When I was 15, I received what felt like weird advice from my pediatrician: “Befriend your breasts.” She was right. Getting to know your breasts really well isn’t just an important step in any pubescent girl’s experience of coming to terms with her changing body, but also a crucial, potentially life-saving means of self-care. Knowing what your breasts feel like, and being able to anticipate changes based on your hormones and menstrual cycle, makes you more likely to stop something that doesn’t feel quite right.
For over half of the world’s women, though, knowing what to expect is a little trickier. These women—who have what is known as “fibrocystic breasts”—experience tissue texture changes, breast pain, and tenderness, and they often find lumps. These symptoms, which we’re rightly taught to pay attention to, can send anyone into a panic. Of course, it’s always best to call your doctor if something is worrying you, but understanding fibrocystic breasts and knowing a few helpful at-home hints might save you an unnecessary trip to the doc.
What exactly are fibrocystic breasts?
What used to be called “fibrocystic breast disease” is now diagnosed as “fibrocystic breast changes”—the benign, hormone-related changes in breast tissue a woman with fibrocystic breasts experiences.
Fibrocystic breasts contain what the Mayo Clinic refers to as “nodular or glandular tissue” that feels lumpy or tender when touched. The tissue changes and becomes especially lumpy (usually near the top of the breast or armpit) just before or during a woman’s period. The changes happen in both breasts and can cause pain, inflammation, discharge, and discomfort.
If you have fibrocystic breasts, your breast tissue actually contains detectable differences, including things like cysts, fibrous tissue deposits (fibrosis), and enlarged lobules (the part of your breast that produces milk if you’re lactating.) Fibrocystic breasts are not the same as fibroids, which are growths that usually need to be removed.
What are the symptoms of fibrocystic breast changes?
The symptoms are usually felt right before or during menstruation, and include changes in how your breasts feel internally and to the touch. According to the NIH, fibrocystic breasts will “feel full, swollen, or heavy” and the tissue will feel “thick, lumpy, or rubbery.” A lump may change size or texture during your period, and if you push on it, it should move easily.
Women also experience pain, pressure, tenderness, inflammation, and achy discomfort—often localized to the underarm or outer edges of the breast. Some women report non-bloody nipple discharge that’s usually clear, but sometimes light yellow or pale green.
Do fibrocystic breasts cause any problems?
“Fibrocystic” refers to two changes in breast tissue—fibrosis and cysts. The American Cancer Association describes fibrosis as “a large amount of fibrous tissue.” Fibrosis feels funky (like scar tissue), but doesn’t require any special care.
Cysts, on the other hand, need a little bit more attention. You’re most likely to find a cyst a day or two before your period, when they’re at their most inflamed. If a cyst is especially painful or large, a doctor can do an aspiration to relieve pressure and fluid build-up. If things don’t start to get better, they’ll examine the fluid or do a biopsy to check for other causes. Cysts are rarely surgically removed, but can be if they are especially large or persistent.
Can fibrocystic breast pain be treated?
Most people use over-the-counter medications like Advil or Tylenol to manage pain and reduce swelling. Many women use homeopathic treatments, including primrose oil and iodine or vitamin E supplements. Some try changes to their diet, including limiting or reducing intake of sodium or caffeine, and some doctors recommend birth control for hormone management.
And, the better your bra fits and the more supportive it is, the less likely you are to suffer from extreme swelling or pain! In some very severe cases, doctors may prescribe more intense pain medication or hormone treatments, or recommend having cysts drained.
How do I know when a lump is cause for concern? When do I consult my doctor?
It’s very important for all women, but especially women with fibrocystic tissue, to perform regular and thorough self-exams. Though fibrocystic tissue doesn’t increase your risk of breast cancer, it can make detection slightly more difficult. It’s very important that women with fibrocystic breasts pay careful attention to what their tissue feels like both on and off their period. Knowing where and when to expect thickness or lumps, and knowing what symptoms are normal for your body, helps prevent unnecessary concern and increases your likelihood of detecting a problem early, should one arise.
Some doctors recommend women with fibrocystic breasts make a “breast map” where they draw where they feel lumpiness and record the date. Others encourage keeping a “breast journal” or using a period tracking app to log changes or symptoms. Whatever method works for you, it’s important to consistently keep track of what you notice so you can be aware of a change.
If you find a lump that’s abnormal for you in size, texture, location, or time of your cycle, or if you feel pain that’s worse or different than usual, call your doctor. A hard lump that doesn’t move when you touch is it or that doesn’t start to get better after at least halfway through your period is worth looking into. In general, it’s always better to be safe than sorry, and a visit to your doctor can certainly alleviate anxiety and help you understand what to look for.
Fibrocystic changes can be frustrating, painful, and unnerving, but knowing your body and trusting your gut are always the best defense.
Cover image courtesy of Shutterstock.