Fibrocystic changes (formerly called fibrocystic breast disease) include breast pain, cysts, and lumpiness that are not due to cancer.
Most women have some general lumpiness in the breasts, usually in the upper outer part, near the armpit. In the United States, many women have this kind of lumpiness, breast pain, breast cysts, or some combination of these symptoms—a condition called fibrocystic changes.
Normally, the levels of the female hormones estrogen and progesterone fluctuate during the menstrual cycle. Milk glands and ducts enlarge and breasts retain fluid when levels increase, and the breasts return to normal when levels decrease. (These fluctuations partly explain why breasts are swollen and more sensitive during a particular time of each menstrual cycle.) Fibrocystic changes may result from repeated stimulation by these hormones. The following increase the risk of these changes:
Other breast disorders, such as infections, can cause these changes.
The lumpy areas may enlarge, causing a feeling of heaviness, discomfort, tenderness to the touch, or a burning pain. The symptoms tend to subside after menopause.
Most fibrocystic changes do not increase the risk of breast cancer, but a few of them do, although only slightly. These changes typically require a biopsy to rule out cancer and may make the breasts appear dense on mammograms. They include the following:
Fibrocystic changes may make breast cancer more difficult to detect.
Lumps, usually only one lump at a time, may be removed, and a biopsy may be done to rule out cancer. Sometimes the biopsy sample can be withdrawn with a needle, but sometimes it must be removed surgically.
Sometimes cysts are drained, but they tend to recur. No specific treatment is available or required, but certain measures may help relieve symptoms:
If symptoms are severe, doctors may prescribe drugs, such as danazol (a synthetic male hormone) or tamoxifen (which blocks the effects of estrogen). Because side effects can occur with long-term use, the drugs are usually given for only a short time. Tamoxifen has fewer side effects than danazol.
Last full review/revision November 2008 by Victor G. Vogel, MD, MHS