Associated Women's Health Specialists  
     
     

Fibrocystic Breast Changes

Women with fibrocystic breast changes have lumpy, tender breasts. These changes most often occur near the time of a woman's period. Fibrocystic breast changes are not a disease and they do not increase your risk of cancer. However, if you feel a lump, it should be checked.

This pamphlet will tell you more about:

  • Normal breast changes
  • How to check your breasts
  • What to do if you have breast changes

Fibrocystic breast changes are common. Know your breasts and what is normal for you.

Your Breasts

Your breast is made up of glands, fat, and fibrous tissue. Each breast has 15–20 sections, called lobes. Each lobe has many smaller lobules. The lobules end in dozens of tiny glands that can produce milk. The lobes, lobules, and glands are linked by thin tubes called ducts.

Your breasts respond to changes in levels of the hormones progesterone and estrogen. These hormone levels change during your monthly menstrual cycle. They also change during pregnancy, breastfeeding, and menopause. You also may notice changes if you use hormones, such as:

  • Birth control pills
  • Implants
  • Injections
  • Hormone replacement therapy (HRT)

Hormones cause a change in the amount of fluid in the breast. This may make fibrous areas in the breast more painful.

Changes in Your Breast

Fibrocystic breast changes are benign (not cancer). Fibrocystic breast changes are lumps, thickened tissue, and swelling. These changes are most common during the childbearing years. Pain in your breasts can occur at any time of your cycle. The breast lumps may become larger or more tender near the time of your period, though. Fibrocystic breast changes also can occur after menopause in women taking HRT. Other symptoms include:

  • Sharp pain
  • Burning
  • Itching
  • Aching pain

One breast may hurt more than the other. Any nipple discharge should be checked by your doctor. A clear, white, creamy, or green discharge from the nipple may occur off and on. Bloody (red) discharge should be checked right away.

If you have fibrocystic breast changes, you should become aware of how your breasts feel. This will help you detect any new changes. Breast changes can be found through an exam of the breast by:

  • Breast self-exam
  • Partner exam
  • Health professional exam

All women should do a monthly breast self-exam (see box). If you have fibrocystic breast changes, it is harder to do the exam—but it is even more important to find new lumps. Knowing what is normal for your breasts will help you detect any changes that may signal a problem. Doing the exam helps you know what is normal for your breasts and makes it easier to find a changed or new lump.

Any new lump should be checked by your doctor to see if it is solid or a cyst. A cyst is a small, fluid-filled cavity that can be almost any size. Cysts are benign in most cases. Lumps that are cancer often appear in only one breast. Benign lumps appear in both breasts in an even pattern in most cases.

Breast Self Exam

Looking

The self-exam should always be done in good light. Stand or sit in front of a mirror. Place arms at your sides. Look for dimpling, puckering, or redness of the breast skin, discharge from the nipples, or changes in breast size or shape. Look for the same signs with your hands pressed tightly on your hips and then with your arms raised high.

Feeling

Lie flat on your back. Place a folded towel or a pillow under your left shoulder. Place your left hand under or over your head. You also can feel for changes when you are standing.

With your right hand, keeping the fingers flat and together, gently feel your left breast without pressing too hard. Use one of the three methods shown here. Then lower your right arm and do the exam on the other breast.

Choose one of these methods

Circle. Begin at the top of your breast and move your fingers slowly around the outside in a large circle. When you return to the top, move your hand a little closer to the nipple and make a smaller circle. Do this in smaller and smaller circles until you have examined all of the breast tissue.

Lines. Begin in the underarm area. Slowly move your fingers down until they are below your breast. Move your fingers closer toward your nipple and go slowly back up, using the same motion. Use this up-and-down pattern all the way across your breast.

Wedge. Begin at the outside edge of your breast. Slowly work your way in toward the nipple, doing one wedge-shaped section at a time. Do this until the entire breast area has been examined.

Don't Forget
  • With any pattern, be sure to examine the nipples also. Gently squeeze the nipple and check for any discharge.
  • Examine the upper chest area and below the armpits—these places also have breast tissue.
  • Call your doctor if you notice any lumps or changes in your breasts.

Signs of a problem include:

  • New lumps
  • A lump that grows in size
  • A distinct lump rather than a lumpy area
  • A change in breast size

Things to Tell Your Doctor If You Find a Lump

Fill out this form before your visit, and be sure to discuss it with your doctor.

Have you had any breast problems? If so, list them.
_______________________________________________
_______________________________________________

Have you had an aspiration or breast biopsy in the past?
When and where?________________________________
_______________________________________________

Do you have any family history of breast cancer?
Who and when?__________________________________
_______________________________________________

Do you have breast implants? ______________________

When was your last mammogram? __________________

What is the date of your last menstrual period?
_______________________________________________

Are you pregnant or lactating? ______________________

What medications are you taking? __________________
_______________________________________________

When did you find the lump? _______________________

What size is the lump? Has it gotten smaller or larger?
_______________________________________________

How does the lump feel? Is it hard, soft, sore, or rubbery?
_______________________________________________

Where is the lump?

Draw it in here.

Do you have any nipple discharge? If so, what color is it?
______________________________________________

Tests

You or your doctor cannot tell whether a lump is cancer just by touching it. Your doctor may request a mammogram, ultrasound, or biopsy to rule out cancer. Often, more than one of these tests will be used.

If a cyst is found, your doctor may suggest you have a fine-needle aspiration. This draws fluid out of the cyst with a needle attached to a syringe. If the fluid is not bloody and the cyst goes away, it is likely that no more tests will be needed. If no fluid is obtained, further tests or a biopsy may need to be done.

You may need closer follow-up. It depends on the results of these tests.

Relief of Symptoms

Fibrocystic changes cannot be treated. Some women find relief from symptoms if they:

  • Avoid caffeine (coffee, tea, cola, and chocolate) for a few months.
  • Take over-the-counter pain relief. Nonsteroidal antiinflammatory drugs (NSAIDs) are the most helpful.
  • Reduce the amount of fluid you retain by not eating foods with a lot of salt, especially the week before your period.
  • Try natural vitamin E supplements.

Talk to your doctor about something that may help you. He or she may suggest treatment to change your hormone patterns if the symptoms do not improve.

What Can I Do?

To find changes early:

  • Do a breast self-exam once a month. The best time to do it is about a week after your period begins, when breast swelling has gone down. If you are not having periods, try to do the exam on the same day each month to help you remember.
  • Avoid things that may cause your condition to worsen.
  • Have a mammogram once every 1–2 years from age 40 to 50. After age 50, have a mammogram once a year.

Finally...

Fibrocystic breast changes are common. The tissue of your breast changes as your hormone levels change. Have regular mammograms if you are age 40 or older or if you are at high risk. Do monthly breast self-exams. This will help you know your breasts and what is normal for you.

Glossary

Benign: Noncancerous growth usually confined to one part of the body.

Biopsy: A minor surgical procedure to remove a small piece of tissue that is then examined under a microscope in a laboratory.

Estrogen: A female hormone produced in the ovaries that stimulates the growth of the lining of the uterus.

Hormones: Substances produced by the body to control the functions of various organs.

Mammogram: An X-ray of the breast, used to detect breast cancer.

Progesterone: A female hormone that is produced in the ovaries and makes the lining of the uterus grow. When the level of progesterone decreases, menstruation occurs.

Ultrasound: A test in which sound waves are used to examine internal structures