Fibrocystic breast disease (FBD), or fibrocystic breast condition or changes, is described as common, benign changes involving the tissues of the breasts. Common breast symptoms are swelling and tenderness, nodularity, palpable lumps, nipple discharge, and inflammation. These changes are typically accompanied by breast pain. The discomfort associated with fibrocystic breast disease is often in the upper outer quadrant, is diffuse, and may radiate to the axilla or upper arm. The incidence of fibrocystic breast disease is estimated to be up to 70% of all women. It can occur in women aged 18 or older, but is most common in women between the ages of 30 and 50, and rare in postmenopausal women.
Fibrocystic changes occur during ovulation and just before menstruation. During these times, hormone level changes often cause the breast cells to retain fluid and develop into nodules or cysts (sacs filled with fluid), which feel like a lump when touched. The nodules or cysts can spread throughout the breast, may be located in one general area or simply appear as one or more large cysts. If the lump is not filled with fluid, it is called a fibroadenoma. A fibroadenoma is a solitary, firm distinct lump, composed of a mass or lump of fibrous tissue.
Having fibrocystic breasts does not place women at a higher or lower risk of developing breast cancer. This generalized breast lumpiness is known by several names, including fibrocystic breast condition, fibrous breasts, fibrocystic breast disease, fibrocystic changes and benign breast disease. There even exist several types of fibrocystic breast condition.
Unfortunately, many women and even doctors think that fibrocystic breast disease is a “normal” condition for women. However, large, palpable cysts have been linked to an increased risk of breast cancer, not to mention the pain the women experience, so women need to be concerned about pain and cysts in their breasts and not let it go on thinking it is “normal”.
Causes
Fibrocystic breasts occur from changes in the glandular and stromal (connective) tissues of the breast. These changes are related to a woman’s menstrual cycle and the hormones, estrogen and progesterone. Women with fibrocystic breasts often have bilateral cyclic breast pain or tenderness that coincides with their menstrual cycles.
During each menstrual cycle, normal hormonal stimulation causes the breasts’ milk glands and ducts to enlarge, and in turn, the breasts may retain water. Before or during menstruation, the breasts may feel swollen, painful, tender, or lumpy. The severity of these symptoms varies significantly from woman to woman. Some women only experience mild breast swelling during menstruation, while others experience constant breast tenderness. Because the condition is hormone-related, it will usually affect both breasts (bilaterally). Symptoms of fibrocystic breasts usually stop after menopause but may be prolonged if a woman takes hormone replacement therapy.
Risk Factors
Women who have a family history of benign breast disorders, particularly in a mother or sister, are most likely to develop FCBD. It is also more common among women who have not had children, who are Jewish or Caucasian, or who have experienced severe PMS.
Symptoms
Symptoms usually get better after women go through menopause. If some take birth control pills, they may have fewer symptoms. If the patient is on hormone therapy, you may have more symptoms.
Symptoms are usually worse right before the menstrual period and improve after the period starts.
Symptoms can include –
- Pain or discomfort in both breasts
- The pain commonly comes and goes with the period, but can last through the whole month
- Breasts that feel full, swollen, and heavy
- Pain or discomfort under the arms
- Thick or lumpy breasts
Women may have a lump in the same area of the breast that becomes larger before each period and shrinks afterward. This type of lump moves when it is pushed with the fingers. It does not feel stuck or fixed to the tissue around it. This lump is common with fibrocystic breasts.
Some may have discharge from the nipple. If the discharge is clear, red, or bloody, talk to the health care provider right away.
Treatment
Supportive therapy treats the symptoms caused by fibrocystic breast changes, but it does not treat the underlying cause of the breast condition. Supportive care options for fibrocystic breast changes may include –
- Wearing a fitted, supportive bra
- Over-the-counter pain medicines
- Ibuprofen (Advil, Motrin)
- Acetaminophen (Tylenol)
- Diclofenac cream (Voltaren)
- Fine needle aspiration to relieve pain from a breast cyst
- Adding ground flaxseed to the diet
If supportive care measures do not reduce the symptoms, or if the symptoms are severe, other treatment options may be offered.
Oral contraceptives (birth control pills)
Surgery – Sometimes done to remove a lump
Drug treatment – Rarely offered for fibrocystic breast changes due to concerns about side effects
- Danazol (Cyclomen, Danocrine) – decreases the production of estrogen
- Tamoxifen (Nolvadex, Tamofen) – blocks the effects of estrogen
Alternative Treatment
Vitamin E has been used for managing fibrocystic breast disease for more than 35 years. Vitamin E reduces pain, relieves tenderness, and limits the development of nodules.
Evening Primrose Oil – The pain and tenderness of benign breast disease associated with “cyclic mastalgia” have been alleviated with evening primrose oil, the only one of the fatty acids to be scientifically studied in relation to fibrocystic breasts.
Chasteberry, also called vitex, adjusts imbalances between the menstrual hormones estrogen and progesterone and can stop excess production of prolactin, thereby reducing discomfort. It helps with painful bloating and may clear up PMS-related complaints, such as irritability and depression, in the process.
Essential fatty acids (EFAs) have an anti-inflammatory action that soothes breast pain and also helps the body absorb iodine. An iodine deficit is associated with fibrocystic breast changes. Good sources of EFAs are evening primrose oil, flaxseed oil, and borage oil
Magnesium is a versatile mineral that appears to reduce the pain and inflammation of fibrocystic breast changes and may also help with PMS and menstrual cramps. It’s less likely to upset the stomach if taken with food; cut the dose if diarrhea develops.
Vitamin B6 helps the liver process any extra estrogen and, like some of the supplements above, also can relieve PMS symptoms. Though this vitamin is essential to nerve health, it can cause nerve damage when taken in very high doses (over 500 mg a day) for a long period of time. Vitamin B6; will be most effective for this condition if used during the two weeks before your menstrual period.
A coenzyme Q10 deficiency has been reported in some cases of both breast cancer and fibrocystic breast changes. Supplementing with this high-potency antioxidant may be helpful in the prevention and treatment of these and other disorders in the body.
Herbal therapies for addressing the symptoms of breast pain, swelling, and cystic nodules in the breast are largely arrived at from traditional uses of herbal medicines and from observational empirical evidence in clinical practice. Herbal diuretics can be useful in decreasing breast swelling and the discomfort associated with it. The most effective of these is dandelion leaf (Taraxacum officinale). Other diuretics to consider are cleavers (Galium aparine), yarrow (Achillea millefolium) and uva ursi (Arctostaphylos uva ursi).
Lifestyle Advice – Start and maintain an exercise program that addresses three key components of health: duration (aerobics), strength (weight resistance), and flexibility (stretching). A moderate daily exercise routine will promote weight loss and hormonal balance, stabilizing your mood and the overall feeling of well being.
Reference –
http://www.mayoclinic.org/diseases-conditions/fibrocystic-breasts/basics/definition/con-20034681
http://www.healthline.com/health/fibrocystic-breast-disease
http://www.007b.com/fibrocystic_breast_pain.php
http://www.msdmanuals.com/home/women’s-health-issues/breast-disorders/fibrocystic-changes
http://womenshealth.about.com/cs/cysticbreasts/a/fibcysbrlubupan.htm
https://umm.edu/health/medical/ency/articles/fibrocystic-breast-changes
http://www.whg-pc.com/webdocuments/Breast-health/Breast-Fibrocystic.pdf
http://www.sphcs.org/fibrocysticbreasts
https://my.clevelandclinic.org/health/diseases_conditions/hic-fibrocystic-breast-changes
http://www.healthywomen.org/content/ask-expert/1290/fibrocystic-disease-hiding-breast-cancer
http://goodbreasthealth.com/breast_pain/fibrocystic_breast_disease/
http://www.medicinenet.com/fibrocystic_breast_condition/article.htm