Treatment and prevention of fibrocystic breasts

The treatment and prevention of fibrocystic breast changes are limited, and range from lifestyle changes to medication. Most treatments focus on minimizing the discomfort associated with any breast changes. Many physicians will recommend that women who have fibrocystic breast changes perform monthly breast self-examinations and note any changes.

In addition, some physicians may suggest that women do the following:

 
•   Wear a firm bra with adequate support  
•   Take oral contraceptives to alleviate symptoms  
•   Limit or avoid caffeine consumption  
•   Reduce dietary fat and salt intake  
•   Use over-the-counter pain medications  
•   Take vitamin E or B-6 supplements  
•   Take evening primrose oil supplements  
•   Use mild diuretics (only for severe cases)  
•   Undergo a needle aspiration of a cyst (if necessary)  
•   Have lumps in the breast surgically removed

Some supplements and herbal preparations are considered controversial. Patients are advised to speak with their physician prior to using these methods.

In addition to over-the-counter pain relievers, or possibly oral contraceptives, a few patients may be prescribed a synthetic drug that is similar to the male hormone testosterone. Recommended use of this medication is rare because the side effects are severe, including weight gain, growth of facial hair, acne, fertility problems, nausea, dizziness, hot flashes and possible menstrual irregularities.

In very rare cases, severe fibrocystic breast pain fails to respond to other treatments and the pain and discomfort reaches debilitating levels. In such cases, a bilateral mastectomy (the surgical removal of both breasts) may be recommended, although this is considered extreme.

In the case of fibroadenomas, another type of benign change in the breast, many physicians advocate the surgical removal of the tumors. This is because fibroadenomas do not resolve by themselves and may continue to grow, particularly during pregnancy and breastfeeding.

Fibrocystic breast changes do not appear to be associated with an increased breast cancer risk; however, this area continues to be studied. Certain benign lesions may have a higher risk of breast cancer, especially if the woman has a history of breast cancer in her family. Some women with benign breast changes may require additional screening or follow-up care. Fibrous or lumpy breasts can make it more difficult to detect a benign (noncancerous) or malignant (cancerous) tumor. If a woman has a family history of cancer, this condition will require closer observation. A woman should discuss the need for any additional screening tests with her physician.