Fibrocystic Breast Disease

Fibrocystic breast disease (FBD), or fibrocystic breast condition or changes, is described as common, benign changes involving the tissues of the breasts. Common breast symptoms are swelling and tenderness, nodularity, palpable lumps, nipple discharge, and inflammation. These changes are typically accompanied by breast pain. The discomfort associated with fibrocystic breast disease is often in the upper outer quadrant, is diffuse, and may radiate to the axilla or upper arm. The incidence of fibrocystic breast disease is estimated to be up to 70% of all women. It can occur in women aged 18 or older, but is most common in women between the ages of 30 and 50, and rare in postmenopausal women.

Fibrocystic Breast Disease

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The cause of pain associated with fibrocystic breast disease is not completely understood; however, changes in the breast tissue are believed to be associated with ovarian sex hormones because the condition usually subsides with menopause and may vary in intensity during the menstrual cycle. Hormone imbalances have been suggested, such as increased estrogen secretion, deficient progesterone production, and hyperprolactinemia. In fibrocystic breast disease there is a wide spectrum of histopathological changes (microscopic tissue changes) from relatively normal histologic findings to features that exhibit mainly patterns of fibrous change and cyst formation.

Diagnosis

Physical examination by physicians is the first step in the diagnosis of the condition. Lumpy breasts are not necessarily indicative of breast cancer. These lumps can be benign (non-cancerous) and can be definitively characterized with either mammograms, MRIs, or ultrasounds.

Having lumpy breasts and being diagnosed with fibrocystic breast disease does not increase a woman’s risk of developing cancer. However, fibrocystic breast disease can mask potentially cancerous lumps. Women with fibrocystic breast disease should be diligent in their breast self-exams and physician exams.

Treatment

Once cancer has been ruled out, treatment for nodularity is unnecessary. However, some cysts may be aspirated to alleviate pain. There are non-surgical methods of dealing with the pain associated with fibrocystic breasts.

Treatment strategies for pain associated with fibrocystic breast disease range from conservative treatment methods such as non-prescription analgesics, properly fitted brassieres, diet change, the application of local heat, or application of evening primrose oil. However, little scientific data exists on the effectiveness of these treatments. Patients may use prescription analgesics, but in more severe cases danazol may be prescribed. Danazol has several significant side effects and is only prescribed for severe cases. With the exception of danazol, no other therapeutic is approved to treat the painful symptoms of fibrocystic breast disease.

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