Fibrocystic Breast Changes

Used to be called fibrocystic breast disease which was wrong.  Fibrocystic changes are part of the normal breast cycle and leads to degree of breast lumpiness.  At times these changes become more pronounced and lead to lumps, pains or discharge.  Due to these it often leads to investigations including mammograms and ultrasounds.

Mastalgia

It is medical term for breast pain.  This pain is often cyclical, usually more severe during the premenstrual phase of period cycle, and resolves following the period.  Pain most commonly occurs in the upper outer part of the breast and may extend to the nipple and inner part of the upper arm.  Non-cyclical mastalgia occurs when the pain is no related to the menstrual cycle.  The pain may be consistent in nature, burning, sharp or stabbing.  Often breast imaging is performed to exclude a mass.  Wearing a supportive bra, using pain relief and decreasing intake of caffeine, salt and tobacco may help.  Evening primrose oil, vitamin E, Vitamin B complex have also shown benefit in some patients in treating persistent pain.  Any masses present should be investigated by a physician.

Breast Cysts

They are very common and are seen as a component of fibrocystic changes.  These are fluid filled sac or may be present as several sacs (cysts).  They usually disappear in menopause.  Most are very small and are not able to be felt.  They often change is size depending on the menstrual cycle.  Cysts can become quite large and then may become palpable.  In this situation they can feel soft or hard and may move on examination.  A breast examination and imaging are done to ensure that the cancer is excluded.  Most cysts do not require any treatment.  Large or painful cysts may be aspirated (fluid removed with a needle under local anesthetic).  If cysts have solid components, biopsy of these needs to be performed. Simple cysts do not increase the risk of getting breast cancer.

Fibroadenomas

They are very common solid breast lesions.  They mostly occur in young women, including teenagers.  They may be tender to touch or not painful at all.  They often feel rubbery.  They can vary in size from few millimeters to more than 5cm.  Imaging is done to exclude cancer.  Often a biopsy is performed to confirm the diagnosis of fibroadenoma that has been suggested on the ultrasound.  Treatment of fibroadenomas is required if they are large or are increasing in size. 

Nipple Discharge

It is also very common breast condition.  Majority of nipple discharge is not associated with malignancy.  The discharge may be milky, clear, yellow, green or brown.  If nipple discharge is bloody in nature, then examination and imaging are indicated.  At times also biopsy is performed to exclude cancer.

Any finding of new breast mass or change in the breast shape should be evaluated by a physician.