Fibrocystic change is categorized as a benign breast problem. Symptoms of fibrocystic change include breast tenderness, swelling, pain, or irregular menstrual cycles (Arslan Solmaz, 2018). Patients can feel lumps in their breasts. Movable lumps filled up with fluid are called cysts. The patients can find their breasts swollen or tender to touch. It happens when breast tissues become firm and rubbery like scar tissues. Fibrocystic change occurs mostly in women of child-bearing age, but they can affect any women (American Cancer Society, 2017). The changes in hormone related to menstruation can cause the lumps to get bigger and tenderer. Therefore, the symptoms are more noticeable just before the menstrual period starts. The patients may also feel a clear or cloudy nipple discharge. Hormonal abnormalities such as an excess of estrogen over progesterone or increased thyroid hormone activity are reported to be the cause of the fibrocystic change (Arslan Solmaz, 2018). A diagnosis is based on symptoms, history, and physical examination. A mammogram, ultrasound, or a biopsy will be needed to rule out cancer.
Treatment for fibrocystic change is necessary if the cysts cause discomfort. Medications include danazol, tamoxifen, hormonal therapies, or vitamin E (Talaei, Moradi, & Rafiei, 2017). The authors also mention that Metformin can help reduce the symptoms of fibrocystic change. Besides that, patients who take Metformin have a reduced mortality rate of cancer due to the medication’s antitumoral properties (Talaei, Moradi, & Rafiei, 2017). Another option is to have the cysts drained to reduce the pressure and pain, but the fluid can build up again (American Cancer Society, 2017). If that happens, the patients can choose surgery to remove the cysts. They can take pain medications such as ibuprofen or acetaminophen for pain relief as well. They need to avoid caffeinated drinks such as coffee, tea, sodas, or chocolate since they can stimulate the symptoms (American Cancer Society, 2017). It is still controversial regarding if fibrocystic change is associated with increased risk of breast cancer, so they need to have a routine mammogram screening to detect cancer early (Arslan Solmaz, 2018).
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Fibrocystic breast is considered to be a non-proliferative lesion. It generally affects women between the ages of 25 and 50 and rarely affects women under age 20 (Arslan Solmaz, 2018). According to the Center for Disease Control (2018), fibrocystic breasts can have symptoms of feeling lumpy, tender to touch and sore and have cysts that are fluid filled sacs within the breast. Patient education would include that fibrocystic breast disease is usually benign and and may be due to hormonal imbalance. Follow up care would include sonography, mammography and possibly biopsy to ensure that the cysts are not cancerous (Talaei, Moradi and Rafiei, 2017). Treatments can include a fine needle aspiration to drain the cysts, or surgical incision. Over the counter Tylenol and Ibprofen can be used for pain control. Oral contraceptives can be taken for women to lower hormone levels associated with breast changes (Talaei, Moradi and Rafiei, 2017). Self management would include pain management, breast self exams, warm compresses and monitoring any cysts for and change in texture, size and if they are causing further pain.