Fibrocystic breast changes are the most common cause of breast lumps. Fibrocystic breast lumps are cysts; that is, fluid-filled sacs surrounded by fibrous tissue. These cysts are not caused by cancer. Fibroadenomas, another common cause of breast lumps, are solid lumps of fibrous tissue. They also are not caused by cancer.

How does it occur?

The cause of fibrocystic breast changes is not known. Estrogen and other hormones produced by the ovaries may play a role. Drinking beverages and eating foods that contain caffeine and caffeine-like substances (methylxanthines) may also contribute to breast changes.

What are the symptoms?

One or both breasts may develop lumps and become tender during the week or so before the start of your menstrual period. Or you may notice lumps in your breast during your breast self-exam.

How is it diagnosed?

Usually a doctor can diagnose fibrocystic changes with a physical exam. To be sure of the diagnosis the doctor may recommend that you get a mammogram or aspiration of the cyst (removal of fluid). Or your doctor may ask that you simply return for a reexamination in 2 to 6 weeks, depending on where you are in your menstrual cycle. How is it treated?

To reduce the size of lumps or cysts or to prevent the formation of new lumps, your doctor may suggest you try avoiding caffeine and/or chocolate. Evening primrose oil, available at health food stores, helps reduce some women's breast symptoms. Nonprescription drugs, such as aspirin, may be helpful for pain. If your symptoms are severe, you may want to discuss the pros and cons of the prescription drugs bromocriptine and danazol. Some cysts can be treated in the doctor's office by aspiration. In this procedure, after local anesthesia, fluid in the lump is removed with a needle attached to a syringe. If a lump doesn't disappear completely after aspiration, it should be reevaluated by the doctor. How long will the effects last?

The lumps may get larger or smaller but they will not disappear. There is no known cure for this disorder, but it is not harmful.

How can I take care of myself?

Do monthly breast self-exams, have a yearly exam by a doctor, and get regular screening mammograms as advised by your doctor. Because lumps can be a symptom of either fibrocystic breast changes or cancer, it is important to see the doctor when:

you haven't had a breast exam in over 1 year
new lumps appear
an existing lump changes in some way
other breast symptoms develop, such as dimpling of the skin or discharge from the nipple.

How can I prevent fibrocystic breast changes?

To prevent fibrocystic breast changes, some doctors advise avoiding food and beverages that contain caffeine, such as coffee, tea, cola, and chocolate. The importance of performing monthly breast self-exams and having your doctor do a yearly breast exam cannot be overemphasized.

Robert B. McWilliams, MD

Robert B. McWilliams, MD Reproductive Endocrinology and Gynecology

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Fibrocystic Breast Changes

Robert B. McWilliams, MD
Reproductive Endocrinology
and Gynecology