Dear Dr. Gott: I am a 37-year-old female. I have been told that I have fibrocystic breast tissue (in both breasts). This is an extremely painful condition, but I was told that nothing could be done for it. The pain has gotten so bad that there are days I can hardly stand it. It has become a problem between my husband and me. Is there anything you can tell me about this condition? Is there anything I can do about the pain? I have had mammograms, and nothing was found. I can’t stand it anymore!
Dear Reader: Fibrocystic breasts are fairly common, with more than half of all women experiencing fibrocystic changes within their lifetimes. These changes involve the development of cysts, the overgrowth of cells lining the milk ducts (hyperplasia) or the milk-producing tissues (lobules), scar-like tissue (fibrosis) and enlarged breast lobules.
These changes are normal and most often occur in women between ages 20 and 50. Postmenopausal women rarely experience these changes unless they are on hormone therapy.
Symptoms include breast lumps, pain or tenderness, areas of thickening, fluctuating lump size, increasing pain or “lumpiness” from ovulation until just before menstruation and green or dark brown non-bloody nipple discharge.
Women with absent or minor symptoms do not require treatment. Severe pain or large cysts may necessitate therapy. Aspirating cysts is beneficial. The fluid confirms that the lump is a cyst and not a tumor. It essentially removes the lesion and often reduces the pain. If a cyst continues to return after aspiration, surgical removal may be appropriate.
Pain is often treated with over-the-counter relievers such as acetaminophen or ibuprofen. Oral contraceptives can ease the pain caused by menstrual cycles. Danazol is a prescription medication that can relieve severe breast pain by mimicking a male sex hormone; however, it can cause acne, excess body hair and more, thus limiting its use.
Home remedies include a low-fat diet, avoiding caffeine, wearing a sports bra during exercise and while sleeping, and using a firm support bra (professionally fitted is best). Some women have found that taking one capsule of evening primrose oil up to three times a day can manage breast pain and other symptoms.
Fibrocystic breast changes are not a risk factor for breast cancer; however, because some of the symptoms overlap, it is important to undergo testing to ensure that the lesions caused by the cysts or thickening are not, in fact, caused by cancer or a tumor.
As you can plainly see from my answer, there are, in fact, several things you can do in an effort to relieve the pain you are experiencing. Either return to your physician and demand answers as to why he or she didn’t provide you with this information or request a referral to a gynecologist with experience in diagnosing and treating painful fibrocystic breasts.
There is no reason for you to suffer from severe and near-debilitating pain when there are treatment options available that may help. Your doctor has dropped the ball. If you would like to learn more about your condition, the Mayo Clinic has an easy-to-understand article online at www.MayoClinic.com/health/fibrocystic-breasts/DS01070.
To provide related information, I am sending you a copy of my Health Report “Managing Chronic Pain.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.