Fibrocystic Breasts

Breasts that feel lumpy or rope-like are called fibrocystic breasts. Sometimes they are referred to as nodular or glandular breast tissue.

Many women experience fibrocystic changes in their breasts at some point in their life. Fibrocystic changes mostly occur in women between the ages of 20 and 50, although it can also affect postmenopausal women on hormone therapy.

Most women with fibrocystic breasts do not experience any symptoms. However, when symptoms are present they may include: pain in the breasts, tenderness and lumps mostly in the superior, lateral part of the breast.

These symptoms may become intense just before menstruation and tend to disappear at the beginning of the menstrual cycle.

When fibrocystic breast tissue is examined under the microscope it includes the following distinct properties:

• round sacs filled with fluid (cysts)
• a prominence of scar-like fibrous tissue
• overgrowth of cells (hyperplasia) lining the milk producing or milk ducts of the breast
• enlarged breast lobules

Treatment is usually not required.

Signs and symptoms of fibrocystic breasts may include:

• lumps in the breasts
• generalized pain and tenderness in the breast
• lumps that increase in size just before menstruation

Although the exact cause of fibrocystic breasts is unknown, many doctors believe it occurs to imbalances in reproductive hormones like estrogen.

During the menstrual cycle, the hormone levels fluctuate and this can cause breast discomfort and areas of breasts may feel lumpy, tender, swollen and painful.

Once the menstrual period begins, the pain and lumpiness tend to decrease or disappear.

Tests to diagnose fibrocystic breasts include:

• a clinical breast exam, in which a doctor examines the breasts visually and manually to check if there are any lumps or tenderness in the breasts
• mammogram, this test is usually done if a doctor suspects fibrocystic breasts. X-ray images are made to detect breast lumps or thickening of the breast tissue
• ultrasound, is a test in which sound waves are used to produce images of the breasts. Ultrasound is mostly used in women who are below the age of 30. An ultrasound is more preferred since it can help doctors to distinguish between fluid-filled cysts and solid masses.
• a breast biopsy is a procedure in which a small sample of the breast tissue is removed for microscopic analysis

Treatment may not be required in women who don't experience any symptoms of fibrocystic breasts. However, treatment is required if a woman experiences intense pain and has large cysts.

Treatment options may include:

• Fine needle aspiration in which a doctor uses a needle to remove the fluid in the breasts if cysts are found. This helps to relieve discomfort associated with fibrocystic breasts.
• Surgical removal of the cysts or lumps. Breast pain is usually relieved by taking over-the-counter pain killers like acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin IB) and aspirin. Taking oral contraceptives can also help to relieve pain since oral contraceptives lower the levels of hormones that are related to fibrocystic changes of the breasts.

Alternative remedies like evening primerose oil and taking vitamin E can help lessen the breast pain and severity of fibrocystic breasts.

A maximum dose of 1,000 milligrams or 1,500 IU of vitamin E is required for women who are older than 18 years, pregnant or breastfeeding.

There is no evidence to suggest that women with fibrocystic breasts have an increased risk of having breast cancer in the future.