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Fibrocystic Breast Disease

Breast nodules are a frequently presented gynecologic complaint. These nodules have two chief causes: benign breast disease and cancer. However, benign breast disease is the most common cause of nodules and can stem from cyst formation, obstructed ducts, inflammation, or infection. Although benign breast nodules have several causes and manifest themselves differently, for purposes of this discussion, all fibrous nodules or lumps will be referred to as fibrocystic breast disease (FBD).

According to the National Cancer Institute/National Institutes of Health (2001a,b), fibrocystic breast disease (FBD) is a common condition that affects many women at some time in their lives. FBD is most common between the ages of 30 and 50 (AMA 1989), but younger women as well as menopausal women taking hormone replacement therapy (HRT) may also experience FBD (Imaginis 2000). More recently, some physicians have preferred to call FBD, fibrocystic breast "condition" or "change" (FBC).

The symptoms of FBD can vary significantly. Some women experience severe breast tenderness and pain with multiple lumps in both breasts. Other women have only mild tenderness with no detectable lumps. In some women the symptoms are relatively constant, while in others the symptoms come and go either monthly or over several months. According to the National Cancer Institute (2001a), the chances of developing FBD are greater in women who have never had children, have irregular menstrual cycles, or have a family history of FBD or breast cancer.

FBD is a condition generally characterized by lumps that move freely in the breast tissue and vary in texture and size (Lark 1996). However, because the clinical signs of breast cancer are not easily distinguished from benign breast conditions, all breast lumps should be examined by a physician and not be assumed to be benign. Only a physician can determine the nature of breast lumps or changes (National Cancer Institute 2001a).

Because FBD is a benign condition, it usually does not lead to breast cancer (American Cancer Society 1991, 1997; National Cancer Institute 2001b). Fortunately, only about 5% of FBD cases involve the type of changes that would be considered a risk factor for developing breast cancer. However, benign conditions may eventually result in calcifications (Anon. 1998). Calcifications are quite small--sometimes as small as a grain of salt--and cannot be detected during a routine exam; however, calcifications may be detected by routine mammography. Since calcifications may be associated with some types of pre-malignant lesions, it is important to follow your physician's recommendations concerning the frequency of mammography (AMA 1989).