Fibrocystic Change

Fibrocystic change (FCC) of the breasts is the most common benign breast condition. These changes are normal and are not a disease.

More than 60 percent of women may experience fibrocystic changes. It occurs more frequently in women aged 30 to 50 years and resolves most often after menopause.

Breast pain and tender lumpiness are the commonest symptoms of fibrocystic change. The size of the breast lump or lumpiness may fluctuate especially from mid-cycle to just before the period.

Causes of Fibrocystic Change

Although the exact cause is not clear, hormonal imbalance, particularly oestrogen predominance over progesterone, seems to play an important role in its development. As hormonal levels may fluctuate during the menstrual cycle, the symptoms of fibrocystic changes may also fluctuate with breasts becoming lumpier, tender and sore just prior to menses.

Risk Factors of Fibrocystic Change

The risks may increase with:

• Menstruation starting at an early age
• Having your first child at age 30 and older
• Never had a baby
• Infections

Careful assessment of the history of the symptoms with a clinical breast examination, followed by mammograms and breast ultrasound may be indicated in some women. Occasionally, a biopsy of the breast tissue may be needed to ensure the symptoms of fibrocystic change are not due to a malignant condition.

Management of fibrocystic change includes:

• Using a supportive bra
• Taking analgesics e.g. Panadol, NSAIDs
• Some women have found avoiding caffeine and reducing salt intake helpful in relieving symptoms of fibrocystic change but studies have not shown any significant impact
• For women with painful breast cysts, this may be relieved by a fine needle aspiration to remove the cyst contents, otherwise management is largely expectant
• Vitamins and dietary supplements such as evening primrose oil and Vitamin E

Cancer Risk

Fibrocystic breasts without atypical proliferations (abnormal growth of cells) do not increase the risk of breast cancer.