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There is nothing more terrifying to a woman than finding what appears to be a lump in her breast. While a lump should always be immediately reported to a doctor, and an appointment made for a diagnosis, women should know that ¡§lumpy¡¨ breasts are prevalent in about 60% of all women of childbearing age. Of these, only about 5% are indicative of a disease state and cause for concern. More often than cancer or other disease, the diagnosis is ¡§fibrocystic breast disease.¡¨
What is Fibrocystic Disease?
The name ¡§fibrocystic breast disease¡¨ is an umbrella term used to describe a host of changes associated with women¡¦s breast tissue. According to the American Cancer Society, fibrocystic changes are most prevalent in women ages 30 to 50, and is also known as cystic disease, chronic cystic mastitis, or mammary dysphasia.
Lumps in the breast are not always indicative of fibrocystic changes. The breast is a naturally lumpy entity, composed of milk glands, ducts, other fibrous tissue, and supporting ligaments.
Fibrocystic condition usually occurs as a result of repeated hormone stimulation. This increases breast tissue firmness, leading to the formation of pockets of fluid in blocked or swollen milk ducts. Such tissue may feel lumpy, with areas of increased thickness, and may have a slightly raised edge. Alternatively, it could feel like tiny beads scattered throughout the breasts.
Fibrocystic changes most frequently occur in both breasts, usually in the upper area of the breast, away from the nipple or underneath the breast. Women with fibrocystic condition who are still menstruating may experience swelling around these cysts, with pain ranging from an ache, with increased sensitivity or a burning sensation to severe pain. These symptoms usually subside with the onset of menopause.
Less frequent than the above changes are the formation of cysts or fluid filled sacs in the breasts. These are usually firm and smooth, with a more regular surface, and range in size from small beads to ball-like. For larger cysts, the sensation is likened to the sensation of feeling an eyeball through a closed lid. Tenderness or pain may accompany the cyst, generally increasing in the time just prior to the menstrual period and subsiding the following week. Small cysts can usually be removed in the doctor¡¦s office by applying suction through a needle and syringe. Surgery is usually recommended only if the cyst grows back. Cysts generally do not recur after menopause.
Diagnosis
Performing Breast Self-Examination (BSE) on a regular basis enables a woman to familiarize herself with the feel of normal breast tissue, so that any changes are readily evident. The condition of the breast changes in response to monthly fluctuations in estrogen and progesterone levels, hormones released by the ovaries of women of childbearing age. Just prior to and during menstruation, milk glands and ducts enlarge, and breasts retain water, causing breasts to feel heavy, tender, and lumpy. The breast returns to a more normal state at the end of the menstrual cycle. Breast examination is best done at this time, 7-10 days after the beginning of the menstrual cycle because this is the time when the breast is most normal.
For women over the age of 20, with no other symptoms, the American Cancer Society recommends performing breast self-examination (BSE) once a month, about a week after the menstrual period. The also recommend that post-menopausal women select a set regularly scheduled day, such as the first of the month, to practice self-examination. They also recommend that all women aged 20-40 should see a doctor or nurse for a physical breast exam at least once every 3 years.
How to Perform a Monthly Breast Self-Exam (BSE)
„h Check each breast all over
„h Use your finger pads
„h Go up and down
„h Check under your armpit, too
„h Feel for lumps, thickness, other changes
(Source: American Cancer Society)
Until recently, manual examination was the only means available for the detection of breast abnormalities. Today, mammography represents the best hope for the early detection of cancer. This has directly contributed to increased rates of cure for cancer. A mammogram is an x-ray of the breast, which can detect lumps infinitely smaller than fingers could feel, with minimal risk to the patient. The American Cancer Society recommends that women should have their first mammogram at age 40 and one every 1-2 years from age 40-49. Women age 50 and over should have a yearly mammogram.
For some women with fibrocystic condition, a sonogram is used to augment the mammogram as some small tumors that may be hidden by dense fibrous tissue in the breasts.
Treatment
Mild forms of fibrocystic condition are usually treated by diet modification, with the use of heat compresses and pain relievers for discomfort. Avoiding caffeine-containing products such as coffee, tea, chocolate, and soft drinks may help alleviate water retention and the associated discomfort. Local heat compresses and a good support bra may also provide relief. Occasionally, a physician may prescribe Vitamin E. Surgery is usually only recommended for lumps that return after a doctor aspirates the fluid, or persist over time.
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