Dr. M.J. Bazos, MD Patient Handout


About Your Diagnosis

Breasts that are “fibrocystic” have an exaggerated response to the hormonal fluctuations of the menstrual cycle. After ovulation, 1–2 weeks before the period, the breasts develop cysts, retain fluid, and enlarge. They may also become tender and sometimes very painful. The pain can radiate into the axilla (the armpit) or even into the shoulder area. After the period, the breasts will shrink in size, and become less lumpy and less tender. Fibrocystic breasts are diagnosed by the symptoms that occur before the period and by examination. Many women with fibrocystic breasts have cysts that can be felt by examination. If you are undergoing mammograms, the mammogram findings may also indicate fibrocystic changes. It is estimated that 50% of all women have some degree of fibrocystic changes of the breast. Fibrocystic breasts are usually symptomatic between the ages of 20 and 50 years. Once a woman has gone through menopause, the fibrocystic changes are less symptomatic or not symptomatic at all. However, if the woman starts on hormone replacement therapy, sometimes the fibrocystic breasts will continue to be symptomatic because of the hormonal stimulation.

Living With Your Diagnosis
The most common symptoms are that both breasts become tender or painful and engorged 1– 2 weeks before the period. The tenderness or pain is often in the outer, upper sides of the breasts (toward the armpit). However, sometimes the tenderness or pain can occur in other areas of the breast as well. If the breasts are examined, they may feel thicker and lumpy as if examining a mound of peas clumped together. Occasionally, a breast cyst will
grow larger than usual, up to 2.5 inches, and will cause pain in one particular spot and can be felt as a distinct lump. The tenderness and/or pain can range from very mild to very severe. However, most of the time pain medication is not necessary. If you have fibrocystic changes, try not to examine your breasts before your period. Do your self-breast examination as recommended, only after your periods. Otherwise, you may feel “lumps” and become unnecessarily alarmed. However, despite your best efforts, you may find that you visit your doctor more often than someone who doesn’t have fibrocystic breasts to get a lump checked out.
Most women will not need medication to treat their fibrocystic breast symptoms. If some medication is needed, often over-the-counter ibuprofen can be effective in relieving some of the symptoms. If more relief is needed, your doctor may prescribe a mild diuretic to start with. If your symptoms do not respond to ibuprofen or a diuretic, your doctor may refer you to a breast surgeon or gynecologist for further medical treatment. Sometimes birth control pills are prescribed. Other medications that may be prescribed are danazol, bromocriptine or tamoxifen. Decreasing the amount of caffeine and nicotine (if you are a smoker) may decrease the severity of the symptoms. One study of women with fibrocystic changes demonstrated that 92% had less severe symptoms when they decreased their caffeine and/ or nicotine intake. Although, other studies have not confirmed this finding, it may be worthwhile to decrease caffeine and nicotine intake to see whether your symptoms lessen. Evening Primrose Oil capsules may also lessen symptoms from fibrocystic breasts. In a study looking at premenstrual symptoms, it was observed that women receiving Evening Primrose Oil capsules had milder breast symptoms than women not taking Evening Primrose Oil. The amount recommended is 1.5–2.0 grams of Evening Primrose Oil twice each day 10–14 days before each period. Usually, it can be purchased at a health food store. No side effects have been reported.

The DOs
• Take as directed any recommended or prescribed medication.
• Wear a good supportive bra.
• Have a yearly breast examination, and have mammograms performed when recommended.

The DON’Ts
• Don’t take in excessive caffeine or nicotine.

When to Call Your Doctor
• If your symptoms are not relieved by the recommended treatment, another medication may be prescribed.
• If you feel a lump in your breast.