Fibrocystic Breast Disease© Susan M. Lark M.D.
Thirty percent of American women have fibrocystic breast disease, a
benign (noncancerous) condition characterized by round lumps that
move freely within the breast tissue. This lumps are usually tender
to the touch. In contrast, a cancerous growth in the breast is often
not tender or freely movable when touched. The texture of the lumps
can vary from soft to firm. For many women, the tenderness may
increase as menstruation approaches. Often the cysts fill with fluid
and can enlarge premenstrually in response to the increase in
hormonal levels during this time.
The main hormones implicated in the worsening of breast symptoms
premenstrually include estrogen, the main female hormone, and
prolactin, the milk release hormone secreted by the pituitary gland.
Dietary factors have also been implicated. These include caffeine
intake from coffee, black teas, colas, and chocolate, as well as
excessive saturated fat and salt. Usually the symptoms of pain and
swelling do not persist once menstruation begins, and most women
notice significant relief at this time. The difference in the breast
swelling can be so marked between the first and second half of the
menstrual cycle that some women actually change bra size.
With repeated cycles of hormonal stimulation, the breast cysts may
become chronically inflamed and surrounded by fibrous tissue which
can harden and thicken the cysts. It is then more difficult for the
fluid trapped in the cysts to escape and be reabsorbed by the body.
This condition occurs most frequently in women in their late
thirties and forties. To distinguish these hardened cysts from
cancer, physicians often perform a simple office procedure called a
needle aspiration. In this procedure, a needle is used to remove
fluid from the cyst. This helps relieve pressure from the cyst on
the surrounding tissue if it is causing pain, as well as rule out
breast cancer. A mammogram will also help distinguish a breast cyst
from breast cancer.
However, if there is a lingering concern
about making an accurate diagnosis, a surgical biopsy might be
performed. This is done under a local anesthetic in a physician's
office or clinic or under general anesthesia in a hospital setting.
A biopsy allows the physician to remove the entire breast mass so
that the cells can be examined microscopically for any cancerous
changes. Fortunately, most masses are benign.
eliminating certain foods from the diet (caffeine, saturated fats,
and salt), a high-fiber diet, including many plant-based foods,
fruits and vegetables, beans and peas, raw seeds and nuts, and whole
grains may help prevent cyclical fluctuations in cyst size and
tenderness. The addition of seafood to the diet, particularly fish,
may be useful in preventing breast cysts due to the iodine content
and healthy oils contained in certain fish. The best fish for female
health include those high in the Omega-3 fatty acids like salmon,
trout, and mackerel.