Fibrocystic breast changes

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Fibrocystic breast changes is a commonly used phrase to describe painful, lumpy breasts.

Causes
The exact cause is not known. It is believed that hormones made in the ovaries can make
a woman's breasts feel swollen, lumpy, or painful before or during menstruation each month.

Up to half of women have this problem at some time during their life. It is most common
between the ages of 20 and 45. It is rare in women after menopause, unless they are taking
estrogen.

Some women feel that eating chocolate, drinking caffeine, or eating high-fat foods cause their
symptoms. But there is no clear proof of this.

Symptoms
Symptoms usually get better after you go through menopause. If you take birth control pills,
you may have fewer symptoms. If you are on hormone therapy, you may have more
symptoms.

Symptoms are usually worse right before your menstrual period and improve after your
period starts.

Symptoms can include:

 Pain or discomfort in both breasts

 The pain commonly comes and goes with the period, but can last through the whole
month
 Breasts that feel full, swollen, and heavy
 Pain or discomfort under the arms
 Thick or lumpy breasts

You may have a lump in the same area of the breast that becomes larger before each period
and shrinks afterward. This type of lump moves when it is pushed with your fingers. It does
not feel stuck or fixed to the tissue around it. This lump is common with fibrocystic breasts.

You may have discharge from the nipple. If the discharge is clear, red, or bloody, talk to your
health care provider right away.

Exams and Tests

Your health care provider will examine you. This will include a breast exam.Tell your doctor
or nurse if you have noticed any breast changes.

If you are over 40, ask you doctor or nurse how often you should have a mammogram to
screen for breast cancer. For women under 35, a breast ultrasound may be used to look more
closely at breast tissue.

You may need further tests if a lump was found during a breast exam or your mammogram
result was abnormal. Another mammogram and breast ultrasound may be done.

Treatment
Women who have no symptoms or only mild symptoms do not need treatment.

Your health care provider may recommend the following self-care measures:

 Take over-the-counter medicine such as acetaminophen or ibuprofen

 Apply heat or ice on the breast
 Wear a well-fitting or sports bra

Some women believe that eating less fat, caffeine, or chocolate helps with their symptoms.
But there is no good evidence that these measures help.

Vitamin E, thiamine, magnesium, and evening primrose oil are not harmful in most cases.
But studies have not shown these to be helpful. Before taking any medicine or supplement,
talk with your health care provider.

For more severe symptoms, your health care provider may prescribe hormones, such as birth
control pills or other medicine. Take the medicine exactly as instructed. Be sure to let your
provider know if you have side effects from the medicine.

Surgery is never done to treat this condition.

Outlook (Prognosis)
If your breast exams and mammograms are normal, you do not need to worry about your
symptoms. Fibrocystic breast changes do not increase your risk of breast cancer. Symptoms
usually improve after menopause.

When to Contact a Medical Professional

Call your health care provider if:

 You find new or different lumps during your breast self exam
 You have new discharge from the nipple or any discharge that is bloody or clear
 You have redness or puckering of the skin, or flattening or indentation of the nipple

Alternative Names
Fibrocystic breast disease; Mammary dysplasia; Diffuse cystic mastopathy; Benign breast
disease; Glandular breast changes

References
Miltenburg DM, Speights VO Jr. Benign breast disease. Obstet Gynecol Clin North Am.
2008;35:285-300.

Katz VL, Dotters D. Breast diseases: diagnosis and treatment of benign and malignant
disease. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive
Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 15.

Update Date: 11/5/2012

Updated by: Shabir Bhimji, MD, PhD, General Surgery, Midland, TX. Review provided by
VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc.,
Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

Browse the Encyclopedia

MedlinePlus Topics

 Breast Diseases

Images

Female Breast

Fibrocystic breast disease

Read More

 Benign
 Caffeine in the diet
 Incidence
 Menopause

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation

HealthCare Commission (www.urac.org). URAC's accreditation program is an independent
audit to verify that A.D.A.M. follows rigorous standards of quality and accountability.
A.D.A.M. is among the first to achieve this important distinction for online health
information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and
privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the
principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the
diagnosis or treatment of any medical condition. A licensed physician should be consulted for
diagnosis and treatment of any and all medical conditions. Call 911 for all medical
emergencies. Links to other sites are provided for information only -- they do not constitute
endorsements of those other sites. Copyright 1997-2013, A.D.A.M., Inc. Duplication for
commercial use must be authorized in writing by ADAM Health Solutions.

http://www.nlm.nih.gov/medlineplus/ency/article/000912.htm

Fibrocystic Breast Changes

Fibrocystic breast changes -- once called fibrocystic breast disease -- is a common
noncancerous breast condition. More than half of all women have fibrocystic breasts at some
point.

Fibrocystic breast changes can occur at any age, but is most common in younger women of
childbearing age. Fibrocystic breasts after menopause are not as common. Fibrocystic
changes can occur in one or both breasts and in more than one type of breast tissue.

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Types and Causes of Fibrocystic Breast Changes

Most fibrocystic breast changes are the result of monthly hormonal changes and are nothing
to be concerned about. However, some may suggest a slightly increased risk of cancer. These
may require other tests to confirm a diagnosis.

Types of fibrocystic breast changes are:

Fibrosis. This is fibrous tissue similar to scar tissue. It feels rubbery, firm, or hard to the
touch. It does not increase the risk for cancer.
Cysts. These are fluid-filled sacs. Microscopic cysts are too small to feel. These may get
bigger and form macrocysts, which may be 1 to 2 inches across; at this size you can feel
them.

Cysts may enlarge and become tender right before your period. They tend to be round and
movable. But it may be hard to tell the difference between a cyst and a mass. So you may
need other tests to confirm a diagnosis.

Symptoms of Fibrocystic Breast Changes

Common symptoms of fibrocystic breast changes are:

 Breast swelling or thickening

 Lumps within the breast, which may vary in size and texture
 Breast pain or tenderness

Other symptoms of fibrocystic breast changes include:

 Aching or sharp pain

 Burning
 Itching

Symptoms may change throughout your menstrual cycle. That's because hormones increase
the amount of fluid in your breasts. Your breasts may also change during pregnancy or in
response to hormones you take. This includes hormones in birth control pills and hormone
replacement therapy.

If you find a lump or other breast change, especially if it remains the same throughout your
cycle, see your doctor. Be prepared to answer questions like these:

 Describe your breast lump or changes. Has this changed over time?
 When was your last period? Are you pregnant or nursing?
 Have you had any breast problems in the past?
 Have you ever had a breast biopsy?
 When was your last mammogram?
 Have you or a family member had breast cancer?

If a lump becomes firm or has other questionable features, your doctor may request a
mammogram, ultrasound, or biopsy to rule out cancer. This involves removing cells and
examining them under a microscope.

For cysts, your doctor may suggest fine needle aspiration. This involves using a very thin,
hollow needle attached to a syringe to drain fluid. If there is no blood present and the cyst
goes away, you will likely need no further tests.

Treatment of Fibrocystic Breast Changes

In most cases, treatment is not needed for fibrocystic breast changes. But doing a monthly
breast exam can help you know what is normal for you and what is new. Your doctor may
also suggest regular follow-up.
Removing fluid through fine-needle aspiration may help relieve symptoms of pain or
pressure. But know that fluid may return at a later time.

These are other steps that may help with mild discomfort:

 Supportive bras
 Over-the-counter pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs)
 Reduced intake of caffeine and stimulants found in coffee, tea, chocolate, and soft drinks

Oral contraceptives may be a good idea for women with severe symptoms. Although certain
vitamins and salt reduction are also sometimes suggested, studies have not confirmed their
benefits.

WebMD Medical Reference

View Article Sources

Reviewed by Kimball Johnson, MD on August 14, 2012

© 2012 WebMD, LLC. All rights reserved.

http://women.webmd.com/guide/fibrocystic-breast-changes-symptoms-treatments-causes

Alternative Names

Mammary dysplasia; Diffuse cystic mastopathy; Benign breast disease

Definition of Fibrocystic breast disease:

Fibrocystic breast disease is a commonly used phrase to describe painful, lumpy breasts. The
word "disease" makes women worry that their breasts are abnormal, but this is not really a
disease.

Some health care providers use the phrase "fibrocystic change" because it sounds less
worrisome to the patient.

Causes, incidence, and risk factors:

During a woman's menstrual cycle, the breasts are affected by hormones made in the ovaries.
These hormones can cause the breasts to feel swollen, lumpy, and painful. After menopause,
these changes in the breasts usually stop happening.

There is no definite cause of painful, lumpy breasts. Some women feel that eating chocolate,
drinking caffeine, or eating a high-fat diet can cause their symptoms, but there is no clear
proof of this.

Fibrocystic changes in the breast with the menstrual cycle affect over half of women, and
most commonly start during their 30s. Women who take hormone replacement therapy may
have more symptoms. Women who take birth control pills have fewer symptoms.
Female Breast

Fibrocystic breast disease

 Reviewed last on: 1/24/2011

 Debra G. Wechter, MD, FACS, General Surgery practice specializing in breast cancer, Virginia
Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA,
Medical Director, A.D.A.M., Inc.

References

Miltenburg DM, Speights VO Jr. Benign breast disease. Obstet Gynecol Clin North Am.
2008;35:285-300.

Valea FA, Katz VL. Breast diseases: diagnosis and treatment of benign and malignant
disease. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive
Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 15.

Related Articles

 Benign
 Menopause
 Incidence
 Fat
 Caffeine in the diet

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission
(www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of
quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and
services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member
of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any
medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical
conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute
endorsements of those other sites. © 1997- 2013 A.D.A.M., Inc. Any duplication or distribution of the information co
Source: Fibrocystic breast disease http://www.umm.edu/ency/article/000912.htm#ixzz2VALgLM77
University of Maryland Medical Center
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Ingin punya anak adalah hak setiap orang, namun perlu dipikirkan risikonya jika menjalani
kehamilan pertama di usia “lanjut”.

Wanita masa kini merdeka memilih jalan hidup dan kehidupannya. Apa yang jadi prioritas
hidupnya, itulah yang diutamakan. Tentu saja situasi ini berpengaruh pada rencana kehidupan
berumah tangga serta keputusan menjalani kehamilan dan punya anak.

Berbagai alasan melatarbelakangi keputusan menjalani kehamilan dan punya anak. Yang
pasti, saat ini tidak sedikit wanita meyakini, bahwa menjalani kehamilan dan punya anak
harus siap fisik dan mental. Masalahnya, tak jarang wanita malah seperti keterusan menunda
kehamilannya dan, tak terasa, usia terus bertambah.

Padahal menurut para ahli, usia dan fisik wanita berpengaruh terhadap proses kehamilan
pertama, pada kesehatan janin dan proses persalinan. World Health Organisation (WHO)
memberikan rekomendasi sebagaimana disampaikan dr. J.M. Seno Adjie, SpOG., ahli
kebidanan dan kandungan dari RSUPN Cipto Mangunkusumo, “Sampai sekarang,
rekomendasi WHO untuk usia yang dianggap paling aman menjalani kehamilan dan
persalinan adalah 20 hingga 30 tahun. Tapi mengingat kemajuan teknologi saat ini, sampai
usia 35 tahun masih bolehlah untuk hamil.”

Beda usia, beda kondisi fisik

Apa pengaruh usia dan fisik wanita pada kehamilan pertama dan proses persalinan?
“Kehamilan di usia kurang dari 20 tahun bisa menimbulkan masalah, karena kondisi fisik
belum 100% siap. Kehamilan dan persalinan di usia tersebut, meningkatkan angka kematian
ibu dan janin 4-6 kali lipat dibanding wanita yang hamil dan bersalin di usia 20-30 tahun,”
jelas dr. Seno.

Beberapa risiko yang bisa terjadi pada kehamilan di usia kurang dari 20 tahun adalah
kecenderungan naiknya tekanan darah dan pertumbuhan janin terhambat. “Bisa jadi secara
mental pun si wanita belum siap. Ini menyebabkan kesadaran untuk memeriksakan diri dan
kandungannya rendah. Di luar urusan kehamilan dan persalinan, risiko kanker leher rahim
pun meningkat akibat hubungan seks dan melahirkan sebelum usia 20 tahun ini,” tambah dr.
Seno.

Berbeda dengan wanita usia 20-30 tahun yang dianggap ideal untuk menjalani kehamilan dan
persalinan. “Di rentang usia ini kondisi fisik wanita dalam keadaan prima. Rahim sudah
mampu memberi perlindungan atau kondisi yang maksimal untuk kehamilan. Umumnya
secara mental pun siap, yang berdampak pada perilaku merawat dan menjaga kehamilannya
secara hati-hati,” jelas dr. Seno

Sedangkan usia 30-35 tahun sebenarnya merupakan masa transisi “Kehamilan pada usia ini
masih bisa diterima asal kondisi tubuh dan kesehatan wanita yang bersangkutan, termasuk
gizinya, dalam keadaan baik,” ujar dr. Seno
Setelah usia 35 tahun, sebagian wanita digolongkan pada kehamilan berisiko tinggi. “Di
kurun usia ini, angka kematian ibu melahirkan dan bayi meningkat. Itu sebabnya, sebenarnya,
tidak dianjurkan menjalani kehamilan di atas usia 40 tahun,” ungkap dr. Seno yang juga staf
pengajar Fakultas Kedokteran Universitas Indonesia ini.

Siap fisik, siap mental?

Bagaimana dengan proses kematangan secara psikologis? Dra. Agustine Sukarlan Basri,
M.Si., staf pengajar Fakultas Psikologi Universitas Indonesia menjelaskan, bahwa
perkembangan masa dewasa bisa dibagi menjadi dewasa muda (usia 21-39 tahun), dewasa
madya (usia 40-50 tahun), dan dewasa akhir (lanjut usia/lansia). Masing-masing fase
memiliki ciri.

“Masa dewasa muda merupakan masa membina kedekatan dan hubungan yang lebih dalam
dengan lawan jenis. Ini bisa berarti masa membina kehidupan berkeluarga. Pada masa ini
secara kepribadian seorang wanita sudah siap. Secara kognitif, perkembangan intelegensia
dan pola pikirnya sudah matang. Ia mampu mengatasi konflik-konflik emosional,” jelas
Agustine.

Dewasa madya merupakan masa ketika secara kepribadian lebih mantap. Kehidupan wanita
masa ini umumnya lebih tenang, sudah berkeluarga, dan punya anak. Bagi yang berkarier,
kariernya juga sudah ‘jelas’.

Di masa dewasa akhir, umumnya kehidupan wanita lebih tenang karena anak-anak mulai
beranjak besar, sehingga lebih memiliki waktu untuk diri sendiri.

Lalu mengapa saat ini tak sedikit wanita usia muda, khususnya usia 20 tahunan malah
menunda berkeluarga dan punya anak?

Agustine menjelaskan, “Kalau dilihat dari tahapan perkembangan kematangan tadi,

sebenarnya wanita-wanita usia 20 tahun ke atas itu siap punya anak. Mereka sudah sampai
pada tahap kematangan kognitif, emosional, maupun aspek-aspek kepribadian lainnya. Tapi
memang, secara situasional, saat ini hanya sedikit wanita usia 20 tahunan yang langsung
memutuskan menikah dan punya anak.”

Biasanya, masih menurut Agustine, karena wanita-wanita usia 20 tahunan tersebut belum
meletakkan prioritas utama hidupnya pada pernikahan. Mungkin mereka masih ingin
menyelesaikan kuliah, atau ingin berkarier dahulu. Bisa jadi, keputusan ini juga karena
pengaruh lingkungan.

“Kehidupan ‘kan berkembang sehingga dalam benak wanita-wanita 20 tahunan itu terbersit
pikiran, ‘Kenapa pada masa ini saya harus mengurus bayi sementara teman-teman saya
belum.’ Akibatnya, mereka malah berkarier, meneruskan pendidikan ke jenjang berikut, dan
lain-lain. Intinya, mereka lebih memilih mendapatkan kebebasan dan mengembangkan diri
seoptimal mungkin dahulu. Padahal, kalau wanita usia 20 tahunan itu memutuskan untuk
kuliah namun bersedia menjalankan kehamilan dan punya anak, ya tidak masalah,” papar
Agustine
Salah satu wanita itu adalah Runi (26 tahun). Ketika memutuskan menikah, ia masih dalam
tahap akhir kuliahnya di Fakultas Kedokteran. Bahkan saat hamil, Runi bertugas sebagai co
ass di rumah sakit yang jauh dari tempat tinggalnya.

Memang dalam perkembangan selanjutnya, wanita-wanita yang menikah dan punya anak di
usia 20 tahunan, di masa dewasa madya merasa tenang karena anak sudah besar dan punya
waktu untuk diri sendiri. Kepuasan perkawinan bagi mereka meningkat tatkala masuk usia
dewasa madya (40-an).

“Bagi wanita yang menunda pernikahan dan keinginan punya anaknya, kelak di masa usia
dewasa madya malah sibuk mengurus bayi. Akibatnya, kepuasan di masa ini pun menurun.
Apalagi, meski secara mendasar di usia dewasa madya wanita lebih matang, tetapi secara
fisik ia berisiko tinggi menjalani kehamilan dan persalinan. Ini bisa mendatangkan
kecemasan,” jelas Agustine.

Usia lanjut, rawan risiko

Mau tidak mau, suka atau tidak suka, proses kehamilan dan persalinan berkaitan dengan
kondisi dan fungsi organ-organ wanita. Artinya, sejalan dengan bertambahnya usia, tidak
sedikit fungsi organ yang menurun.

“Semakin bertambah usia, semakin sulit hamil karena sel telur yang siap dibuahi semakin
sedikit. Selain itu, kualitas sel telur juga semakin menurun. Itu sebabnya, pada kehamilan
pertama di usia lanjut, risiko perkembangan janin tidak normal dan timbulnya penyakit
kelainan bawaan juga tinggi, terutama sindroma Down,” jelas dr. Seno.

Lebih lanjut dr. Seno menjelaskan, meningkatnya usia juga membuat kondisi dan fungsi
rahim menurun. Salah satu akibatnya adalah jaringan rahim tak lagi subur. Padahal, dinding
rahim tempat menempelnya plasenta. Kondisi ini memunculkan kecenderungan terjadinya
plasenta previa atau plasenta tidak menempel di tempat semestinya.

Selain itu, jaringan rongga panggul dan otot-ototnya pun melemah sejalan pertambahan usia.
Hal ini membuat rongga panggul tidak mudah lagi menghadapi dan mengatasi komplikasi
yang berat, seperti perdarahan. Pada keadaan tertentu, kondisi hormonalnya tidak seoptimal
usia sebelumnya. Itu sebabnya, risiko keguguran, kematian janin, dan komplikasi lainnya
juga meningkat.

Silakan hamil, asal…

Bagaimana bila seorang wanita baru menikah setelah usia 35 tahun, apakah mereka tidak
diizinkan punya anak? Tentu saja tidak!. Hamil dan punya anak adalah hak asasi setiap
wanita. Silakan jalani. “Tapi, selayaknya wanita yang bersangkutan memahami segala
konsekuensi kehamilan di usia tua, bahwa ia memasuki kehamilan dengan risiko. Jadi, pada
dasarnya, tidak penting apakah seorang wanita menunda kehamilannya sehingga baru
memutuskan hamil di usia lanjut atau karena memang menikahnya di usia lanjut, yang
penting wanita itu menyadari betul usia berapa ia pertama kali hamil, dan sadar risikonya,”
jelas dr. Seno.

Menguatkan anjuran dr. Seno, Agustine menegaskan, “Semua terpulang pada individu yang
bersangkutan. Standar ideal orang itu berbeda-beda. Hamil itu ‘ kan artinya siap jadi ibu.
Banyak orang yang mau punya anak tapi masih sulit melihat bahwa mereka harus siap
berkorban. Mereka harus siap memikirkan orang lain, terutama janinnya. Memang idealnya,
menikah dan punya anak di masa usia prima, yaitu di bawah 30 tahun. Pada masa ini
perkembangan kepribadian seorang wanita sudah siap. Maksudnya, sekolah sudah selesai dan
sudah berkarier.”

Seandainya belum memungkinkan hamil dan melahirkan di usia prima, dr. Seno berpesan,
“Periksakan diri secara teratur ke dokter. Dengan memperhatikan risiko, wanita bersangkutan
harus lebih memperhatikan kondisi atau asupan gizinya. Krena, penurunan fungsi
metabolisme tubuh dan nutrisi calon ibu sangat menentukan kondisi kehamilan dan
persalinannya. Komplikasi yang mungkin muncul bisa ditekan bila kondisi keduanya baik.”

Satu hal yang patut diingat adalah tak perlu terlalu takut seandainya baru bisa hamil pertama
di usia lewat dari 35 tahun. Tidak semua wanita hamil mengalami risiko itu. Ini dialami
Satyorini (37 tahun). Kondisi kesehatan membuatnya terpaksa baru bisa menjalani kehamilan
di usia ‘batas aman’. “Tetapi saya selalu berpikir positif dan tentu saja menjalani semua
anjuran dokter,” katanya.

“Ya, konsultasi yang teratur memperkecil segala komplikasi,” tegas dr. Seno. Menyadari dan
memahami risiko yang bisa terjadi, wanita bersangkutan tentu perlu memiliki kesadaran
tinggi untuk menjaga dan memantau kondisi kesehatan tubuh dan janinnya, seperti
memeriksakan diri dan janin secara teratur ke dokter kandungan.

http://bibilung.wordpress.com/2008/07/13/hamil-di-usia-20-30-atau-40-an/