At one time or another, more than fifty percent of all women will discover an unusual lump in their breast. Although breast cancer is the immediate fear upon finding such a lump, more than eighty percent of these masses turn out to be benign, or noncancerous. Variously called cystic breast disease, fibrocystic disease, or cystic mastitis, these benign breast disorders are characterized by the development of lumpy breast tissue, which may or may not be painful. Such lumps are usually composed of fluid-filled sacs called cysts. In some cases, the cysts may be large enough to distort the contour of the breast; in others, they produce no symptoms other than mild discomfort.
Cystic breast disease is typically related to the menstrual cycle, and usually becomes less severe with menopause as hormone levels decrease. During a woman’s fertile years, hormonal changes occur in the breasts each month in preparation for the possibility of pregnancy. At the time of ovulation, the milk-producing glands start to fill with fluid and the fibrous tissue around the glands increases in order to provide additional support for them. In some women, in the following seven to ten days, the breasts become swollen and tender; in others, the changes are barely noticeable. If the ovum (egg) is unfertilized and pregnancy is not initiated, menstruation occurs, the breasts return to their usual size and condition as the additional fluid is lost, and the supporting tissue returns to its pre-ovulatory state. When the monthly mechanism breaks down - either because of an overproduction of fluid and tissue or faulty reabsorption - the cysts develop, either in small clusters or in groups of one or two large sacs.
As women have become increasingly vigilant about checking for early signs of breast cancer, they have also become aware of changes in the consistency of breast tissue even when there are no other symptoms. Any unusual breast change should be evaluated by a health care provider. Most of these benign breast lumps turn out to be cysts. If fluid can be drawn from the cyst, no further tests are usually required. If not, a biopsy may be needed. A biopsy need not always involve hospitalization; it may often be done in the doctor’s office by aspiration - a technique in which a sample of the tissue is removed through a hollow needle inserted into the lump. Because some women with cystic breast disease have a higher than normal rate of breast cancer, they should undergo regular breast examination by a health care provider. In addition, it is recommended that all women over the age of 40 undergo yearly mammography. An initial mammogram should be done after age 35 as a baseline to compare later films with. ***If you are on HT (hormone replacement therapy), it is helpful to stop your HT two weeks prior to your mammogram***. It makes reading the mammogram and seeing subtle lesions easier. The early, subtle changes of breast cancer will appear as small calcifications (white spots). It is at this early stage that most breast cancers can be cured. The radiation exposure from a mammogram has been reduced by modern technology to very low levels.
THE IMPORTANCE OF SELF EXAMINATION
Self-examination of the breasts should be a continuing routine for all women. The examination should be done at the same time each month; this is especially important for women who are still menstruating. For such women, the best time is a few days after menstruation, when hormonal processes are at a minimum and the breasts are least full. Familiarity with lumps that come and go each month will make it possible to detect changes that may persist through several monthly cycles and require medical attention.
OTHER BENIGN DISEASE OF THE BREAST
There are other conditions that may produce a benign lump in the breast, including fibroadenosis and fat necrosis. A fibroadenoma is a solid mass that grows slowly, is not necessarily related to the menstrual cycle, and rarely causes pain. It is seen most commonly in women in their late teens and early twenties. While there appears to be a higher incidence of breast cancer among women with cystic breast disease, no similar relationship has been established between fibroadenosis and eventual malignancy. However, such lumps should also be examined by a health care provider. In cases where the lump is large enough to deform the contour of the breast, surgical removal may be desirable, both for cosmetic reasons and for reassurance that there are no cancerous cells. Fat necrosis is caused by a severe blow to the fatty tissue (a woman’s breasts are one of the main storage areas of fat). The lump may not form until long after the injury, and it may cause a deformation of the skin surface. Any such development should always be checked.
Following a diagnosis of fibrocystic breast disease, no other treatment may be necessary other than support from a properly constructed brassiere. Other women with cystic breasts obtain relief through restricting their intake of caffeine containing beverages (coffee, cola, tea, cocoa, chocolate, and through vitamin E supplementation 400-800IU or Oil of Evening Primrose 500mg. Tylenol or Ibuprofen may be used for pain.
HOW TO MAINTAIN HEALTHY BREAST TISSUE
Maintaining an ideal body weight will decrease the excessive estrogen which is produced in fat tissue and thereby decrease the estrogenic stimulation of the breast tissue. Avoidance of excessive red meat, foods high in polyunsaturated fats, and excessive alcohol intake will decrease breast pathology including breast cancer. The addition of foods containing indole-3-carbinol (I3C) or supplements of diindolymethane (DIM) have been found to be beneficial in decreasing the potent carcinogenic estrogens in the body. DIM and I3C are found in the cruciferous vegetables like broccoli, cauliflower, cabbage, and Brussels sprouts. The Women’s Wellness Place supplements for healthy breast (“Women’s Liberation”) and the menopause supplements (“Cool Menopause AM Formula” and “Cool Menopause PM Formula”) have these substances included just for that reason!!
Several plant compounds have structural and functional similarities to estrogens and are called “Phytoestrogens”. Soy beans and clover contain the isoflavonoids genestein and diadzein. Green tea and legumes contain the lignans enterolactone and enterodiol. These estrogen-like substances may bind to estrogen receptors in tissue like breast and block the action of the more carcinogenic estrogens thereby preventing breast stimulation and cancer. Also, Soy, green tea, and legumes are excellent additions to the diet and help you maintain your ideal body weight!!
Cystic breast disease is an abnormal or exaggerated response of areas of the breast to cyclic hormonal stimulation. Fibrocystic breast disorders are mostly benign, but if they cause pain or a disfiguring distortion of breast contour, they can be treated in various ways. Occasionally, a pre-cancerous change will be found on a biopsy of an area of fibrocystic change. This is why any lump in the breast should be checked by a health care provider to rule out the possibility of cancer. Self examination of breasts should be a monthly routine for all women; any doubtful symptoms should be brought to your provider’s attention for prompt diagnosis. You are the most likely candidate to find a lump - and if you do, be sure you and your doctor follow up on it.
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