Category Archives: Fibrocystic breasts

Fibrocystic breast illustrating fibroadenoma

Fibrocystic breasts

ICD-9: 610.1


Fibrocystic breasts are breasts with palpable lumps or cysts that fluctuate in size with the menstrual cycle. The condition is seen more frequently in women ages 30 to 55 and rarely after menopause. Fibrocystic breast tissue exhibits fluid-filled round or oval cysts, fibrosis, and hyperplasia of the cells lining the milk ducts or lobules of the breast. Fibrocystic breasts are fairly common; more than half of women experience fibrocystic breast changes at some point in their lives. Medical professionals stopped using the term fibrocystic breast disease because fibrocystic breasts are not considered a disease.

Fibrocystic breast illustrating fibroadenoma

FIGURE. Fibrocystic breast illustrating fibroadenoma.


The causes of fibrocystic breasts are not well understood, but they are linked to the hormonal changes associated with ovarian activity. There is a tendency for fibrocystic breasts to run in families.

Signs and Symptoms

There may be widespread lumpiness or a localized mass, usually in the upper, outer quadrant of the breast. Pain, tenderness, and feeling of fullness are likely before menstruation. There can be fluctuating size of breast lumps, nonbloody nipple discharge (rare), and changes in both breasts.

Diagnostic Procedures

Monthly breast self-examinations cannot be overemphasized. Palpation is essential. A mammogram is especially useful if there is any suspicious change in the breast. Ultrasound is particularly helpful in distinguishing between fluid-filled breast cysts and any solid masses. When a suspicious area is discovered through these tests, a biopsy is essential to confirm the diagnosis. The clinical picture of pain, fluctuation in size, and lumpiness helps to differentiate fibrocystic breasts from breast cancer.


No treatment is usually warranted; however, severe pain or large cysts may need treatment. Treatment is usually fine-needle aspiration to draw the fluid from the cyst or, on rare occasions, surgical excision. Acetaminophen or ibuprofen can reduce pain; oral contraceptives to lower the hormone levels linked to fibrocystic breasts may be prescribed. Breast pain also may be lessened with a good supportive bra. Caffeine intake may be restricted, salt intake reduced, and a low-fat diet advised because some studies indicate that these steps may reduce symptoms.

Complementary Therapy

Many women take one capsule of evening primrose oil up to three times a day to manage symptoms of fibrocystic breasts. It is believed that evening primrose oil may replace linoleic acid in women who are deficient in this essential fatty acid that can help to make breast tissue less sensitive to hormonal influences. Removing all forms of caffeine from the diet is suggested.

Client communication

Teach clients how to perform breast self-examinations. Fibrocystic breasts often feel lumpy, and clients can best assess whether the lumps they feel are normal or abnormal.


The prognosis is good, although exacerbations may continue until menopause, after which they subside. Fibrocystic breasts can make breast examination and mammography more difficult to interpret, possibly causing a few early cancerous lesions to be overlooked.


There is no known prevention. Monthly selfexamination of the breasts and regular mammography are advised. Reducing caffeine and fat in the diet are other helpful measures.

Fibrocystic Breast Disease: Signs, Symptoms, and Treatment

Understanding Fibrocystic Breast Disease

Fibrocystic breast disease, like fibroids, PMS, and menstrual irregularities are all parts of the continuum of estrogen excess in your body. Fibrocystic breast disease tends to be one of the first symptoms of estrogen dominance. It can affect women of 20 to 50 years and even teenagers.

Let’s take a step back so that we can understand the concept of fibrocystic breast disease. When you are growing, estrogen is very necessary. It is most of the time balanced with progesterone. When your body produces estrogen in excess, it flows into different tissues of your body, including the breast, and then the fibrocystic breast disease can become an issue. Fibrocystic breast disease is a type of condition that causes breast pain, non-cancerous breast lumps, and cysts.

Most young girls begin their menstruation at the age of 10 nowadays even though historically, the menstruation period began between ages 14 and 16 as recently as one generation ago. Menopause occurs around age 50. This unprecedented extension of the menstrual lifetime can have a devastating effect on women. This is especially especially true for areas sensitive to high estrogen such as the breast and ovaries. The fluctuating estrogen level accounts for inflammatory tendencies with cysts and swelling common in women suffering from PMS.

Cysts are fluid-filled sacs found in the breast. The often feel soft and oval shaped, but a cyst which is deep within the breast may feel hard. A woman who has a cyst in her breast may experience pain, particularly if the cyst increases in size ahead of the menstrual cycle.

What Are the Signs and Symptoms of Fibrocystic Breast Disease?

If you are experiencing fibrocystic breast disease, you may experience the following:

  • Pain
  • Swelling
  • Tenderness
  • Lumps in one or both breasts
  • Thickening of tissue
  • Increased swelling or lumps in one of your breasts compared to the other
  • Pain under your arms
  • A dark brown or green discharge from the nipple
  • Aching or sharp pain
  • Itching
  • Burning

Other symptoms may include:

  • Wandering tension
  • Irritability
  • Brain fog
  • Period pain and heavy bleeding

The symptoms are not static and can vary during your menstrual cycle as fluid changes in the breast are driven by hormone fluctuations. Changes in the breast as a result of hormone fluctuations also may appear during pregnancy

Types of Fibrocystic Breast Disease

Most fibrocystic breast diseases are the outcome of monthly hormonal changes. There are two types of fibrocystic breast changes:

Fibrosis: Fibrosis is fibrous tissue that is similar to a scar tissue. It may be hard to the touch and feel rubbery or firm.

Cysts: These are fluid-filled sacs. They may enlarge to the point that you can feel them. The cyst may enlarge and become tender before your period. It may be difficult to differentiate between a solid mass and a cyst because they tend to be movable and round.

Getting to the Root of Fibrocystic Breast Disease

When you are suffering from fibrocystic breast disease your breast feels enlarged and it can often become lumpy. Ultrasound can show multiple cysts, and this can be very uncomfortable. These cysts are often made worse during the menstrual cycle.

Fibrocystic breast disease is one of the signs of a body in hormonal imbalance. Most health professional, conventional doctors especially, will attempt to resolve this with the use of birth control pills. There are benefits to this, but at the same time it really just suppresses the symptoms and does not address the real, underlying cause of the fibrocystic breast disease.

If you have the symptoms mentioned above, check with your doctor to make sure that everything is fine. However, if you also have other symptoms, including possibly wandering tension, irritability, brain fog, as well as period pain and heavy bleeding, you need to think about what is really going on in your body that is causing these symptoms. These are not normal signs from your body. These are behaviors that your body is trying to send you a message, and the message is do not put more estrogen in the system.

Estrogen Dominance and Adrenal Fatigue

As mentioned earlier, fibrocystic breast disease is part of the estrogen dominance continuum. Estrogen dominance is the result of excessive estrogen over time. Symptoms of estrogen dominance also include PMS, fibroids, endometriosis, and cancer. Estrogen dominance is very serious in that it can start at an early age, even as a teenager, but often goes unnoticed. One possible cause of estrogen dominance is the intake of estrogenic compounds which are structurally similar to estrogen. Estrogen is very prevalent in the modern world. It exists in our food, from hormones in meat; it can even come from our garden. Xenoestrogens, compounds that act like estrogen, are present in chemicals that exist in many products including shampoo and plastic containers. So there is a host of places where we get estrogen.

Not only can estrogen dominance encourage fibrocystic breast disease, but it can also stimulate the tissue of the breast and can lead to breast cancer. Estrogen is largely secreted from the ovaries, adipose tissue(fat cells), and the adrenal glands.

Adrenal Fatigue and Fibrocystic Breast Disease

When the body is stressed and low on energy, the adrenal glands can shunt production of progesterone towards cortisol, the anti-stress hormone. When this occurs, progesterone levels drop as its building blocks are instead converted into cortisol. One of progesterone’s function in the body is to help balance estrogen function. Accordingly, a drop in progesterone leads to a rise in estrogen on a relative basis. This does not result in an absolute increase in the estrogen levels in your blood, but estrogen dominance is still present as the ratio of estrogen to progesterone is skewed, leading to estrogen dominance. If you have are overweight, then the increase in fat tissue also boosts estrogen levels. This increased estrogen can lead to fibrocystic breast disease, so look at fibrocystic breast disease as a symptom.

Remedies for the Fibrocystic Breast Disease

In many cases of fibrocystic breast disease, you need a breast examination to be able to ascertain the proper remedy. Your doctor may be able to help you remove the fluid to relieve the pain, but the fluid will likely return later. You can also try the following to assist you with mild discomfort:

  • Reduce the amount of stimulants and caffeine you are consuming, such as coffee, which stimulates adrenal gland function.
  • Reduce stress and physical overexertion.
  • Use a supportive bra to avoid physical trauma to the cysts that can increase inflammation.
  • Stop or reduce taking synthetic hormone therapy. Bioidentical hormone replacement needs to be carefully considered to weigh the risk and benefits.
  • Use warm water or heating pad for any pain or discomfort.
  • Wear a sport bra while sleeping or during exercise for extra support.

Supplement Consideration:

  • Iodine supplementation (12-50 mg daily): fibrocystic breast disease and iodine deficiency are strongly associated. Iodine supplementation has been shown to improve fibrocystic breast disease.
  • Natural progesterone cream (20 mg topically): natural progesterone can help offset estrogen dominance and relieve fibrocystic breast pain.
  • Calcium D glucurate (200-800 mg daily): Calcium D glucarate helps eliminate excess estrogen in the body, thereby decreasing estrogen dominance and improving fibrocystic breasts.

Fibrosis and Simple Cysts in the Breast

Many breast lumps turn out to be caused by fibrosis and/or cysts, which are non-cancerous (benign) changes in breast tissue that happen in many women at some time in their lives. These changes are sometimes called fibrocystic changes, and used to be called fibrocystic disease.

Fibrosis and/or cysts are most common in women of child-bearing age, but they can affect women of any age. They may be found in different parts of the breast and in both breasts at the same time.


Fibrosis refers to a large amount of fibrous tissue, the same tissue that ligaments and scar tissue are made of. Areas of fibrosis feel rubbery, firm, or hard to the touch.


A round, movable lump, which might also be tender to the touch, suggests a cyst. Cysts are fluid-filled, round or oval sacs within the breasts. They are most often found in women in their 40s, but they can occur in women of any age. Monthly hormone changes often cause cysts to get bigger and become painful and sometimes more noticeable just before the menstrual period.

Cysts begin when fluid starts to build up inside the breast glands. Microcysts (tiny, microscopic cysts) are too small to feel and are found only when tissue is looked at under a microscope. If fluid continues to build up, macrocysts (large cysts) can form. These can be felt easily and can be as large as 1 or 2 inches across.


Most often, fibrocystic changes are diagnosed based on symptoms, such as breast lumps, swelling, and/or tenderness or pain. These symptoms tend to be worse just before your menstrual period begins, and may change as you move through different stages of your menstrual cycle. Your breasts may feel lumpy and, sometimes, you may notice a clear or slightly cloudy nipple discharge.

Sometimes, one of the lumps might feel firmer or have other features that lead to a concern about cancer. When this happens, an ultrasound may be done to see if the lump is solid or is just filled with fluid (called a simple cyst). If the ultrasound shows the lump is solid or if the cyst has both fluid and solid components (a complex cyst), a biopsy may be needed to make sure that it’s not cancer.

How do fibrosis and simple cysts affect your risk for breast cancer?

Neither fibrosis nor simple cysts increase your risk of later developing breast cancer. Complex cysts are more of a concern, as there is a small chance they might contain cancer or put you at risk of cancer later on, depending on what is found at the time of biopsy.


Cyst fluid doesn’t need to be removed unless it’s causing discomfort. But it can be drained by putting a thin, hollow needle into the cyst, which might be done to confirm the diagnosis. Removing the fluid may reduce pressure and pain for some time. If removed, the fluid might come back later, but cysts may also go away over time. For cysts that continue to come back and cause symptoms, surgery to remove them might be an option.

Most women with fibrocystic changes and without bothersome symptoms do not need treatment, but they might be watched closely. If you have mild discomfort from fibrosis, you may get relief from well-fitted, supportive bras, applying heat, or using over-the-counter pain relievers.

Some women report that their breast symptoms improve if they avoid caffeine and other stimulants found in coffee, tea, chocolate, and many soft drinks. Studies have not found that these stimulants cause these symptoms, but many women feel that avoiding these foods and drinks for a couple of months is worth trying.

Because breast swelling toward the end of the menstrual cycle is painful for some women, some doctors recommend pain relievers such as acetaminophen or ibuprofen, or other medicines. It’s been suggested that some types of vitamin or herbal supplements might relieve symptoms, but so far none have been proven to be helpful, and some may have side effects if taken in large doses. Some doctors prescribe hormones, such as oral contraceptives (birth control pills), tamoxifen, or androgens. But these are usually given only to women with severe symptoms because they also can have serious side effects.

Fibrocystic breasts: Symptoms and causes


Fibrocystic breast changes. Fibrocystic breast changes lead to the development of fluid-filled round or oval sacs (cysts) and more prominent scar-like (fibrous) tissue, which can make breasts feel tender, lumpy or ropy.

Fibrocystic breasts are composed of tissue that feels lumpy or rope-like in texture. Doctors call this nodular or glandular breast tissue.

It’s not at all uncommon to have fibrocystic breasts. More than half of women experience fibrocystic breast changes at some point in their lives. In fact, medical professionals have stopped using the term “fibrocystic breast disease” and now simply refer to “fibrocystic breasts” or “fibrocystic breast changes” because having fibrocystic breasts isn’t really a disease. Breast changes categorized as fibrocystic are considered normal.

Although many women with fibrocystic breasts don’t have symptoms, some women experience breast pain, tenderness and lumpiness — especially in the upper, outer area of the breasts. Breast symptoms tend to be most bothersome just before menstruation. Simple self-care measures can usually relieve discomfort associated with fibrocystic breasts.


Signs and symptoms of fibrocystic breasts may include:

  • Breast lumps or areas of thickening that tend to blend into the surrounding breast tissue
  • Generalized breast pain or tenderness
  • Breast lumps that fluctuate in size with the menstrual cycle
  • Green or dark brown nonbloody nipple discharge that tends to leak without pressure or squeezing
  • Breast changes that are similar in both breasts
  • Monthly increase in breast pain or lumpiness from midcycle (ovulation) to just before your period

Fibrocystic breast changes occur most often in women in their 20s to 50s. Rarely do postmenopausal women experience fibrocystic breast changes, unless they’re on hormone therapy.

When to see a doctor

Most fibrocystic breast changes are normal. However, make an appointment with your doctor if:

  • You find a new breast lump or area of prominent thickening
  • You have specific areas of continuous or worsening breast pain
  • Breast changes persist after your period
  • Your doctor evaluated a breast lump but now it seems to be bigger or otherwise changed



Breast anatomy. Each breast contains 15 to 20 lobes of glandular tissue, arranged like the petals of a daisy. The lobes are further divided into smaller lobules that produce milk for breast-feeding. Small tubes (ducts) conduct the milk to a reservoir that lies just beneath your nipple.

The exact cause of fibrocystic breast changes isn’t known, but experts suspect that reproductive hormones — especially estrogen — play a role.

Fluctuating hormone levels during your menstrual cycle can cause breast discomfort and areas of lumpy breast tissue that feel tender, sore and swollen. Fibrocystic breast changes tend to be more bothersome before your menstrual period, and the pain and lumpiness tends to clear up or lessen once your menstrual period begins.

When examined under a microscope, fibrocystic breast tissue includes distinct components such as:

  • Fluid-filled round or oval sacs (cysts)
  • A prominence of scar-like fibrous tissue (fibrosis)
  • Overgrowth of cells (hyperplasia) lining the milk ducts or milk-producing tissues (lobules) of the breast
  • Enlarged breast lobules (adenosis)

Risk factors

Having fibrocystic breasts doesn’t increase your risk of breast cancer.