Not every breast lump is cause for concern. In fact, most breast changes, including lumps, are unrelated to cancer. Two of the most common causes of benign breast lumps are fibrosis and cysts, collectively referred to as “fibrocystic breast changes.” While this used to be referred to as (and some sources still mention) “fibrocystic breast disease,” it is not actually a disease process and does not threaten the life or health of women who experience it.
Fibrosis refers to thickening of the breast tissue, which can give the breast a rubbery or ropy feel and create palpable lumps. Fibrous breast tissue includes ligaments, connective tissue (stroma), and scar tissue. Fibrosis is often caused by hormonal changes during the menstrual cycle and, consequently, the size of lumps can fluctuate throughout the month. It can also result from breast surgery, and fibrous tissue commonly forms around breast implants. Fibrosis can result in tenderness or pain in the breasts and can be accompanied by nipple discharge.
Cysts are round, fluid-filled structures that can develop in the breast. If palpable, they often feel movable under the skin. Cysts can cause tenderness or pain and swelling, which often worsen and improve at different times during the menstrual cycle. Many women develop multiple breast cysts. Cysts that are composed entirely of fluid are called simple cysts and do not require follow up. Complex or complicated cysts also contain solid components and, for this reason, are sometimes recommended for biopsy; however, it is rare that these turn out to be cancerous.
Most fibrocystic breast changes do not require treatment. If fibrous tissue causes discomfort, applying heat, wearing a well-fitting and supportive bra, or over-the-counter pain medication may be recommended. If cysts become painful, the fluid within them can be drained using fine needle aspiration—a technique also used to perform breast biopsy. Some women also find relief by limiting their intake of caffeine, saturated fats, alcohol, and salt.
Neither fibrosis nor simple cysts increase a woman’s risk of developing breast cancer. Because breast cancer affects 1 in 8 women during their lifetimes, however, women at average risk should undergo annual screening mammography beginning at age 40, as recent research shows that this screening regimen offers the potential to save the most lives.
Iowa Radiology provides state-of-the-art 3-D mammography, breast ultrasound and MRI, and imaging-guided biopsy at our Des Moines-area clinics. If you have questions about a procedure scheduled with us, feel free to contact us directly. For general information about mammography and breast health, access our free resources below.
Sources
Arleo, Elizabeth Kagan, MD, et al. "Comparison of recommendations for screening mammography using CISNET models." Cancer. 21 Aug 2017. Accessed 25 Feb 2019.
Daly, CP, et al. "Complicated breast cysts on sonography: is aspiration necessary to exclude malignancy?" Academic Radiology. vol. 15, no. 5, pp. 610-7.
"Fibrocystic Breast Changes." Breastcancer.org, 16 Oct 2018. Accessed 25 Feb 2019.
"Fibrosis and Simple Cysts in the Breast." Cancer.org. American Cancer Society, 20 Sept 2017. Accessed 25 Feb 2019.
Halls, Steven, MD. "Breast Fibrosis." Moose & Doc Breast Cancer, 25 Feb 2019. Accessed 25 Feb 2019.
Simpson, Jamie. "Which Foods Should You Avoid With Fibrocystic Disease?" Livestrong.com. 3 Dec 2010. Accessed 25 Feb 2019.