About 50% of women of reproductive age may experience breast tissue changes known as fibrocystic breasts. This condition is common in premenopausal women due to the natural fluctuations that occur during menstrual cycles. Women might notice these changes during self-examination, which can sometimes cause concern about breast cancer.
While that may be an initial fear, medical experts have concluded that fibrocystic breasts do not increase the risk for breast cancer. Understanding the characteristics of these breast tissue changes, their common causes, and steps you can take to support your health can be beneficial.
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What Are Fibrocystic Breasts?
Benign texture changes to the breast tissue can result in a condition known as fibrocystic breast. "Fibro" refers to fibrous thick tissue, and "cystic" refers to fluid-filled sacs, which can result in a ropey, lumpy, or knotty feeling along the breast tissues.
While this is a non-cancerous condition, it can be uncomfortable, especially during menstrual cycles. The most common age range to see these changes is between 30 and 50 years old due to hormonal fluctuations. After menopause, these breast changes can also occur with the use of hormone replacement therapy.
Fibrocystic Breast Signs & Symptoms
You may notice changes in your breast tissue as you age. If you are experiencing any of these symptoms, they could be a sign of changes to your breast tissue. Here are examples of how breast tissue changes could feel:
- Nodules or lumpy tissue changes
- Symmetrical breast tissue changes
- Breast pain or tenderness
- Worsening pain from ovulation to menses
- Discomfort in the upper outer part of the breast
- Fluctuation in the size of the lumps during menses
- Green or dark brown nipple discharge
What Causes Fibrocystic Breasts?
This condition is not fully understood but has primarily been linked to hormonal fluctuations. Elevated estrogen, with lower levels of progesterone, seems to play a key role in developing fibrocystic breasts in reproductive years. One study evaluated this by measuring estradiol (E2) and progesterone (P), along with symptoms rating during days 21 and 24 of the luteal phase of the menstrual cycle. The study found that those with fibrocystic breast changes had a significant drop in progesterone on day 24 and an increase in estrogen. The imbalance of estradiol to progesterone ratio, explicitly having a low E2/P, is correlated to an increased probability of developing fibrocystic breasts.
Additionally, women who are on hormone replacement therapy (HRT) of estrogen have a higher likelihood of experiencing breast tissue changes than those who do not take exogenous estrogen during menopause. Another area to consider is young adulthood alcohol consumption. One study found that consuming around three alcoholic beverages or more per day from ages 18-22 showed an increased association with benign breast changes like fibrocystic breasts. This constitutes a small percentage of the population and should be assessed based on an individual's current or past lifestyle history.
Functional Medicine Labs to Explore Hormonal Imbalances
Hormone imbalances are thought to be a primary factor in fibrocystic breast changes. Evaluating sex hormones through hormone testing, while also assessing gut health, can provide insight into potential imbalances.
Comprehensive Hormone Panel
DUTCH Complete is a dried urine test that looks at hormone metabolites. The urine collection is a multi-day process that provides insight into hormone fluctuation. This may be helpful for women who are experiencing potential hormone imbalances or for monitoring hormone levels while taking HRT.
Gut Health Assessment
Microbiome health is essential to the metabolism and use of circulating estrogen. Having a healthy balance of bacteria in the gut can support estrogen balance. While gut health has not been directly linked to fibrocystic breast changes, it is worthwhile to investigate gut microbiome health as it’s essential in hormone health.
The GI-MAP + Zonulin test by Diagnostic Solutions and the GI Effects® Comprehensive Profile from Genova Diagnostics are two tests that can help determine your status of beneficial versus pathogenic bacteria. They also test for beta-glucuronidase-producing bacteria and beta-galactosidase-producing bacteria, which are both involved in estrogen metabolism.
Additional Lab Tests
Depending on your presentation, your primary care provider may want you to have multiple tests done. The most common assessment is through a clinical breast exam. Additional investigation may include a mammogram, ultrasound, or biopsy if the abnormal findings are indicated on imaging.
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Conventional Approaches for Fibrocystic Breasts
In most cases, there is no conventional treatment to change these breast tissue characteristics, but there are recommendations to help manage the associated discomfort. Pain relief methods, warm compresses, and wearing a supportive bra can all assist with associated discomfort. More severe situations may require a procedure, which will consist of puncturing simple cysts. This is done under guided ultrasound in which the needle is precisely placed for aspiration of the cyst. This is only warranted in cases where discomfort has been persistent and impacting someone's daily life. In more complex cases of recurring, painful cysts, surgical excision may be necessary.
Functional Medicine Approaches for Fibrocystic Breasts
From diet to integrative healthcare options, functional medicine can provide complementary support to cases of fibrocystic breast.
Diet and Fibrocystic Breast Health
Consuming food that fuels your body without creating inflammation and imbalance is an ideal route to take in order to support your hormone health. Since elevated estrogen and lower progesterone are the patterns most associated with this condition, it’s important to eat food that will support a balance between these two. A whole-foods high in fiber diet, such as legumes, flaxseed, oats, spinach, various nuts, and fruits, may help the body metabolize and excrete extra estrogen.
Eating adequate amounts of lean protein daily, in the form of chicken, fish, and organ meats, is a great source of vitamins and fuel. Fats, primarily anti-inflammatory omega-3s, may also assist in hormone function. Great sources of omega-3s include wild-caught salmon, chia seeds, oysters, and sardines. Combining all these critical components in your daily meals can provide the nutrients your body needs to thrive.
Supplements & Herbs for Fibrocystic Breasts
The use of nutraceuticals and herbs may help support hormone balance and manage discomfort associated with fibrocystic breasts. Here are some options to consider if you have been diagnosed with this condition.
Evening Primrose Oil (EPO)
This fatty acid plant source derivative provides a source of gamma-Linolenic acid (GLA). Women deficient in this may have an increased chance of breast tissue sensitivity to sex hormones, leading to breast discomfort. Multiple clinical trials have shown that supplementing with EPO may help manage mastalgia (breast discomfort), a common symptom of fibrocystic breast. One source states that EPO can be dosed at 1000 mg two to three times daily for up to three months.
Vitex Agnus-Cactus
This botanical, commonly called chasteberry, is utilized for hormone imbalances. In cases of estrogen dominance and progesterone deficiency, chasteberry may be helpful. It’s also known to be helpful in cases of cyclical breast discomfort. The dosage for this herbal extract is between 20 to 40 mg per day, depending on the patient's case and intended goals. It’s best to consult with a practitioner trained in botanical medicine who can recommend an individualized dosage.
Vitamins
There are two vitamins that have been shown to support overall breast health. These include vitamin B6 and vitamin E. The dosage for vitamin B6 that was found to be effective was 50 mg twice a day, while vitamin E was 200 IU twice a day for two months.
Complementary and Integrative Medicine
Incorporating holistic health modalities to assist with this condition can provide a multifaceted approach. Acupuncture and exercise therapy are two options for addressing fibrocystic breasts.
Traditional Chinese Medicine-Acupuncture
Acupuncture uses tiny needles inserted at specific energetic points to help facilitate balance within the body. When it comes to discomfort, acupuncture has been widely used to help the body process discomfort synergistically. Acupuncture is also a tremendous integrative health practice to help balance hormones, which is often the underlying factor in fibrocystic breasts.
Exercise Therapy
There is some evidence suggesting the percentage of body fat and total lean body mass may be predictors of the development of fibrocystic breast changes. Maintaining a healthy percentage of body fat through both diet and exercise may be one avenue to assist you in decreasing your risk of developing this condition. Participating in at least 150 minutes a week of moderate-intensity physical activity such as biking, walking, or other aerobic exercises can help you stay fit while also supporting your hormone health.
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Summary
The condition of fibrocystic breasts may be common, but it does not necessarily mean that it is normal. If you have found yourself with these changes, it might indicate an underlying imbalance. Exploring this imbalance through functional medicine and then taking a root cause approach to wellness can both help manage your symptoms and lead you down a path to a healthier you!
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