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Understanding Fibrocystic Breasts
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It is NOT a disease!

If you have ever discovered one or more lumps in your breast, you were probably concerned. Such lumps often are caused by changes that can occur with the natural menstrual cycle of a woman’s body.

 

Most often, women who find lumps in their breasts are between the ages of 30 and 50. The same hormones that control the menstrual cycle—estrogen and progesterone—also can cause the breasts to become lumpy or “fibrocystic.” The incidence tends to decrease with menopause.

 

If you experience these fibrocystic changes, you may have noticed that your breasts tend to be more tender and painful before menstruation begins. The pain and tenderness usually subside after your period.

 

What are fibrocystic lumps?

Fibrocystic lumps are a benign (not cancerous) breast condition. Your doctor may refer to them as “fibrocystic changes” or a “fibrocystic condition.”

 

What is fibrocystic “disease”

Fibrocystic disease is basically a meaningless term covering all breast problems that are not cancerous. The symptoms, such as breast pain and lumpiness, are varied and not necessarily related to each another. To a pathologist, the term describes any one of about 15 histological (a term describing the microscopic characteristics of tissues) conditions that exist in virtually every woman's breasts, cause no trouble, and have no relation to cancer. They are the result of natural wear and tear. Of these conditions, only one -- ADH (atypical intraductal hyperplasia) -- is a danger sign because, if combined with a family history of breast cancer, it can suggest an increased degree of risk. Finally, to radiologists, the presence of large amounts of dense breast tissue signals fibrocystic disease. However, this is perfectly normal in younger women.

 

 

How are these lumps found?

Doctors estimate that up to 85% of breast lumps are found by patients through self-examination before they consult their physician or undergo a breast x-ray (mammogram). Self-examination should be done monthly, at least 5-10 days after menstruation, when breast swelling subsides.  If you no longer menstruate, choose a date and conduct a self-examination every month.

 

How are these lumps diagnosed?

If your physician recommends that a lump in your breast be biopsied (surgically removed and examined), a pathologist will examine the lump or tissue and determine if it benign or malignant (cancerous).  The pathologist will then consult with your physician regarding the diagnosis and appropriate treatment.

 

Myths about breast lumps—do they increase my risk of breast cancer?

There are two prevailing myths about breast lumps. One is that they are precursors of cancer; the other is that almost every substance on the planet is responsible for them. Over the years, chocolate and tea have been implicated, but caffeine has gotten the worst rap. They have also been thought to be a precursor of cancer. However there is little or no evidence to support most of these hypotheses, and you should file them away as "myth" not "fact." The idea that caffeine causes fibrocystic disease and all its alleged manifestations originated with an Ohio surgeon who tested his theory on 40 women in 1980. His research offers little real evidence to substantiate this claim. An honest statement about the effects of caffeine might be: "Some women have found that reducing caffeine in their diets has helped alleviate their breast symptoms. We have no real medical evidence to back it up, but it works for them and you might want to try it for a while and see if it helps you too."

 

What does it mean if my doctor tells me I have a fibrocystic condition?

It means that you have a common benign alteration on your breast tissue that may cause scarring and the formation of small, fluid-containing cysts.  In fact, there are other benign conditions that cause lumps in the breast.

 

Based on the pathologist’s examination, a benign change may be categorized as “no increased risk,” “slightly increased risk” (1.5 to 2 times the normal risk), or “moderately increased risk” (5 times the normal risk).

 

What is meant by relative risk?

These conditions have been grouped into three categories that describe the “relative risk” each has for later developing into breast cancer.  Relative risk is an estimate of the likelihood that a woman with a benign breast lesion will develop breast cancer, as compared with a woman who had no known significant breast abnormality.

 

            No increased risk of cancer: a woman whose biopsy shows one of these breast changes is at no greater risk for developing invasive breast cancer as compared with a woman who has no known significant breast abnormality:

         Apocrine metaplasia

         Duct ectasia

         Fibroadenoma

         Fibrocystic change

         Hyperplasia, mild

         Mastitis (inflammation)

 

Slightly increased risk (1.5 to 2 times): a woman whose biopsy shows one of these breast changes has a slightly increased risk (1.5 to 2 times) for developing invasive breast cancer as compared with a woman who has no known significant breast abnormality:

         Sclerosing adenosis

         Hyperplasia, moderate or sever (florid)

         Papilloma

 

 

Moderately increased risk (5 times): a woman whose biopsy shows one of these breast changes has a moderatley increased risk (5 times) for developing invasive breast cancer as compared with a woman who has no known significant breast abnormality:

         Atypical hyperplasia of ductal or lobular type