgement;
  • Breast thickening;
  • Nipple discharge (sometimes).

Risk Factors

Unknown.

Some studies indicate that ingestion of methylxanthine- containing substances (e.g. coffee, tea, cola and chocolates), and smoking cigarettes are associated with a higher incidence and greater extent of fibrocystic breast disease.

Diagnosis & Treatment

Diagnostic evaluation may include a physical examination, mammogram, ultrasonograph (useful for distinguishing cystic from solid lesion) and surgical diagnostic procedures such as biopsy or cyst aspiration. Routine laboratory tests are not helpful in evaluation of benign breast disease.

General Measures:

  • Examine breasts carefully each month, a few days after the onset of menstruation. Report any changes in lumps that have been diagnosed previously;
  • Visit your doctor at least every 6 months for a breast exam or other studies, especially if you have a family history of cancer;
  • Cold compresses may be helpful for relieving discomfort or pain;
  • Wear a well-fitting, supportive bra (day and night);
  • Possibly, excision of benign tumors or fat necrosis lesions.

Medications:

  • For pain, analgesics may be recommended;
  • For cyclical pain unresponsive to general measures, oral contraceptives (birth control pills) have been shown to eliminate breast pain, usually after the first cycle of pills, and improve fibrocystic changes after 6 months of treatment;
  • Progestins such as medroxyprogesterone acetate (Provera), 10mg. from day 15 to 25 of the menstrual cycle, provide symptomatic relief in 80 to 85% of women;
  • For very severe disease, danazol, bromocriptine (Parlodel) or tamoxifen may be prescribed;
  • There is some evidence that a combination of vitamin E , B-complex,and selenium may be beneficial.

Activity:

No restrictions. Avoid activities that may cause trauma to the breasts.

Diet:

No special diet, but avoid smoking and caffeine, chocolate, and cola drinks.

Possible Complications:

Fibrocystic changes can make physical examinations and mammograms difficult to interpret. Some lumps appear benign, but may be cancerous. Diagnostic studies, including biopsy, are often necessary to rule out malignancy.

Prognosis

Women with fibrocystic breast disease continue to have breast lumps that appear and dissolve; some remain permanently. The disorder is presently incurable, but it does not jeopardize health. Some cysts can be aspirated in a doctor’s office, causing the lump to disappear. If the lump does not disappear completely after aspiration, it may be cancerous and should be diagnosed by biopsy and microscopic analysis.

Other

Nothing Specified.

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