Symptoms and Complications
The signs and symptoms of fibrocystic breast disease include:
- one or more lumps in your breasts, which may or may not be painful
- nipple discharge
- breast tenderness or sensitivity
Some cysts are very small, but others can be as large as a hen's egg. If you apply pressure, larger cysts may change shape slightly and can be moved around a bit under your skin.
Most fibroadenomas have a firm, smooth, rubbery feeling and a well-defined shape. They also tend to move around under your skin.
Making the Diagnosis
If a woman has a lump in her breast, her doctor's chief concern is to make sure the lump is not cancerous. If she has a single lump that feels like a cyst, her doctor may try to aspirate it by removing fluid from the cyst with a thin needle. This procedure is usually done right in a doctor's office or with the help of an ultrasound. Most women may not even need a local anesthetic for this procedure. If the fluid from a lump can be removed through aspiration, the lump should disappear and not return, indicating that it was a cyst. If the fluid is bloody or appears abnormal in any way, a sample of the fluid will be sent to a lab for examination.
If a lump doesn't feel like a cyst, or no fluid can be drawn from it, the doctor will likely send the woman for a mammogram, which is a special X-ray of the breast. Ultrasound may also be used, as it is proving to be quite useful in diagnosing breast lumps.
If the ultrasound shows a solid area rather than a hollow cyst, the next step is usually a biopsy. This procedure involves surgically removing a small sample of tissue from the breast lump so that it can be examined under a microscope. Needle biopsies are being used more and more as a method for obtaining the tissue sample instead of surgical biopsies that remove the entire lump. Surgical biopsies are usually done at a hospital under local or general anesthetic.
Treatment and Prevention
The discomfort caused by breast lumps may be treated by medication. Usually, mild pain relievers such as aspirin or ibuprofen* are quite effective. In addition, a well-fitted bra that provides good support may also be effective. The bra can even be worn at night. Some women say vitamin E helps, but there is no solid evidence for this type of treatment. Other women find warm compresses, ice packs, and gentle massage to be helpful.
If medication doesn't alleviate the discomfort, your doctor may try to treat cysts by removing the fluid through aspiration. If the cyst persists and continues to cause discomfort, it may be removed surgically. Other breast lumps may also be removed by surgery.
Proper nutrition may help in the treatment of breast lumps. If a woman smokes or drinks caffeine, she may want to reduce her consumption or eliminate these altogether. Although the evidence is inconclusive, some women have reported that their lumps subsided after they stopped smoking or gave up caffeine.
Regular breast self-examinations are extremely important. The American Cancer Society recommends that all women from the age of 20 should be aware of the benefits and limitations of examining their own breasts regularly. Women between 20 and 40 years should have a clinical breast examination (CBE) by a health professional every 3 years. If a woman hasn't reached menopause, the best time for a breast examination is usually a few days after her period at the time when her breasts are less likely to be tender or swollen. If she's no longer menstruating, she should choose the same day each month to examine her breasts. After age 40, the American Cancer Society recommends that women should have a breast exam and a mammogram every year.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.
Melanie N. Smith, MD, PhD, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.