Lumpy breasts are not as uncommon as you would think. As a matter of fact, lumpy breasts that result from fibrocystic breast condition (FCC) affect more than 60% of women. Women between the ages of 30 and 50 are the most affected with those in menopause dealing with the condition less.
Fibroids – Not Just in the Uterus
When we think of fibrocystic areas of the body, we usually place them in the reproductive organs of the pelvic region. However, the breasts are also part of the reproductive system and fibrocystic breast condition involved the glandular tissue of the breasts. As part of the reproductive system, the breast’s sole function is to produce and secrete milk. Consequently, a large part of the breast is glandular tissue that is surrounded by fatty tissue and muscles that support the weight of the breast. There are two types of cells in the glandular tissue; those that produce milk and are attached to milk ducts and cells that line the surfaces of the cells that secrete the milk (epithelial cells).
Since the breasts are part of the reproductive system, they are affected by menstruation and especially by the hormones that affect reproduction – estrogen and progesterone. These two, along with a number of other hormones produced outside of the breast tissue such as prolactin, growth factor, insulin, and thyroid hormone, along with the hormones that are excreted by the breasts themselves all contribute to the symptoms of fibrocystic breast condition. The very same hormones that prepare the breasts for lactation are the ones responsible for menses. The difference lies in the way tissue is handled by the body when the cycle is over.
How Cysts are Formed
In the uterus, all of these hormones encourage the growth of the endometrium which is sloughed off if pregnancy doesn’t occur. In the breast, these hormones stimulate tissue growth, increase blood flow, cell metabolism and activity in the supporting tissues. This is what likely contributes to the feeling a woman has of fullness and tenderness in the breasts prior to menstruation. When menstruation is over the breast cannot just slough off the cells that were activated. Instead, these cells go through a process called apoptosis, which is basically a programmed death and removal of the cells. Enzymes begin to digest the cells, breaking them down and the scavenger (inflammatory cells) and glandular cells come in and break the fragments down even further. It is during this process that scarring, called fibrosis, may occur that can damage the ducts and glandular tissue in the breast. Hormone-type substances can be released during this period that act on the glandular, ductal, and support cells. This entire process and all of the aspects of it vary from woman to woman and may fluctuate from month to month even in varying areas of the same breast in a woman. There is no predictability.
Breast Cancer Risks
Although FCC is a non-cancerous condition, it does carry the threat of breast cancer and as such, should be properly diagnosed. The lumps in the breast that are caused by fibrocystic breast condition closely mimic breast cancer lumps and consequently, their presence can make both a woman and her doctor a bit skittish. Diagnostic testing along with a mammogram is often done to rule out cancer in women who are at higher risk for the disease.
There are different types of FCC. They present differently under a microscope:
- little disturbance of breast tissue
- large number of cysts and fibrous tissue
- abnormal breast cells
Cysts and fibrosis are formed when secretions produced by the glands in the breast become trapped in glandular tissue by scarring (fibrosis) in the breast. Fluid-filled sacs form, called cysts. When the cysts are stimulated by hormones they may grow to be quite large. Some of them remain very small, like little peas, while others may contain a considerable amount of fluid. It is the larger lumps that are felt by touch. If the tiny cysts clump together, they too can be felt as lumps, especially if there is scar tissue (fibrous tissue) built up around them.
In other cases, the cells that line the ducts of the breasts may lose control of their ability to limit production. Multiplication of the cells intensifies and the cell structure within the breast becomes abnormal. Over-production of the cells is called hyperplasia. Some of the cells that have overproduced become abnormal or atypical and then, when more normal cells cycle and die, the atypical cells move in and take over. The extensive growth of these cells is called atypical hyperplasia.
Things You Can Do
It is the situation of atypical hyperplasia that is associated with a higher risk of breast cancer in women with fibrocystic changes in their breasts. Uncontrolled cell growth of atypical cells tends toward genetic errors which can, in some cases, escalate to cancer. Therefore, women with FCC are recommended to:
- have regular medical breast examinations
- have yearly mammograms and follow-up ultrasound (as prescribed)
- learn about the risks of cancer – become well informed
In order to learn more about breast fibroids and how you can make lifestyle adjustments that will make a difference, see our article in this section.