Fibrocystic changes (FCCs) in the female breast are an extremely common occurrence. Estimates suggest that one-third of women between the ages of 20 and 45 years will develop this problem. FCCs are benign, meaning non-cancerous, and with rare exception are not considered a precursor to breast cancer.
What are Fibrocystic Changes?
Fibrocystic changes, once referred to as fibrocystic breast disease, is inclusive of a variety of benign changes in the breast. These can be divided into proliferative and nonproliferative changes. Proliferative changes are potentially the most problematic and have the potential to be a precursor to breast cancer. Nonproliferative changes are the most common and are typified by an increase in fibrous tissue, dilation of ducts and cyst formation. Most women who refer to FCC are referring to this type of problem.
Fibrocystic Changes and Breast Cancer
The extent of the link between breast cancer and FCC is controversial, but it does exist and is relatively low. The presence of atypical hyperplasia results in the greatest risk. Hyperplasia is the over-production of cells and the changes are classified as atypical when the cells begin to take on abnormal shapes and sizes. This is a type of proliferative change.
Causes
The breasts are influenced by a variety of factors, including ovarian hormones, environmental compounds similar to estrogen known as xeno estrogens or endocrine disruptors, nutritional deficiencies and medication. Disruption in a woman's delicately balanced hormonal system can stimulate unwanted changes in the breast, leading to fibrocystic changes as well as other benign and malignant changes.
Symptoms
Symptoms depend upon the extent of the FCC but typically include breast tenderness, multiple lumps and a thickening quality to the tissue. At times these changes are so minimal they can only be identified via microscopic exam. It is common for women to experience an increase in symptoms premenstrually as breast tissue is influenced by fluctuating estrogen levels. Methylxanthines, compounds found in caffeine, appear to exacerbate FCC changes and even straightforward premenstrual breast tenderness. Interestingly, even though many women are absolutely convinced of the connection between FCC, breast tenderness and methylxanthines, various studies have shown no relationship.
Treatment
Treatment varies based on the underlying cause and can include pharmaceutical, herbal and nutritional approaches. Estrogen dominance, a situation where the estrogen-to-progesterone ratio is off, requires either improving estrogen clearance or increasing progesterone. Other pharmaceuticals include Tamoxifen and Danazol. As of 2008, the use of iodine in high doses has recently become increasingly popular and in many women has a pronounced effect. Other nutritional considerations include the use of vitamin E and diets high in plant lignans. Elimination of methylxanthines may prove beneficial as well. There are a wide variety of herbs that have the ability to treat FCC as well. Although FCCs are very common and are considered by some to be a normal process, these changes can often be successfully treated and resolved.
References
- MayoClinic.com: Atypical hyperplasia of the breast
- Pathology of the Breast; Tavassoli; 1999
- American Cancer Society: Non-Cancerous Breast Conditions
