woman’s ROUTINE MEDICAL EXAMINATION. Fibroade-
nomas are characteristically firm, smooth, oval or
round, and rubbery in texture. They move freely
(are not attached to any surrounding tissues).
Biopsy is the only means of definitive diagnosis.
MAMMOGRAMis often not helpful in women under
age 30 because their breast tissue is quite dense,
which makes it difficult to distinguish growths
within the breast. As well, the radiologic charac-
teristics of fibroadenoma are very similar to those
of breast cysts and BREAST CANCER. ULTRASOUND
imaging is sometimes useful to visualize the
growth though does not provide definitive diagno-
sis either.
Some doctors recommend surgery to remove a
fibroadenoma because although fibroadenoma
does not evolve into cancer, there is a slight possi-
bility cancer may develop within the epithelial
cells the fibroadenoma contains. Other doctors
suggest a course of watchful waiting when the
diagnosis is certain and the fibroadenoma is small.
About 10 percent of fibroadenomas spontaneously
disappear within a year or two of their discovery.
Should the fibroadenoma grow or change, the
doctor may biopsy it again or remove it.
See also FIBROCYSTIC BREAST DISEASE.
fibrocystic breast disease A chronic condition in
which multiple noncancerous cysts develop in the
breasts. As the cysts rupture and heal, they cause
clusters of scarlike tissue that form palpable lumps
in the BREAST. Though called a disease, this condi-
tion is benign (harmless and noncancerous) and
very common, affecting more women than not;
doctors consider it a normal process associated
with the fluctuation of hormones during the MEN-
STRUAL CYCLE. Fibrocystic breast disease commonly
affects both breasts though may affect only one
breast.
The health concerns of fibrocystic breast disease
are twofold. First, the cysts often cause PAINand
swelling of the breasts, particularly in the week
before and the first day or two of the menstrual
period. Second, it is not possible to be certain a
breast lump is a cyst, raising concerns about
BREAST CANCER. As well, though the cysts them-
selves do not become cancerous, when they are
abundant their presence can delay detection of a
breast cancer tumor. Fibrocystic breasts are more
dense, decreasing the effectiveness of the MAMMO-
GRAM.Symptoms and Diagnostic Path
Fibrocystic breasts are typically painful. The dis-
comfort may be persistent, having the quality of
dull aching or a sensation of fullness, or cyclic ten-
derness that intensifies the week before and first
few days of the menstrual period. Other symp-
toms may include- bumpy or lumpy texture to one quadrant, one
side, or all of the breast - itching or tingling of the nipples
- premenstrual swelling of the breasts
Fibrocystic lumps are characteristically rubbery,
smooth, and rounded. With palpation they move
within the breast; they are not anchored to the
underlying structure of the breast. The diagnostic
path includes comprehensive palpation of the
breasts. Depending on the woman’s age, health
history, risk for breast cancer, and other factors,
the doctor may use diagnostic imaging procedures
such as mammogram and breast ULTRASOUND to
obtain additional information about the shape,
size, and pattern of the fibrocystic tissue. The doc-
tor may also biopsy several lumps to evaluate their
pathology (cell structure and organization) and
rule out other causes for the symptoms.Treatment Options and Outlook
Lifestyle treatments that help mediate discomfort
include wearing a supportive bra when symptoms
are most significant. Some women get relief by
limiting their intake of dietary fats and CAFFEINE,
though clinical studies of the correlations between
these factors and fibrocystic breasts so far have
produced inconclusive and sometimes conflicting
findings. Others find that vitamin E, vitamin B 6
(pyridoxine), and the herbal preparation evening
primrose oil reduce tenderness and swelling. Med-
ical interventions that may provide relief include
NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS),
which reduce INFLAMMATION, and oral contracep-
tives (birth control pills), which regulate the hor-
monal cycle. Nearly always the discomforts offibrocystic breast disease 285