Fibrocystic changes are the most common form of breast lumps in women age 30 to 50. The condition is benign (non-cancerous). Physicians in our practice do not like to refer to this as “fibrocystic disease” since it occurs in over 50% of women in this age group. We like to refer to it as “fibrocystic change.”
This condition is usually diagnosed by a physician at the time of the breast examination. Hormone changes through the month and the way breasts respond to these hormones are the cause of fibrocystic change. The reaction to the ups and downs of hormones causes many pockets of fluid to form. These pockets are called cysts and can lead to an increase in fibrous tissue in the breasts. The breasts frequently feel swollen, painful, tender, and lumpy the week before a menstrual cycle and then decrease within the week after menstruation. For this reason, the best time for a patient to do self-breast examination is the week following a menstrual cycle. Both breasts are usually affected by fibrocystic change. For most women, fibrocystic changes stop forming after menopause.
If breast lumps thought to be due to fibrocystic change are found on examination, they are sometimes followed for resolution over one menstrual cycle. If resolution does not occur, further tests may be recommended. These tests include mammography, ultrasonography, and cyst drainage.
For some women, the pain is excessive, and they cannot exercise or lie on their abdomen. The pain can often be controlled with ibuprofen. Heat application, a good support bra, and avoidance of excess caffeine products are helpful as well. Evening primrose oil capsules can also be helpful.
We recommend yearly breast examination in the office, monthly self–breast examination with changes requiring an office visit, and mammography. Mammography should start at age 40 unless there is a positive family history of breast cancer (and then it should start earlier).