Explaining Fibrocystic Breast Disease

If you have ever discovered one or more lumps (a change in the density of an area of the breast), you were probably concerned. Such lumps often are caused by changes that can occur with the natural menstrual cycle of a woman's body.

Generalized breast lumpiness is one common type of benign (not cancerous) breast change. Benign breast conditions also include several types of distinct, solitary (single) lumps. Such lumps, which can appear at any time, may be large or small, soft or rubbery, fluid-filled or solid.

Generalized breast lumpiness is known by several names, including fibrocystic changes, fibrocystic disease, and benign breast disease. Such lumpiness, which is sometimes described as "ropy" or "granular," can often be felt in the area around the nipple and areola and in the upper outer part of the breast. During pregnancy, the milk-producing glands become swollen and the breasts may feel lumpier than usual. It can be difficult for a woman to examine her breasts when she is pregnant, but she should continue to do so; although very uncommon, breast cancer has been diagnosed during pregnancy. Lumpiness may become more obvious as a woman approaches middle age and the milk-producing glandular tissue of her breasts increasingly gives way to soft, fatty tissue.

Most often, women who find lumps in their breasts are between the ages of 30 and 50. The same hormones that control the menstrual cycle - estrogen and progesterone-also can cause the breasts to become lumpy or "fibrocystic." The incidence tends to decrease with menopause.

Cysts are fluid-filled sacs and they often enlarge and become tender and painful just before the menstrual period. They are usually found in both breasts. Some cysts are so small they cannot be felt; rarely, cysts may be several inches across. Cysts are usually treated by observation or by fine needle aspiration. They show up clearly on ultrasound. The pain and tenderness usually subside after your period.

The pathologist's diagnosis of the removed tissue enables your doctor to estimate what risk, if any, you have of developing a cancer.

A woman whose biopsy shows one of the breast changes listed below is at no greater risk for developing invasive breast cancer as compared with a woman who has no known significant breast abnormality:

  • Apocrine metaplasia
  • Duct ectasia
  • Fibroadenoma
  • Fibrocystic change
  • Hyperplasia, mild
  • Mastitis (inflammation)

A woman whose biopsy shows one of the changes listed below has a slightly increased risk (1.5 to 2 times) for developing breast cancer as compared with a woman who has no known significant breast abnormality:

  • Sclerosing adenosis
  • Hyperplasia, moderate or severe (florid)
  • Papilloma

A woman whose biopsy shows the change listed below has a moderately increased risk (5 times) for developing breast cancer as compared with a woman who has no known significant breast abnormality:

  • Atypical hyperplasia of ductal or lobular type

The information provided here is only to educate women about fibrocystic changes and other benign conditions of the breast. If you discover any lumps in your breasts, consult your physician. Use this information to help you understand what you may be experiencing and to assist you in knowing what questions to ask your doctor.

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