Fibrocystic Breasts

Mary Heim, RPh, FAAFM

Mary Heim, RPh, FAAFM

With the passage of public act 517 in Michigan, I have received many questions about dense breasts versus fibrocystic breasts. A fibrocystic breast is not the same as a dense breast. Fibrocystic breasts can appear dense due to cysts and/or areas of fibrosis (which resemble scar tissue). These cysts are very common and do not increase the risk for breast cancer. In fact they are the most common benign condition involving the breast, affecting up to 60% of pre-menopausal women. Fibrocystic breasts can be painful and women who suffer from this condition may often be limited in their activities to avoid pain from jarring or contact.

Despite the frequency of this condition, the cause is still not entirely understood, but is likely related to hormonal imbalance. Fibrocystic changes are most pronounced when women are young and usually decrease after menopause. Fibrocystic changes typically worsen during the days and weeks prior to menstruation. Estrogen dominance is likely the primary factor as estrogen causes proliferation of breast tissue and treatment with progesterone cream has been shown to be effective to manage fibrocystic changes in the breast. Topical progesterone in doses of 25-30 mg/day often results in an abatement of symptoms in 2-3 menstrual cycles.

Additionally, there are several diet choices and nutritional interventions that can make a big difference with this population. The primary diet choice is to eliminate caffeine and other methylxanthines such as theophylline and theobromine that may be present in coffee, tea, colas and chocolate. These compounds can lead to fibrocystic changes in breast tissue. There are many studies on the effects of methylxanthines and fibrocystic changes with reports of improvement in up to 88% of women who avoided the compounds all together. Studies show that it may be important to cut these compounds out completely as opposed to simply reducing them, as the studied women who reduced their intake by only 50% had less of a reduction in symptoms.

In addition to eliminating methyxanthines, you may want to consider adding a few nutrients including vitamin E and iodine. 400-800 iu/day of mixed tocopherols is a good starting point for vitamin E supplementation. The research on vitamin E is varied, but it is a low cost and relatively safe nutrient. Preparations of iodine and iodide such as Lugol’s solution or Iodoral have been shown to improve symptoms of fibrocystic breast disease in 70% of women and one study of 108 women for 9 months resulted in a 98% reduction in symptoms. Thyroid function should be monitored in all patients who are receiving iodine therapy.

Next month: Dense breasts

LARA     http://www.michigan.gov/lara/0,4601,7_35791-347791–,00.html
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Brooks PG et al. Measuring the effect of caffeine restriction on fibrocystic breast disease: the role of graphic stress telethermometry as an objective monitor of disease. J Repord Med 1981;26:279-282.
Smyth PP. Thyroid disease and breast cancer. J Endocrinol Invest. 1993 May;16(5):396-401.
Ghent WR, et al. Iodine replacement in fibrocystic disease of the breast. Can J Surg 1993;36:453-460.
Gaby AR. Nutritional Medicine. © 2011.
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