Fibrocystic Breast Disease

Fibrocystic disease is a condition in which benign (noncancerous) lumps form in the breast, either temporarily or for the duration of the childbearing years.

This condition is not dangerous in itself, but it has been found that women with certain forms of breast lumps may be two to four times more likely to develop breast cancer than are other women. To complicate matters, the presence of these benign lumps makes it difficult to detect any new, possibly dangerous growths.

Cause

The exact cause of fibrocystic disease is not known. However, the tendency to develop it may be inherited. Also, it is seen more often in women who have never breast-fed a child; the reason for this is not known.

Symptoms

The most noticeable symptom of this disorder is the presence of the lumps, which may take the form of either solid masses or fluid-filled sacs called cysts. Large cystic lumps near the surface can be moved about freely, unlike cancerous lumps, which are usually firmly attached to surrounding tissue. Changes in hormonal secretions during the menstrual period tend to increase the size of the lumps slightly, which causes additional pain, but the size of the cysts decreases after the period. Another symptom of fibrocystic breast disease is persistently heavy and tender breasts, not only before and during menstruation (as is commonly seen in healthy breasts) but all the time.

Diagnosis

Diagnostic evaluation will begin with a physical examination. Mammography (a special X-ray study of the breasts) and ultrasound are often done to determine whether the lumps are fluid-filled cysts or solid masses. If they are found to be solid, a biopsy (the removal of a small piece of tissue for analysis) may be performed to detect the presence of cancerous cells.

Treatment

Fibrocystic disease often requires no treatment. In some cases, the lumps disappear in a few months. Cysts that are unusually large or particularly bothersome may be drained of their fluid by the insertion of a hollow needle in a procedure called aspiration. If there are many small lumps or if there is continuous development of new ones, other forms of treatment may be necessary to prevent the formation of cysts. Birth control pills may be prescribed, since they act to equalize the concentration of hormones in the body throughout the monthly cycle; however, birth control pills have also been found to cause cysts in some women. Large doses of vitamin E (taken under a doctor's supervision) have reportedly been effective in treating fibrocystic disease.

Prevention

Relieving or preventing fibrocystic disease may be promoted by discontinuing or drastically limiting the intake of nicotine and a chemical called methylxanthine, found most commonly in coffee, tea, cola, chocolate, and some cold medications. Because certain forms of breast lumps carry a greater risk of breast cancer, women with lumps should have a physical examination regularly. They should also report any new growths or enlargements of existing lumps, and they should perform self-examination of their breasts each month after menstruation.