What are fibrocystic breasts?

 "Fibrocystic breasts" is a term used to label a number of benign (non-cancerous) breast irregularities. The term typically refers to breasts that are lumpy, usually at the time of your menstrual cycle when one or more of these benign lumps, or the general feeling of lumpiness, may increase due to extra fluid collecting in the breast tissue. While in the past it was referred to by physicians as "fibrocystic breast disease", critics have said that this was a terminology used by doctors as an umbrella under which to categorize numerous, and vastly different, breast irregularities. Benign breast irregularities will occur in over half of all women at some point in their lifetime, accounting for nearly 90% of breast masses in women. 80% of lumps which are biopsied are found to be benign. It is increasingly important for women to become familiar with their breasts so they can sense irregularity and advocate for testing.

  What causes breast pain?

Breast pain is most commonly associated with the menstrual cycle and therefore is referred to as cyclical pain. It is thought to be related to hormone activity in combination with a reaction from the breast tissue. Studies show that most women are more concerned about the possibility of cancer than the pain itself. There are treatments available to help with this pain. Some physicians may recommend limiting consumption of caffeine or reducing salt intake. If necessary, doctors can offer medicinal interventions.

Non-cyclical breast pain is much less common and can be caused by a trauma such as an injury or a breast biopsy. In both cases, if you are experiencing breast pain it is important to take the time to find a good breast specialist to examine you and determine what steps you can take.

 What are some benign (Non-Cancerous) breast conditions?

· Cysts- These are fluid filled sacs occurring most commonly in women approaching menopause. These are often observed by doctors over time or drained using fine-needle aspiration.

· Fibroadenomas- These are smooth, round, and hard lumps that can usually move easily around the breast. This lump can be anywhere from 5mm to 5cm and may become larger during pregnancy or nursing. Fibroadenomas will usually disappear or get smaller over time and therefore are normally left alone, especially in younger women in which they are most common. However, the procedure for removal is simple and some women may choose to have the lumps removed.

· Fat Necrosis- This is an often painless swelling of fatty breast tissue, often occurring after surgery or injury to the breast. This tumor can look like cancer and is therefore sometimes removed by surgical biopsy.

· Sclerosing Adenosis- Is an enlargement of breast lobules which is sometimes painful and can contain calcifications.

· Intraductal Papilloma- This is a wart-like growth located inside the nipple which can cause discharge. It is usually treated by surgery.

 Do any breast conditions increase the risk of breast cancer?

Most breast conditions do not put a woman at increased risk for breast cancer. The conditions listed above are examples of this. Two conditions that may increase the risk of breast cancer are Atypical Ductal Hyperplasia (ADH) and Lobular Carcinoma in Situ (LCIS). A finding of either of these conditions should result in more frequent screenings and/or other interventions to reduce the risk of breast cancer.

 Questions to ask your doctor about breast irregularities:

Ø What type of lump do I have?

Ø Will I need to have a fine-needle aspiration?

Ø Will I need to have a biopsy?

Ø What are the risks and benefits of removing the lump?

Ø What are the risks and benefits of "watching and waiting"?

Ø Does my condition increase my risk for breast cancer?

Ø What are my treatment options?

Ø Would changing my diet help my condition??

For more information on breast changes see the NCI Booklet Understanding Breast Changes.