What Causes Fibrocystic Breasts?

“Fibrocystic breasts” describe a benign condition in which the breast tissue is denser in some areas than others, giving the feel of lumpiness. This is a common condition that often affects premenopausal women.

Fibrocystic breast changes are a common benign (noncancerous) condition that results in “lumpy” cystic changes in the breast tissue that can be firm, ropy, or rubbery. Cysts may or may not be present. It means the breasts have denser breast tissue and that “lumps and bumps” are part of the normal feel of a woman’s breasts. It affects mostly premenopausal women and may persistent or cyclical (every month). 

Fibrocystic breasts used to be called fibrocystic breast disease, but that was a misnomer since there is not really any disease present.

Symptoms of fibrocystic breasts include: 

• Swelling throughout one or both breasts/change in breast size
• Appearance of lumpy, free-moving masses in the breast, often near the armpit 
  • Usually asymptomatic (do not cause pain) and discovered by accident or during breast self-exams
• Breast tissue may feel firm, ropy, or rubbery
• Breast pain, tenderness, or discomfort
  • May be worse during the premenstrual period
  • Often felt as persistent, dull pain
  • May be perceived as throbbing or burning
• Nipple discharge
  • May be grayish, greenish, dark, or milky
  • May be bloody/watery and with high quantity (rare)

Fibrocystic breast changes usually occur in premenopausal women and are affected by shifts in hormone levels during the menstrual cycle, pregnancy, and lactation. Nearly half of all women will experience fibrocystic breast changes.

Risk factors for developing fibrocystic breasts include:

• Childbearing age
• Not yet having had a child
• Older age at birth of first child
• Late onset of menopause
• Being overweight
• Estrogen hormone replacement therapy 

Women may notice breast changes on their own with breast self-exams. Fibrocystic breast changes are usually diagnosed by a breast exam and a symptom history. To rule out other causes for the symptoms, tests may include: 

• Mammogram
• Ultrasound 
• Biopsy

Fibrocystic breast changes are common and don’t require treatment. Fibrocystic breasts don’t increase a woman’s risk of breast cancer. 

Symptoms of fibrocystic breast changes such as breast pain may be treated with: 

• Over-the-counter (OTC) pain relievers such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) 
• Warm or cool compresses applied to breasts 
• Wear a supportive, comfortable bra 
• Use bra inserts for nipple discharge
• Limit or avoid caffeine, salt, and/or fat, which may worsen symptoms in some women

Medical treatment for fibrocystic breast symptoms may include: 

• Draining very large cysts that cause pain
• Take an oral contraceptive if you are not already taking one, or stop taking or change oral contraceptive if you’re already on one 
  • Shifts in hormone levels may help some women
• Modify hormone replacement therapy

Never stop taking a prescribed medication without first talking to your doctor.