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What You Need to Know About Fibrocystic Breast Tissue

Thanks to the success of early detection campaigns for breast cancer, more women than ever are monitoring changes in their breast tissue by performing monthly breast self-exams. But, with that awareness comes trepidation and anxiety if irregularities arise.

Changes in breast tissue are more common than you might expect, and they aren’t always a cause for alarm.

“Many women notice changes in their breast tissue depending on their hormone levels or where they are in their menstrual cycle,” said Francesca M. Delach, MD, a breast oncology surgeon on-staff at Abington - Jefferson Health.

Fibrocystic breasts—once called Fibrocystic Breast Disease—affect more than half of women at some point in their lives.

“Most medical professionals have stopped using the word ‘disease’ when talking about fibrocystic breasts, because it’s a benign condition,” said Dr. Delach.

Breast Architecture

Breasts are made up of three types of tissue: glandular, fibrous and fat. Glandular tissue is composed of lobular and ductal tissues responsible for producing and transporting milk during lactation, while fibrous connective tissue holds the system together. Fat extends from below the surface of the skin, through the rest of the breast tissue, and interdigitates between the connective and glandular tissue.

Symptoms of fibrocystic breast tissue appear when the tissue thickens due to hormonal factors and becomes more ropy or hard to the touch. It can occur in one or multiple locations.

“Each person has a different combination of tissue,” said Dr. Delach. “Those who have more glandular or fibrous tissue are more likely to experience fibrocystic breasts.”

Symptoms and Treatment of Fibrocystic Breasts

Beyond a lumpy or dense texture in their breast, patients may also experience swelling, soreness or discharge from the nipple—these are all benign. However, if the discharge is bloody or red, you should see your doctor immediately.

“Fibrocystic breast tissue still works normally,” said Dr. Delach. “There is no evidence of an increased incidence of breast cancer or issue with breastfeeding.”

In many cases, fibrocystic breast tissue is affected by hormone levels and the menstrual cycle. Symptoms can also be caused by environmental factors like diet and stress level.

“If your symptoms fluctuate, keeping a diary can help you track it to see if there might be a connection to your period or other environmental factors,” said Dr. Delach. “If it is dependent on your menstrual cycle and fluctuation of hormone levels, patients may find comfort in knowing these symptoms are considered normal and will subside.” Patients may also consider speaking to their doctor about starting a low dose hormonal contraceptive if they do not have an increased risk of breast cancer.

Self-Checks and Speaking to Your Doctor

At-home breast exams are a first line of defense when monitoring for breast cancer, and should be performed at the same time each month in order to account for the menstrual changes in fibrocystic tissue.

“If you notice a lump, don’t panic,” said Dr. Delach. “The purpose of self-exams is to recognize new changes that stand out from the background texture of the breast. You should not ignore symptoms, but know that many women have lumpy breasts, and some of this can be caused by normal variations in breast tissue.”

It’s also important to communicate your concerns with your doctor. “Tell your primary care physician or gynecologist if you notice a new lump. They can perform a breast exam and determine if further screening is warranted,” Dr. Delach said.

When speaking to your provider about a lump, there’s no better time to begin a conversation about family and personal health history, as well as other factors that can affect your lifetime risk of breast cancer.

“Sometimes the testing that proves a lump is benign also uncovers an unrelated risk factor,” said Dr. Delach. “This can be a good time to discuss breast cancer risk and determine if alterations should be made to a patient’s surveillance program.”

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