Fibrocystic breasts

DEFINITION

Fibrocystic breasts are composed of tissue that feels lumpy or rope-like in texture. Doctors call this nodular or glandular breast tissue.

It’s not at all uncommon to have fibrocystic breasts. More than half of women experience fibrocystic breast changes at some point in their lives. In fact, medical professionals have stopped using the term “fibrocystic breast disease” and now simply refer to “fibrocystic breasts” or “fibrocystic breast changes” because having fibrocystic breasts isn’t really a disease.

Although breast changes categorized as fibrocystic breasts are normal, they can cause breast pain, tenderness and lumpiness — especially in the upper, outer area of your breasts. Breast symptoms tend to be most bothersome just before menstruation. Simple self-care measures can usually relieve discomfort associated with fibrocystic breasts.

It’s important to have your breasts evaluated if you have specific areas where pain continues to occur or worsens, or if you have new areas of lumps or thickening that persist after your period. Your doctor will examine you to see if the new changes are concerning and to eliminate other causes.

CAUSES

The exact cause of fibrocystic breast changes isn’t known, but experts suspect that reproductive hormones — especially estrogen — play a role.

If you aren’t yet menopausal, your discomfort may result from the way your hormone levels fluctuate during your menstrual cycle. The fluctuations can make your breasts have areas of lumpy thickening that feel tender, sore and swollen. Those fibrocystic breast changes often feel the worst before your menstrual period, and the pain and lumpiness tends to clear up once your menstrual period begins.

When examined under a microscope, fibrocystic breast tissue includes distinct components such as:

• Fluid-filled round or oval sacs (cysts)
• A prominence of scar-like fibrous tissue (fibrosis)
• Overgrowth of cells (hyperplasia) lining the milk ducts or milk-producing tissues (lobules) of the breast
• Enlarged breast lobules (adenosis)

SYMPTOMS

Signs and symptoms of fibrocystic breasts may include:

• Breast lumps or areas of thickening that tend to blend into the surrounding breast tissue
• Generalized breast pain or tenderness
• Fluctuating size of breast lumps
• Green or dark brown nonbloody nipple discharge that tends to leak without pressure or squeezing
• Changes that occur in both breasts, rather than just one
• Monthly increase in breast pain or lumpiness from midcycle (ovulation) to just before your period

Fibrocystic breast changes occur most often in women in their 20s to 50s. Rarely do postmenopausal women experience fibrocystic breast changes, unless they’re on hormone therapy.

When to see a doctor

Most fibrocystic breast changes are normal. However, if you find a new breast lump or area of thickening that persists after your period, or if a previously evaluated breast lump seems to have grown or otherwise changed, make an appointment with your doctor to get it checked out.