FIBROCYSTIC BREA...

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Definition

Fibrocystic breast disease refers to benign (noncancerous) changes in the tissues of the breast. The term "disease" in this case is misleading, and many health care providers prefer the term "change."

The condition is so common that it is believed to be a variation of normal. It may also be called mammary dysplasia, benign breast disease, and diffuse cystic mastopathy.

Alternative Names

Mammary dysplasia; Benign breast disease

Causes, incidence, and risk factors

The cause is not completely understood. The changes are believed to be associated with hormones produced by the ovaries because the condition usually subsides with menopause, when ovary function changes. The changes also may vary during the menstrual cycle.

Fibrocystic breast disease is estimated to affect over 60% of all women. It is common in women between the ages of 30 and 50, and rare in women who have gone through menopause. It is less common in women who take birth control pills.

Risk factors include a family history of the condition, a high fat diet, and excess caffeine intake, although these are controversial.

Symptoms

Symptoms may range from mild to severe. They typically peak before each menstrual period and improve immediately afterwards.

Symptoms include:

• Dense, irregular and bumpy "cobblestone" consistency in the breast tissue
  • Usually more noticeable in the outer upper part of the breast
• Breast discomfort
  • Usually in both breasts
  • May be persistent or it may come and go
• Breast feels full
• Dull, heavy pain and tenderness
• Premenstrual tenderness and swelling
• Occasional nipple discharge

Signs and tests

The health care provider will perform a breast exam. A breast exam will reveal breast "masses" that move and change shape. The masses are usually rounded with smooth borders and may feel rubbery.

Mammograms may be difficult to interpret because of dense breast tissue. A breast ultrasound can help identify cystic changes in the breast. A biopsy of the breast may be necessary to rule out other problems.

Aspiration of the breast with a fine needle can often diagnose and treat larger cysts.

Reviewer Info: Susan Storck, MD, FACOG, Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine; Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., 05/26/2008