Fibrocystic breast disease refers to benign (noncancerous) changes in the tissues of the breast. The term "disease" in this case is misleading, and many health care providers prefer the term "change."

The condition is so common that it is believed to be a variation of normal. It may also be called mammary dysplasia, benign breast disease, and diffuse cystic mastopathy.

The cause is not completely understood. The changes are believed to be associated with hormones produced by the ovaries because the condition usually subsides with menopause, when ovary function changes. The changes also may vary during the menstrual cycle.

Fibrocystic breast disease is estimated to affect over 60% of all women. It is common in women between the ages of 30 and 50, and rare in women who have gone through menopause. It is less common in women who take birth control pills.

Risk factors include a family history of the condition, a high fat diet, and excess caffeine intake, although these are controversial.

Symptoms may range from mild to severe. They typically peak before each menstrual period and improve immediately afterwards.

Symptoms include:

• Dense, irregular and bumpy "cobblestone" consistency in the breast tissue
  • Usually more noticeable in the outer upper part of the breast
• Breast discomfort
  • Usually in both breasts
  • May be persistent or it may come and go
• Breast feels full
• Dull, heavy pain and tenderness
• Premenstrual tenderness and swelling
• Occasional nipple discharge

The health care provider will perform a breast exam. A breast exam will reveal breast "masses" that move and change shape. The masses are usually rounded with smooth borders and may feel rubbery.

Mammograms may be difficult to interpret because of dense breast tissue. A breast ultrasound can help identify cystic changes in the breast. A biopsy of the breast may be necessary to rule out other problems.

Aspiration of the breast with a fine needle can often diagnose and treat larger cysts.

Self care may include restricting dietary fat to approximately 25% of the total daily calorie intake, and eliminating caffeine.

Performing a breast self-examination monthly, and wearing a well-fitting bra to provide good breast support are important.

The effectiveness of vitamin E, vitamin B6, and herbal preparations, such as evening primrose oil, are somewhat controversial. Discuss their use with your health care provider.

Birth control pills may be prescribed because they often decrease the symptoms. In severe cases, a medicine called danazol may be prescribed if the potential benefit is thought to outweigh the potential negative effects. Tamoxifen is occasionally used in severe cases.

If dietary changes decrease the symptoms, and are maintained, the benefit most likely will persist. A combination of treatment and use of medications may be necessary to obtain relief for severe cases.

Women with fibrocystic breast disease do not have an increased cancer risk.

Because fibrocystic changes may make breast examination and mammography more difficult to interpret, early cancerous lesions may occasionally be overlooked.

Call your health care provider if you feel a new, unusual, or "dominant" lump during a breast self-examination.

Call for an appointment with your health care provider if you are a woman, aged 20 or older, who has never been taught, or does not currently know how, to perform breast self-examination. Also call if you are a woman, aged 40 or older, who has not had a screening mammogram.

Reducing the amount of fat and caffeine in your diet may help reduce symptoms, although studies have questioned their role in the disease.