Everything You Need to Know About Breast Cysts
But not all bumps mean you have cancer. If you find one, you might be experiencing what doctors call a fibrocystic breast change, or a breast cyst: “It’s a term used to describe normal breast tissue that is nodular or lumpy on palpation [a fancy term for examination by touch] of the breast,” says Lauren Cornell, M.D., an internal medicine physician at the Robert and Monica Jacoby Center for Breast Health at Mayo Clinic. “When examined microscopically, the tissue has fluid-filled sacs, or cysts, and prominent fibrous tissue.”
If you’re a woman, you could probably bet money that you’ll have fibrocystic breasts at one point or another—typically between ages 20 and 50. “Estimates suggest over 50 percent of women might experience fibrocystic breast changes during their lifetimes,” says Alyssa Dweck, M.D., a gynecologist at CareMount Medical in New York and co-author of The Complete A to Z for Your V.
It’s so common, in fact, that the medical community stopped calling the condition by its original name, “fibrocystic breast disease,” and started referring to it as “fibrocystic breast changes” instead, really driving the point home that breast cysts are a natural occurrence in the body—and that they don’t necessarily mean something’s wrong.
So if you find a lump, before you jump to assuming you’re dealing with the worst-case scenario, remember these seven must-know facts about fibrocystic breasts.
You might think that fibrocystic breasts have the C-word written all over them. But in reality, they are benign—so having them doesn’t mean you have cancer, and it doesn’t up your chances of developing cancer, either.
“It is important to know that having fibrocystic breast changes does not increase your risk of breast cancer,” says Nicole Zaremba, M.D., breast oncology surgeon at Aurora Health Care in Milwaukee. “Many women with fibrocystic breasts have a history of multiple benign solid breast masses.”
“However,” Zaremba continues, “women with fibrocystic breasts sometimes [but not always] have dense breasts, and women with high-density breasts are four to five times more likely to develop breast cancer than women with low-density breasts. Therefore, it is important to distinguish benign breast lumps from potentially cancerous or malignant breast masses, which is done with breast imaging, like a mammogram and/or ultrasound.”
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Doing regular self-exams lets you know your normal so you can spot potential issues, whether they’re cysts or something else. “Although a religious monthly breast self-exam isn’t necessarily recommended, ‘breast self-awareness’ is,” says Dweck. “Examine yourself from time to time, so if a change occurs, you can bring it to your gyno’s attention.” The best time to check for fibrocystic changes is about a week after the first day of your period, when your hormones have settled down a bit.
There are lots of different ways to do a breast self-exam, but what matters most is that you’re thorough with whatever method you choose. Here’s one effective technique recommended by Ross:
- Stand in front of the mirror with your hands on your hips.
- Raise your arms over your head while looking for changes in the mirror. Look for asymmetry, redness, dimpling, discharge or any other suspicious visual clues.
- Lie on your back and feel each breast, looking for lumps and unfamiliar tissue changes. Extend the hand that’s on the same side as the breast your examining, reaching over your head. Using the opposite hand, run your fingertips firmly over the breast tissue in a circular motion, one-quarter of your breast at a time.
- Once you’ve finished examining each breast, check each underarm as well to feel for similar changes.
- Stand up or sit and recheck your breasts like you did in step 3.
Watch this video on how to do a breast self-exam:
If something feels or looks off, keep calm and notify your doctor right away. “Regardless of the presence or absence of fibrocystic breasts or your risk for breast cancer, it is important to get regular screening mammograms as well, as recommended by your doctor,” says Zaremba. “Most women should begin yearly mammograms at age 40 to 45. Women at high risk for breast cancer—because of family history, a breast condition or another reason—need to begin screening earlier and/or more often. Talk to your medical provider to be sure.”
Most women with fibrocystic breasts don’t experience annoying symptoms. At times, the condition is so unnoticeable that some women don’t even know the cysts are there until they stumble upon them during an X-ray or a breast self-exam.
For other women, that’s not the case: “Some patients will experience breast tenderness and pain,” says Sherry Ross, M.D., women’s health expert and author of She-ology: The Definitive Guide to Women’s Intimate Health. Period. “Fibrocystic breasts are classically lumpy and tender in the upper and outer areas of both breasts. Varying sizes of fluid-filled cysts are more noticeable one week before their period, as well.”
It can also be normal for women to experience some nipple discharge—either brown-ish or green-ish in color—when pressure is applied on their breasts. If your set is leaking without warning, however, keep a close eye on them; there are certain scenarios where this symptom could be a sign of something more serious. “If the discharge is bloody or only seen in one breast, patients should contact their healthcare provider for further evaluation and consideration of other potential causes, [such as breast cancer],” says Cornell.
If you have harmless breast cysts that are just sort of chillin’ without bothering you too much, your doc will most likely leave them alone. But if they get too big or too painful to ignore, they can be drained with a needle by a physician or surgically removed without too much fanfare. Before you opt for a procedure, though, there are a few things you can try at home to alleviate any bothersome symptoms.
“Women with fibrocystic breast changes usually do not require treatment,” says Cornell. “However, breast pain or tenderness can be managed in several ways. It is recommended that patients wear a firm-support bra, especially while exercising, to prevent pain. Patients who experience mild to moderate pain may apply warm compresses or use over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Some patients have also reported improved pain by limiting caffeine intake; however, available research studies have not demonstrated a significant relationship between caffeine and fibrocystic changes. There has even been some suggestion that use of primrose oil and/or vitamin E supplementation may improve breast pain, although the evidence is still inconclusive.”
Remember: Make sure your doctor checks out the lumps in your breasts to confirm they are benign cysts before you move ahead with at-home remedies. With that said…
Unless you have X-ray vision (and if you do, please drop us a line to let us know how that’s working out for you!), you can’t differentiate between a benign cyst and a malignant tumor just by feeling it under your skin. The only way to get legit answers is to pay a visit to your doctor’s office.
“Diagnosis is based on a clinical exam, imaging such as a mammogram or sonogram (ultrasound), or a biopsy to rule out other findings,” says Dweck. “Many times I will examine someone and then repeat the exam after their menstrual cycle ends to see if the findings have resolved.”
Whatever you do, don’t try to self-diagnose. No need to freak out; just play it on the safe side and get a professional opinion to find out if cysts are what you’re dealing with, and then you can treat them accordingly.
The medical community still hasn’t quite figured out exactly why fibrocystic breast changes happen, but they do have their eyes on a possible cause: menstruation.
“Women’s breast tissue is sensitive and responsive to many internal influences,” says Carolyn DeLucia, M.D., of VSPOT Medi SPA in New York City. “Internal factors, such as hormones and menstrual cycling, cause changes in the breast tissue cyclically. These changes can cause a fibrous or toughening of the breast tissue. The most clinical and evidence-based cause is uninterrupted menstrual cycles without pregnancy. Each cycle, with [its associated] changing hormonal levels, stimulates the tissue to prepare for pregnancy and lactation. Glands begin to enlarge and increase in number; but when pregnancy does not occur, the extra cells go through a natural cell death and inflammatory response. This inflammation may cause the pain, tenderness, and development of fibrous tissue, as well as the small cysts of accumulated fluid associated with fibrocystic breasts.”
Fibrocystic changes often happen right after ovulation, with symptoms reaching their peak right before menstruation—which is why some doctors might prefer to test you for the condition both before and after your period. And because cysts form naturally (most likely) as a result of your cycle, there’s not much you can do to prevent them.