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Fibrocystic Changes


Maj Patel
One fairly common benign breast condition is known as fibrocystic changes. These changes in the breast tissue usually involve both the glandular and supporting, or stromal, tissues. This condition affects up to 50% of all women at some point, most often during their childbearing years. Major Spencer, can you tell us more about fibrocystic changes?

Maj Spencer
Definitely, Dr. Patel. The term "fibrocystic" refers to the fact that both fibrosis and cysts are often present in the breast. Fibrosis is a fibrous tissue similar to ligaments and to scar tissues. Fibrosis often changes the way that a breast feels to the touch, for example making areas of the breast feel hard or "rubbery." Fibrosis does not increase the risk of developing breast cancer and usually does not require any special treatment.

The cysts that characterize fibrocystic breast changes are spaces filled with fluid lined by breast glandular cells. Fluid builds up inside the glands of the breast, initially forming small cysts, or microcysts, that are detectable only when breast tissue is examined under a microscope. If fluid continues to build up, larger cysts, or macrocysts, can develop. These cysts can be detected during a self-exam and can grow to several inches in diameter. As cysts grow, they can cause pressure and stretching of the surrounding breast tissue, which can be uncomfortable. These cysts often become larger and more painful just before a woman’s period, as a result of monthly hormonal changes.

Frequently a lump found in a woman’s breast is simply a result of fibrocystic changes, and the cysts that have developed. A round lump that can be moved and is tender to the touch is often a cyst. An ultrasound can confirm the presence of the cyst, and the cyst can often be drained using a technique called fine needle aspiration. Removing the fluid can reduce the pressure and pain. Fluid may sometimes accumulate again, and more aspirations may be necessary. Having one or more cysts does not affect the risk of later developing breast cancer.

Symptoms of fibrocystic changes can include:

  • Pain or discomfort in both breasts
  • Pain that commonly comes and goes with your period, but may last through the whole month
  • Breasts that feel full, swollen, or heavy
  • Thick or lumpy breasts, and
  • A lump that grows and shrinks with your menstrual cycle. This type of lump moves when you push it with your fingers.

Women who have heavy, irregular periods often have worse symptoms, and women who take birth control pills may have fewer symptoms. In most cases, symptoms improve or go away after menopause.

While there is no specific treatment for fibrocystic changes, your provider may suggest some self-care measures. These can include:

  • Taking over-the-counter pain relievers, such as acetaminophen or ibuprofen
  • Applying heat or ice on the breast, and
  • Wearing a well-fitting bra or sports bra