Fibroadenosis
Introduction
Fibroadenosis, often referred to as fibrocystic breast disease, is a frequently encountered benign breast condition affecting women in the reproductive age group, more prevalent between the ages of 30 and 50. It involves the development of fibrous and cystic changes that can cause feel of lump in breast, pain and discomfort in the breasts, particularly during menstrual cycles due to fluctuations in hormonal levels.
What is Fibroadenosis?
Fibroadenosis is characterized by the presence of lumpy breast tissue caused by fibrosis (thickening of connective tissue) and cyst formation. Unlike fibroadenomas, which are discrete benign tumors, fibroadenosis involves more diffuse changes in the breast tissue. These changes are not considered a disease but rather a variation of normal breast tissue that can cause symptoms such as tenderness, lump in breast, and pain, particularly before menstruation and in the majority of patients it resolves after completion of cycle. However, in a few subsets of patients, pain and discomfort may be severe hampering daily activities and may persist even for prolonged duration.
Symptoms of Fibroadenosis
- Lumpy or thickened areas in the breast, often described as rubbery, glandular, firm consistency
- Breast tenderness or pain, especially in the upper outer quadrants (area with maximum breast tissue)
- Fluctuation of lump size and pain/ discomfort with the menstrual cycle (cyclical mastalgia)
- Occasional nipple discharge (serous/ watery or greenish colour)
- Symptoms typically improve after menstruation
- Subsides during pregnancy, lactation and after menopause
Causes and Risk Factors
The exact cause of fibroadenosis is unknown, but it is believed to be related to hormonal fluctuations, particularly estrogen dependence. These hormonal changes lead to the development of cysts and fibrous tissue in the breast.
Diagnosis
Diagnosis of fibroadenosis usually involves a combination of:
- Clinical breast examination to feel for lumps or thickened areas/ increased glandularity and tenderness
- Imaging such as ultrasound or mammography to differentiate cysts and rule out other conditions
- Sometimes, fine needle aspiration (FNAC) or biopsy may be recommended if the diagnosis is uncertain or if lumps are persistent or growing – to rule out any malignancy (cancer)
Treatment and Management
Fibroadenosis often does not require aggressive treatment and conservative is the preferred management focussing on relief of symptoms and monitoring:
- Pain Relief: Over-the-counter pain medications like NSAIDs (pain killers) can help reduce breast pain.
- Warm Compresses: Applying warm compresses can alleviate discomfort.
- Supportive Bras: Wearing a well-fitted, supportive bra can reduce breast movement and tenderness.
- Lifestyle Adjustments: Reducing caffeine intake, chocolates and salt. Managing stress may help some women.
Drugs:
- Evening primrose oil / Vit E supplements can help in mild to moderate symptoms
- Danazol can be tried in severe cases – can cause menstrual disturbances, acne, male pattern hair growth and not advised in patients planning for pregnancy.
- Few also uses Tamoxifen: anti-estrogen drug
- Surgery: Subcutaneous mastectomy (remove breast tissue) – reserved only for patients not relieved with conservative management and any suspicion of cancer in FNAC.
When to see a doctor
Seek medical advice if you notice:
- New or changing lumps in the breast
- Persistent or worsening breast pain
- Skin changes such as dimpling
- Nipple changes, including discharge or inversion
- Redness or warmth of the breast skin
For personalized advice and treatment, consult our expert team at “Vizag Surgicare”.
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