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The breast specialists at MedStar Health treat both benign (non-cancerous) breast diseases and breast cancer. Our comprehensive care approach is designed for women on the road toward overcoming breast disease.

What you can do to protect your breast health

You can help increase the chance of early detection by the following these steps:

  1. Perform regular monthly breast self-examination.

  2. See your doctor once a year for a clinical breast exam.

  3. Schedule an annual digital mammogram, as appropriate based on age and family history.

These three steps are the keys to maintaining breast health. However, there are times when a woman or her doctor may find a lump in her breast during an exam, or a suspicious area may be seen on a digital mammogram. Findings such as this do not always signal the presence of breast cancer; however, it is critical to your health that you have it checked immediately in order to determine if the lump is dangerous or benign.

The specialists at MedStar Health treat the following

  • Breast Cancers including:

    • Breast Cancer During Pregnancy

    • Breast Cancer in Men

    • HER2/Neu Positive Breast Cancer

    • Inflammatory Breast Cancer

    • Locally Advanced Breast Cancer

    • Paget’s Disease of the Nipple

    • Triple-Negative Breast Cancer

  • Benign Breast Disease, including:

    • Breast Infections

    • Breast Pain

    • Fibroadenoma

    • Fibrocystic Changes

    • Nipple Discharge

    • Papilloma

  • Genetics and Breast Cancer Risk

    • BRCA1 or BRCA2 Genes 

    • Abnormal Breast Biopsy

  • Pregnancy/Lactation

    • Breast Infections

    • Breast Cancer During Pregnancy

  • Male Breast Conditions, including:

    • Breast Cancer

    • Gynecomastia

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Fibrocystic Breast Disease – Lumpy Breasts

  • What Are Fibrocystic Breasts?
  • What is Fibrocystic Breast Disease?
  • What Causes Fibrocystic Breasts?
  • How Are Fibrocystic Breasts Diagnosed?
  • How Are Fibrocystic Breasts Treated?
  • Breast Health Guidelines For Women With
    Fibrocystic Breasts
  • Additional Resources and References

What Are Fibrocystic Breasts?

Fibrocystic breast condition is a common, non-cancerous condition that affects more
than 50% of women at some point in their lives. The most common signs of fibrocystic
breasts include lumpiness, tenderness, cysts (packets of fluid), areas of thickening,
fibrosis (scar-like connective tissue), and breast pain.
Having fibrocystic breasts, in and of itself, is not a risk factor for breast cancer.
However, fibrocystic breast condition can sometimes make it more difficult to detect a
hidden breast cancer with standard examination and imaging techniques.

Fibrocystic breast condition is most common among women between the ages of 30 and 50,
although women younger than 30 may also have fibrocystic breasts. Because the condition is
related to the menstrual cycle, the symptoms will usually cease after menopause unless a
woman is taking hormone replacement therapy. In some cases,
fibrocystic breast symptoms may continue past menopause.

Fibrocystic breast condition is the most common cause of non-cancerous breast lumps in women between 30 and 50 years of age. More than 50% of women have fibrocystic breast symptoms at some point in their lives.

Symptoms of fibrocystic breasts include:

  • cysts (fluid-filled sacs)

  • fibrosis (formation of scar-like connective tissue)

  • lumpiness

  • areas of thickening

  • tenderness

  • pain

The degree to which women experience these symptoms varies significantly. Some women
with fibrocystic breasts only experience mild breast pain and may not be able to feel any
breast lumps when performing breast self-exams. Other women
with fibrocystic breasts may experience more severe breast pain or tenderness and may feel
multiple lumps in their breasts. Most fibrocystic breast lumps are found in the upper,
outer quadrant of the breasts (near the axilla, armpit, region), although these lumps can
occur anywhere in the breasts. Fibrocystic breast lumps tend to be smooth, rounded, and
mobile (not attached to other breast tissue), though some fibrocystic tissue may have a
thickened, irregular feel. The lumps or irregularities associated with fibrocystic breasts
are often tender to touch and may increase or decrease in size during the menstrual cycle.

What is Fibrocystic Breast Disease?

In the past, many physicians have referred to fibrocystic breasts, or lumpy breasts, as
“fibrocystic breast disease.” This term is misleading because fibrocystic breast
condition is not a disease at all. Rather, it is a common, non-cancerous breast
condition that affects over half of all women at some point in their lives. Today,
most physicians refer to this condition as “fibrocystic breast condition” or
“fibrocystic breast change.” Other terms that may be used to describe the
condition include “cystic disease,” “chronic cystic mastitis,” or
“mammary dysplasia.”

In fact, since fibrocystic breasts are so common among women during their reproductive
years, some physicians do not even like to label the symptoms as a “condition. “
They believe that these women simply have lumpier and more tender breasts than others.

What Causes Fibrocystic Breasts?

Fibrocystic breasts occur from changes in the glandular and stromal (connective)
tissues of the breast. These changes are related to a woman’s menstrual cycle and the
hormones, estrogen and progesterone. Women with fibrocystic breasts often have bilateral cyclic breast pain or tenderness that coincides with their
menstrual cycles.

During each menstrual cycle, normal hormonal stimulation causes the breasts’ milk
glands and ducts to enlarge, and in turn, the breasts may retain water. Before or during
menstruation, the breasts may feel swollen, painful, tender, or lumpy. The severity of
these symptoms varies significantly from woman to woman. Some women only experience mild
breast swelling during menstruation, while others experience constant breast tenderness.
Because the condition is hormone-related, it will usually affect both breasts
(bilaterally). Symptoms of fibrocystic breasts usually stop after menopause but may be
prolonged if a woman takes hormone replacement therapy.

How Are Fibrocystic Breasts Diagnosed?

Fibrocystic breasts are often first noticed by the woman, and further investigated by
her physician. Breast tenderness, pain, and/or lumpiness are common indicators of
fibrocystic breasts, especially when they coincide with menstruation. Often, fibrocystic
breasts will be diagnosed with a physician-performed clinical
breast exam alone.

While having fibrocystic breasts is usually not a risk factor for breast cancer, the
condition can sometimes make breast cancer more difficult to detect. Therefore, in some
cases, breast imaging exams, such as mammography or ultrasound, will need to be performed on women who show symptoms
of fibrocystic breasts. However, screening mammography may be
more difficult to perform on women with fibrocystic breasts because the breast density
associated with fibrocystic breasts may eclipse breast cancer on the mammogram film. In
some cases, additional mammography or ultrasound imaging, followed by fine needle aspiration or biopsy, will
be performed on women with fibrocystic breasts to determine whether breast cancer is
present. Fine needle aspiration (to drain large, painful cysts) may also be performed by a
physician help relieve some of the more severe symptoms of fibrocystic breast condition.

How Are Fibrocystic Breasts Treated?

Often, physicians may recommend that the symptoms of fibrocystic breasts be treated
with self-care. Depending on the individual situation, several measures may be recommended
to relieve the symptoms of fibrocystic breasts. For instance, women may wish to wear extra
support (athletic type) bras to help hold the breasts closer to the chest wall, which may
provide some symptomatic relief. Extra support bras are especially important for large
breasted women and may provide relief when breasts are full and tense with fluid.
Physicians will often recommend that a support bra be worn both during the day and at
night, especially during times of the woman’s menstrual cycle when the breasts are
most tender.

In addition, certain vitamins (particularly vitamin E, vitamin B6, or niacin) or herbal
supplements such as evening primrose oil may help alleviate the symptoms of fibrocystic
breasts by reducing inflammation and fluid retention. It is important that these
supplements be used according to directions and that women avoid megadoses since serious
side effects may occur from incorrect use.

Some women also find that reducing their caffeine intake by avoiding coffee, tea,
chocolate, and soft drinks decreases water retention and breast discomfort. However, this
is a controversial topic among healthcare professionals because studies linking breast
pain and caffeine have been inconsistent.

In 1978, a study revealed that patients who took oral contraceptives were less likely
to have fibrocystic breasts. The study has since been reconfirmed several times, though
some health care professionals (and women) do not believe oral contraception has any
significant effect on treating fibrocystic breasts.

If fibrocystic breast pain is severe and interferes with a woman’s daily
activities, further treatment may be necessary. Diuretics, substances that encourage the
excretion of excess fluid from the body in the form of urine (which may in turn reduce
tissue swelling and pain) are usually reserved for women who experience non-cyclical breast pain, but may be used to alleviate the
symptoms of fibrocystic breast condition in some cases. The release of fluid in the body
can help decrease breast pain and swelling.

Additional drug treatments for severe breast pain include:

  • bromocriptine (brand name, Parlodel)

  • danazol (brand name, Danocrine)

Bromocriptine and danazol both relieve cyclical breast pain by blocking estrogen and
progesterone. However, these drugs may cause serious side effects in some women.
Bromocriptine is poorly tolerated by many patients; side effects include nausea,
dizziness, and fertility problems. Side effects of danazol may include weight gain,
amenorrhea (absence of menstruation), and masculinization (such as extra facial hair) when
given high doses. Other drugs, such as tamoxifen (brand name,
Nolvadex) or goserelin  (brand name, Zoladex) have
been shown to have some effect on cyclical breast pain; however, these drugs are currently
only approved for use in the United Kingdom for treating severe fibrocystic breast pain.

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causes, symptoms, signs, diagnosis, treatment, prevention

Causes

Symptoms

Classification

Complications

Diagnosis

Treatment

Prevention 90 003

Mastopathy is a disease of the mammary gland in women, the main symptoms of which are pain, abnormal secretion from the nipples and tissue growth. This is the most common breast pathology known since ancient times. Globally, 70% of all women of childbearing age have been diagnosed with this condition.

Causes and risk factors

The only cause of the disease is a hormonal imbalance. These or other provoking factors cause a deficiency of progesterone and an increase in estrogen, which causes the growth of the epithelium of the alveoli, ducts and connective tissue. Some role in the development of the disease can be played by increased production of the hormone prolactin, which is responsible for the growth, development and functionality of the mammary gland.

Today the main provoking factors are:

  • onset of menstruation before age 13;
  • late menopause, in which the long-term effect of hormones on the mammary gland also causes a negative effect;
  • lack of conception in a woman’s life;
  • numerous abortions that cause severe hormonal fluctuations;
  • stress;
  • refusal to breastfeed;
  • obesity;
  • liver disease;
  • PCOS;
  • endocrine diseases;
  • infertility;
  • unreasonable appointment and uncontrolled intake of contraceptives;
  • liver disease;
  • heredity.

The causes of mastopathy and provoking factors can only be established by a doctor. Self-diagnosis, and even more so self-treatment, often cause negative consequences and adversely affect the course of the disease, often leading to the development of complications.

Symptoms

The most common symptom of mastopathy is the appearance of a seal in the chest, which is well palpable on palpation. Often the bump can be painful, and this is especially noticeable in the second half of the menstrual cycle and a few days before the onset of menstruation.

Seals can be either single or multiple, located throughout the gland. Most often they are detected in the upper sections, and both glands are always affected, which is a distinctive feature of mastopathy from cancer.

The pain is dull, aching or drawing. It is not sharp and unbearable. This is due to pressure on the nerve endings, which is caused by tissue growth. Sometimes the pain syndrome gives to the arm or shoulder blade.

However, such a sign of mastopathy as pain is not detected in 15% of all women with this diagnosis. This is due to the fact that they have a higher level of pain sensitivity, and the branches of the nervous system do not fall under the pressure of overgrown tissues. About 10% of women notice an increase in the lymph nodes in the armpits, sometimes they can be quite painful.

Other symptoms include:

  • breast enlargement up to 15%;
  • engorgement of the gland, which occurs from time to time;
  • the appearance of venous stasis;
  • swelling of connective tissue;
  • discomfort on palpation;
  • increased sensitivity of the chest.

Another sign of breast mastopathy is discharge. They can be diagnosed only with pressure on the nipple, and can flow spontaneously. The color of the discharge is different – from white and cloudy to green and brown. However, the most dangerous option is bloody, which indicates the beginning of the development of a malignant process.

Classification

Breast mastopathy is classified depending on what the doctor can see on the x-ray.

  • fibrous mastopathy is characterized by swelling, narrowing, and sometimes complete fusion of the duct, and enlarged interlobular connective tissue septa exert strong pressure on adjacent tissues;
  • cystic mastopathy is characterized by the appearance of cavities that are filled with fluid and clearly delimited from the surrounding tissue;
  • diffuse mastopathy is manifested by edema and an increase in the volume of glandular tissue;
  • fibrocystic is diagnosed with the growth of connective tissue with an increase in the number of glandular lobules;
  • sclerosing – diagnosed as the appearance of formations of a dense consistency;
  • nodular – is considered a poor-quality form and is characterized by the appearance of clearly defined nodes.

Complications

What can happen if this disease is left untreated? Firstly, over time, aesthetic discomfort occurs, which is caused by deformation of the breast contour. This is especially common in the cystic form.

Secondly, cysts can become inflamed from time to time, and this will become a risk for the development of mastitis, which often has to be treated in a hospital.

Thirdly, with mastopathy with a strong growth of pathological tissue, there is a high probability of developing breast cancer.

Diagnosis

To diagnose mastopathy, you should contact a gynecologist or mammologist. The appointment begins with a patient interview. The doctor will clarify the presence or absence of pain, their nature, the time the seal appeared or the period when it was noticed. You should also talk about discharge from the mammary glands, about diseases of this type in relatives, and other gynecological problems. It is important to accurately describe the menstrual cycle, to talk about the method of protection used. Then palpation of both mammary glands is carried out in a standing and lying position.

The next mandatory diagnostic step is mammography and ultrasound. Based on their results, the issue of a biopsy is decided, which will help to quickly determine the malignancy or good quality of the existing process.

Additional tests may include blood and urine tests, CT or MRI.

Treatment

Conservative therapy involves taking medications prescribed by a doctor. To relieve pain, drugs from the NSAID group are used, vitamin complexes help strengthen the immune system, and antidepressants and sleeping pills help to cope with depression, insomnia and irritability – frequent companions of mastopathy.

To improve the function of the thyroid gland, iodine preparations are prescribed, and diuretics help to cope with tissue edema. In difficult cases of treatment of mastopathy, hormonal agents are used. Such therapy is used strictly individually and requires constant monitoring by the doctor.

Preparations for mastopathy are also available for local use. Gels and ointments are applied directly to the skin over the affected area several times a day. The medicine Progestogel is especially popular, which helps to eliminate the main symptoms – pain, swelling, increased capillary permeability.

Treatment should include not only taking prescription drugs for mastopathy, but also diet therapy, avoiding coffee, strong tea, smoking and drinking alcohol. But seafood in the diet of a woman should be in sufficient quantities. It is important to choose the right bra so that it always turns out to be the right size, does not press and does not allow the breasts to sag. And, of course, do not forget to regularly take natural antioxidants.

Surgical treatment is used in two cases. The first is the rapid growth of education, the second is a high risk of degeneration of the seal into a cancerous tumor. The entire affected sector of the mammary gland is removed. After the operation, antibiotics and vitamin therapy are required.

If the cysts are large, laser photocoagulation may be used. The method is relatively young and is not used in all clinics. The procedure does not require incisions and anesthesia, but allows complete coagulation of the cyst.

Prevention and prognosis

A favorable prognosis is possible when contacting a doctor in the early stages, performing all prescribed procedures and taking prescribed drugs. Usually the disease is completely cured and passes without the development of complications.

Prevention of mastopathy includes the fight against excess weight, an active lifestyle, quitting smoking and drinking alcohol, avoiding stressful situations. Once a year, it is necessary to undergo an ultrasound of the mammary glands or perform a mammogram.

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