Fibrosis and Simple Cysts in the Breast
Many breast lumps turn out to be caused by fibrosis and/or cysts, which are non-cancerous (benign) changes in breast tissue that happen in many women at some time in their lives. These changes are sometimes called fibrocystic changes, and used to be called fibrocystic disease.
Fibrosis and/or cysts are most common in women of childbearing age, but they can affect women of any age. They may be found in different parts of the breast and in both breasts at the same time.
Fibrosis refers to a large amount of fibrous tissue, the same tissue that ligaments and scar tissue are made of. Areas of fibrosis feel rubbery, firm, or hard to the touch.
A round, movable lump, especially one that’s tender to the touch, suggests a cyst. Cysts are fluid-filled, round or oval sacs within the breasts. They are most often found in women in their 40s , but they can occur in women of any age. Monthly hormone changes often cause cysts to get bigger and become painful and more noticeable just before the menstrual period.
Cysts start out from fluid building up inside the breast glands. Microcysts (tiny, microscopic cysts) are too small to feel and are found only when tissue is looked at under a microscope. If fluid continues to build up, macrocysts (large cysts) can form. These can be felt easily and can be as large as 1 or 2 inches across. As they grow, the breast tissue around the cyst may stretch and be painful.
Most often, fibrocystic changes are diagnosed based on symptoms, such as breast lumps, swelling, and tenderness or pain. These symptoms tend to be worse just before a woman’s menstrual period begins, and may change as you move through different stages of your menstrual cycle. Your breasts may feel lumpy and, sometimes, you may notice a clear or slightly cloudy nipple discharge.
Sometimes, one of the lumps might feel firmer or have other features that lead to a concern about cancer. When this happens, an ultrasound may be done to make sure that the lump is a simple fluid-filled cyst. If the ultrasound isn’t clear, a biopsy may be needed to make sure that it’s not cancer.
Putting a thin needle into the cyst can confirm the diagnosis and, at the same time, drain the cyst fluid. Removing the fluid may reduce pressure and pain for some time, but the fluid doesn’t need to be removed unless it’s causing discomfort. And if removed, the fluid might come back later. Cysts may go away over time.
Most women with fibrocystic changes and without bothersome symptoms do not need treatment, but they might be watched closely. If you have mild discomfort from fibrosis, you may get relief from well-fitted, supportive bras, applying heat, or using over-the-counter pain relievers.
Some women report that their breast symptoms improve if they avoid caffeine and other stimulants found in coffee, tea, chocolate, and many soft drinks. Studies have not found that these stimulants cause these symptoms, but many women feel that avoiding these foods and drinks for a couple of months is worth trying.
Because breast swelling toward the end of the menstrual cycle is painful for some women, some doctors recommend that women with severe symptoms cut out salt in their diets or take diuretics (drugs to help remove fluid from the body). It’s been suggested that some types of vitamin or herbal supplements might relieve symptoms, but so far none have been proven to be helpful, and some may have side effects if taken in large doses. Some doctors prescribe hormones, such as oral contraceptives (birth control pills), tamoxifen, or androgens. But these are usually given only to women with severe symptoms because they also can have serious side effects.
How do fibrosis and simple cysts affect your risk for breast cancer?
Neither fibrosis nor cysts increase your risk of later developing breast cancer.
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Last Medical Review: March 16, 2015 Last Revised: April 21, 2016
- Fibrosis and Simple Cysts in the Breast
- Hyperplasia of the Breast (Ductal or Lobular)
- Lobular Carcinoma in Situ (LCIS)
- Adenosis of the Breast
- Fibroadenomas of the Breast
- Phyllodes Tumors of the Breast
- Intraductal Papillomas
- Granular Cell Tumors of the Breast
- Fat Necrosis and Oil Cysts in the Breast
- Duct Ectasia
- Other Non-cancerous Breast Conditions