Fibrocystic breast changes is a commonly used phrase to describe painful, lumpy breasts.
Fibrocystic breast disease; Mammary dysplasia; Diffuse cystic mastopathy; Benign breast disease; Glandular breast changes
Causes, incidence, and risk factors
The exact cause is not known. It is believed that hormones made in the ovaries can make a woman's breasts feel swollen, lumpy, or painful before or during menstruation each month.
Up to half of women have this problem at some time during their life. It is most common between the ages of 20 and 45. It is rare in women after menopause, unless they are taking estrogen.
Some women feel that eating chocolate, drinking caffeine, or eating high-fat foods cause their symptoms. But there is no clear proof of this.
Symptoms usually get better after you go through menopause. If you take birth control pills, you may have fewer symptoms. If you are on hormone therapy, you may have more symptoms.
Symptoms are usually worse right before your menstrual period and improve after your 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
You 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 your fingers. It does not feel stuck or fixed to the tissue around it. This lump is common with fibrocystic breasts.
You may have discharge from the nipple. If the discharge is clear, red, or bloody, talk to your health care provider right away.
Signs and tests
Your health care provider will examine you. This will include a breast exam.Tell your doctor or nurse if you have noticed any breast changes.
If you are over 40, ask you doctor or nurse how often you should have a mammogram to screen for breast cancer. For women under 35, a breast ultrasound may be used to look more closely at breast tissue.
You may need further tests if a lump was found during a breast exam or your mammogram result was abnormal. Another mammogram and breast ultrasound may be done.
Women who have no symptoms or only mild symptoms do not need treatment.
Your health care provider may recommend the following self-care measures:
- Take over-the-counter medicine such as acetaminophen or ibuprofen
- Apply heat or ice on the breast
- Wear a well-fitting or sports bra
Some women believe that eating less fat, caffeine, or chocolate helps with their symptoms. But there is no good evidence that these measures help.
Vitamin E, thiamine, magnesium, and evening primrose oil are not harmful in most cases. But studies have not shown these to be helpful. Before taking any medicine or supplement, talk with your health care provider.
For more severe symptoms, your health care provider may prescribe hormones, such as birth control pills or other medicine. Take the medicine exactly as instructed. Be sure to let your provider know if you have side effects from the medicine.
Surgery is never done to treat this condition.
If your breast exams and mammograms are normal, you do not need to worry about your symptoms. Fibrocystic breast changes do not increase your risk of breast cancer. Symptoms usually improve after menopause.
Calling your health care provider
Call your health care provider if:
- You find new or different lumps during your breast self exam
- You have new discharge from the nipple or any discharge that is bloody or clear
- You have redness or puckering of the skin, or flattening or indentation of the nipple
Miltenburg DM, Speights VO Jr. Benign breast disease. Obstet Gynecol Clin North Am. 2008;35:285-300.
Katz VL, Dotters D. Breast diseases: diagnosis and treatment of benign and malignant disease. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 15.