Fibrocystic Breast Disease

Fibrocystic breast disease describes areas of dense, thick breast tissue, cysts, and breast lumps. Also known as mammary dysplasia, diffuse cystic mastopathy, or benign breast disease, fibrocystic breast disease affects approximately sixty percent of women at some point in their lives. While referred to as a disease, fibrocystic breast disease is so common that many doctors consider the condition to be part of the normal range of female breast composition, and prefer to use the term fibrocystic breast disorder.

Fibrocystic breast disease refers to unusually dense breast tissue. The breast contains a higher than normal amount of fibrous tissue, the same tissue found in ligaments and scar tissue. Dense areas of fibrocystic tissue may give breasts a bumpy, irregular consistency.

Women with fibrocystic breast disease may also develop painful breast cysts and breast lumps. Discovering a breast lump is disconcerting, and raises the specter of breast cancer. However, only five percent of physical changes and breast lumps associated with fibrocystic breast cancer are thought to even be risk factors for breast cancer.

The exact cause of fibrocystic breast disease is unknown, but is thought to be related to estrogen and other ovarian hormones. Discomfort and pain caused by fibrocystic cysts and breast lumps often worsen just before a woman's menstrual period, and become less painful at the end of the period.

Women between the ages of thirty and fifty are most likely to develop fibrocystic breast disease. The condition is rare in postmenopausal women. Women taking estrogen/progesterone oral contraceptives are less likely to develop fibrocystic tissue, cysts, and breast lumps than women not taking birth control pills.

The most obvious symptom of fibrocystic breast disease is the presence of dense tissue or "lumpiness" in the breasts. Breasts may have a "cobblestone" texture, or feel as if tiny balls or beads are scattered throughout the tissue. Fibrocystic tissue is often found in the upper area of the breast, and ridge-like areas of thick tissue may develop on the breasts' undersides.

Breast lumps associated with fibrocystic breast disease usually have smooth borders, and are slightly rubbery when manipulated. Unlike breast cancer, where the breast lump usually develops in one breast, fibrocystic breast lumps and cysts tend to affect both breasts.

Cysts associated with fibrocystic breast disease develop when fibrocystic tissue blocks milk ducts. The cyst is filled with fluid and starts a tiny microcyst too small to be seen without a microscope. Over time, cysts grow larger, and can reach up to half an inch in length. Large cysts, or macrocysts, press on surrounding breast tissue and milk ducts, and can cause varying degrees of pain.

In addition to breast lumps, thick breast tissue, and cysts, fibrocystic breast tissue symptoms include:

Certain factors have been suggested as fibrocystic breast disease triggers, but none have been proven to definitely increase the risk of the condition. A family history of fibrocystic breast disease may up a woman's risk level slightly. Diets rich in fat and excessive caffeine consumption have also been suggested as possible risk factors, but any firm connection between fibrocystic breast disease and diet has yet to be established.

Diagnosis of fibrocystic breast disease usually begins when a physical examination discovers a breast lump or lumps. The thick fibrocystic tissue surrounding cysts and breast lumps may make physical examination or mammography (breast x-ray) results difficult to interpret. If so, a biopsy sample may be gathered to rule out breast cancer. Fine needle aspiration uses a long, thin needle to gather tissue samples from cysts and breast lumps.

Treatment options for fibrocystic breast disease are limited. While some women report symptom relief by changing their diet to less than 25 percent fat and avoiding caffeine, reports of this treatment's success are largely anecdotal. Moist, hot compresses applied to the breasts provide some relief when symptoms flare up.

Large cysts produced by fibrocystic breast disease can be drained using fine needle aspiration. Fluid often returns in time, however, along with symptoms of pain and discomfort.

Generally, breast lumps associated with fibrocystic breast disease are left untreated. A breast lump that changes shape, consistency, or which does not vanish over time may require a biopsy or surgical removal to rule out cancer. While fibrocystic breast disease itself does not significantly increase the risk of breast cancer, thick fibrous tissue, breast lumps, and cysts can interfere with breast cancer screening techniques, making it possible to miss the early development of a breast tumor.

Resources

American Cancer Society. (updated 2003). Benign breast conditions.

American Cancer Society. (nd). Fibrocystic breasts: A non-disease.

American College of Obstetricians and Gynecologists. (2000). Fibrocystic breast changes. Medem Medical Encyclopedia.

National Library of Medicine. (updated 2004). Fibrocystic breast disease. MedlinePlus Medical Encyclopedia.