Fibrocystic Change

Fibrocystic changes are commonly present in an otherwise normal breast–this is not a breast disease that requires treatment per se. The term fibrocystic mastopathy is used to describe dense “lumpy” breasts. Excessive caffeine consumption can cause the development of fibrocystic changes.

Women with fibrocystic changes may notice a palpable lump during their self-examination or a mammogram may show that a particular area of the breast is unusually dense. Finding a lump such as this can create significant anxiety so it’s important to have a complete evaluation to acess the lump and determine if there is an actual mass or cyst. This evaluation includes a breast examination by your physician as well as additional breast imaging, including additional mammographic views or an ultrasound. When physical examination and breast imaging cannot completely resolve the underlying cause of the lump or density, a biopsy may be recommended. In most cases, the biopsy will be done using a fine needle aspiration, which entails placing a small needle into the palpable thickening and extracting a sample of cells for examination. If there is concern that a fine needle aspiration will not make the diagnosis, than a core needle biopsy which obtains a slightly larger sample of breast tissue may be performed.

If you have fibrocystic breasts it does not mean that you are at greater risk of developing breast cancer. It is true however, that women with fibrocystic breasts may have more difficult to interpret mammograms. If this is the case, then breast ultrasound is often utilized along with screening mammography to further evaluate areas on the mammogram that may be too dense for accurate assessment.

Fibrocystic breast changes do not necessarily require any treatment. Women with symptomatic fibrocystic changes particularly women with breast pain may be counseled to limit their caffeine intake or to undergo drainage of large cysts if they are present.

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