Fibrocystic breast disease; Mammary dysplasia; Diffuse cystic mastopathy; Benign breast disease; Glandular breast changes; Cystic changes; Chronic cystic mastitis; Breast lump - fibrocystic; Fibrocystic breast changes
Fibrocystic breasts are painful, lumpy breasts. Formerly called fibrocystic breast disease, this common condition is, in fact, not a disease. Many women experience these normal breast changes, usually around their period.
Fibrocystic breast changes occur when thickening of breast tissue (fibrosis) and fluid-filled cysts develop in one or both breasts. It is thought that hormones made in the ovaries during menstruation can trigger these breast changes. This may make your breasts feel swollen, lumpy, or painful before or during your period each month.
More than half of women have this condition at some time during their life. It is most common between the ages of 30 and 50. It is rare in women after menopause unless they are taking estrogen. Fibrocystic breast changes do not change your risk for breast cancer.
Symptoms are more often worse right before your menstrual period. They tend to get better after your period starts.
If you have heavy, irregular periods, your symptoms may be worse. If you take birth control pills, you may have fewer symptoms. In most cases, symptoms get better after menopause.
Symptoms may include:
You may have a lump in the same area of the breast that becomes larger before each period and returns to its original size afterward. This type of lump moves when it is pushed with your fingers. It does not feel stuck or fixed to the tissue around it. This type of lump is common with fibrocystic breasts.
Your health care provider will examine you. This will include a breast exam. Tell your provider if you have noticed any breast changes.
If you are over 40, ask your provider how often you should have a mammogram to screen for breast cancer. For women under 35, a breast ultrasound may be used to look more closely at breast tissue. You may need further tests if a lump was found during a breast exam or your imaging result was abnormal.
If the lump appears to be a cyst, your provider may aspirate the lump with a needle, which confirms the lump was a cyst and sometimes may improve the symptoms. For other types of lumps, additional imaging may be done. If these exams are normal but your provider still has concerns about a lump, a biopsy may be performed.
Women who have no symptoms or only mild symptoms do not need treatment.
Your provider may recommend the following self-care measures:
Some women believe that eating less fat, caffeine, or chocolate helps with their symptoms. There is no clear evidence that these measures help.
Vitamin E, thiamine, magnesium, and evening primrose oil are not harmful in most cases. Studies have not shown these to be helpful. Talk with your provider before taking any medicine or supplement.
For more severe symptoms, your provider may prescribe hormones, such as birth control pills or other medicine. Take the medicine exactly as instructed. Be sure to let your provider know if you have side effects from the medicine.
Surgery is never done to treat this condition. However, a lump that stays the same throughout your menstrual cycle is considered suspicious. In this case, your provider may recommend a core needle biopsy. In this test, a small amount of tissue is removed from the lump and examined under a microscope.
If your breast exams and mammograms are normal, you do not need to worry about your symptoms. Fibrocystic breast changes do not generally increase your risk for breast cancer. However, if you have a family history of breast cancer and fibrocystic changes, there is a small increase in the risk. Symptoms usually improve after menopause.
Contact your provider if:
American College of Obstetricians and Gynecologists website. Benign breast conditions. www.acog.org/womens-health/faqs/benign-breast-problems-and-conditions. Updated February 2021. Accessed January 21, 2023.
Klimberg VS, Hunt KK. Diseases of the breast. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 35.
Sandadi S, Rock DT, Orr JW, Valea FA. Breast diseases: detection, management, and surveillance of breast disease. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 15.
Sasaki J, Geletzke A, Kass RB, Klimberg VS, Copeland EM, Bland KI. Etiologoy and management of benign breast disease. In: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, eds. The Breast: Comprehensive Management of Benign and Malignant Diseases. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 5.BACK TO TOP
Review Date: 10/10/2022
Reviewed By: Jonas DeMuro, MD, Diplomate of the American Board of Surgery with added Qualifications in Surgical Critical Care, Assistant Professor of Surgery, Renaissance School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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