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Fibrocystic Breast Disease

Fibrocystic breast disease, characterized by lumps in the breast, is caused by the changing of hormones during menstruation. These lumps are often palpable in both breasts, but do not usually have clear borders and may not be fully felt by hand. The skin on the breast may appear “wrinkled” or have dimples. The lumps are usually not hard and are moveable. Some women experience pain or discomfort, sometimes at the lumps themselves and sometimes under their arms. The breasts may feel hard or swollen. Symptoms usually worsen just before a menstrual period and improve during menstruation. Birth control pills can alleviate these symptoms while hormone replacement therapy, such as prescribed after ovarian surgery, may worsen the symptoms. These lumps do not usually become cancerous.

Symptoms
  1. Swelling of the breasts.
  2. Breast pain.
  3. One or more palpable lumps in one or both breasts, without clear borders.
  4. Worsening symptoms close to menstruation.
The doctor can diagnose the lumps and the cause of the lumps by asking the patient about their age, medical history, various symptoms, medication history, and menstruation. The doctor will also physically examine the patient’s breast and body and may recommend imaging studies such as mammogram and/or ultrasound as well as further laboratory testing, such as a biopsy, where tissue or fluid is removed from the breasts to be examined in the laboratory. Which tests are done will depend on what the doctor feels is most appropriate for the individual patient.
Initial treatment of breast lumps is usually to remove them for further examination. If fibrocystic breast disease is confirmed and there are too many lumps that are too small to remove, the doctor may choose to treat the symptoms rather than do any surgery (as it may require a mastectomy or removal of the entire breast). The patient may have to see the doctor every few months to monitor the lumps and follow up on symptoms, keeping in mind that if the lumps do change in shape and size, surgery may be required. If the lumps are fluid-filled cysts, they may be drained.
 
There is presently no way to prevent the development of these lumps in the breasts so it is very important for patients to regularly examine both breasts to become aware of any changes that may occur. Check your breasts every time you take a bath or shower. Lather your fingers and breasts with soap to help your fingers glide more smoothly over your skin. See a doctor as soon as possible if you notice any changes to rule out breast cancer. This is especially important if you are older than 40. Mammogram and/or ultrasound is recommended for screening of breast cancer starting at age 50 if there are no other symptoms or at 40 if there is a family history (parents or siblings) of breast cancer. Frequency of imaging will be determined by the doctor, depending on risk factors.
 

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