Fibrocystic Breast Disease
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[edit] Fibrocystic Breast Disease
As mentioned above about 40% of breast lumps are caused by fibrocystic disease. This diagnostic term is misleading as it implies that it would be the opposite of health and should be treated. The term "breast nodularity" is often used now by clinicians instead. It is often symptomatic in the premenstrual period of the menstrual hormone cycle when progesterone from the ovaries increases blood flow to the breasts. This leads to more nodularity in a woman who has this tendency (Ref. 9, p. 1083).
The important part is to screen for the small number of women in this group who have breast cancer. Depending on the clinical findings the doctor may elect to follow-up and observe only or to do tests when there is suspicion of cancer. Mammography is usually not recommended in a woman younger than 30 except for a high risk setting with a family history of genetic breast cancer or prominent symptoms on only one breast. Digital infrared thermal imaging can be utilized where available to help distinguish between fibrocystic breast tissue and early breast cancer.
There has been a theory that perhaps caffeine could be blamed as a cause of fibrocystic breast disease. However, a recent thorough review of dietary factors that may play a role in causing fibrocystic disease failed to show evidence to condemn caffeine(Ref. 24). Instead these authors found that a low fat, high fiber diet with socalled soy isoflavone (found in soy products or soy protein powder) will give relief for this condition. Primrose oil, vitamin E, or pyridoxine (Vit. B6) were not found to be effective contrary to many flyers from health food stores. Cutting out cigarette smoking and curtailing excessive alcohol consumption has general health benefits and in my opinion contributes to some reduction in breast pain.
Treatment must be individualized. Drugs like danazol, tamoxifen and bromocriptine are not recommended by the FDA (see Ref. 9, p.1083) because of the longterm side effects. Simple steps such as the zone diet plan (Ref. 2) are redommendable and often effective (Ref. 24, also see "breast pain" under the link "common breast problems"). General life style changes as mentioned above will be helpful.
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