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Fibrocystic breast disease (FBD) is a term given to a group of benign conditions affecting the breast. This group of conditions is very common in younger women, occurring in about 20% of premenopausal females. Both breasts become tender or painful and lumpy, and the symptoms vary at different times in the menstrual cycle.
Diagnosis & Tests
Despite the fact that signs and symptoms of fibrocystic disease appear to be quite distinct from textbook signs and symptoms of breast cancer, any lump in the breast should be diagnosed by a healthcare professional to rule out the possibility of cancer. FBD is associated with a 3-fold higher risk for the development of breast cancer.
Treatment & Prevention
For many women, FBD is very treatable and preventable. For years, doctors have recommended that women avoid caffeine, high fat diets and so on, and even to take drugs with strong side effects. In some cases this helps, in others it doesn't. However, recent research has offered new hope because it has shown a strong connection between the wearing of bras and benign fibrocystic lumps, cysts and pain. For example, Dr. Gregory Heigh of Florida has found that over 90% of women with fibrocystic changes find improvement when they stop wearing their brassieres. This exciting new "treatment" has NO side-effects, costs nothing, and is something that women try for themselves by making a personal clothing choice.
There is scientific support for the plausibility of this connection with breast disease. Two published studies have shown that women who wear bras have much (over 100 times!) higher breast cancer rates than women who don't wear a bra. A husband and wife research team published a study of almost 5,000 women in the book Dressed to Kill: The Link Between Breast Cancer and Bras (ISBN #0-89529-664-0, Avery Publishing Group, 1995, available from Amazon Books). They found that the more hours per day that women wear bras, the higher their rates of breast cancer. Their theory is that bras can bind and constrict the lymphatic circulation. This prevents the natural flushing out of accumulated cancer-causing wastes and toxins from the breast. Fluid pooling could then result in fibrocystic changes (benign lumps, cysts and pain). This gives a breeding ground for various problems, including cancer.
Another possible mechanism is that bras prevent the natural movement of the breasts and thereby also hamper circulation. People experience something similar when their feet swell and their legs "go to sleep" on long airplane flights (lack of movement, and pressure on the legs). Contrary to a common myth, going bra-less will not make you sag more. In fact, some women actually find that they sag less, presumably because their chest ligaments and muscles improve their tone and strength when they must do the work of supporting the breasts. Medical research gives plausibility to this theory, since it shows that ligaments depend on weight bearing and movement for maintaining proper structure and function.
Dietary changes may be helpful: Long-term and complete avoidance of caffeine reduces symptoms of fibrocystic disease. Caffeine is found in coffee, black and green tea, cola drinks, chocolate, and a number of over-the-counter drugs. The decrease in breast tenderness can take six months or more to occur after caffeine is eliminated. Breast lumpiness may not go away, but the pain often decreases.
Many doctors are confused about the effects of caffeine on breast tissue because, at first glance, the research appears contradictory. When researchers tell women to cut back or to eliminate caffeine for less than six months, results are unimpressive. Moreover, for every study that says fibrocystic disease patients do not drink more coffee than other women do, there is a study that says otherwise. More important, the original research did not claim that fibrocystic patients drink much coffee - only that they are especially sensitive to the coffee they do drink.
Twins with similar or identical genes should be affected similarly by caffeine. Research has been done studying the effects of caffeine on breast symptoms in twins. In that report, the twin with symptoms was more likely be the coffee drinker. This evidence clearly supports the idea that coffee drinking can affect breast symptoms in some women.
Fibrocystic disease has been linked to excess estrogen. When those with fibrocystic disease are put on a low-fat diet, their estrogen levels decrease. After three to six months, the pain and lumpiness also decrease. The link between fat and symptoms appears to be most strongly related to saturated fat. Foods high in saturated fat include meat and dairy products. Fish, nonfat dairy and tofu are possible replacements.
Estrogens and progesterone are sometimes considered antagonistic hormones. When too much estrogen is present in relationship to progesterone, progesterone supplementation can restore balance. Elevated levels of estrogen may need to be dealt with separately. The administration of natural progesterone for FBD is suggested by John Lee, MD as a protective therapy that can reduce breast tenderness and fibrocystic changes. Natural progesterone is very effective in treating fibrocystic breast disease.
Lifestyle changes that may be helpful: Exercise may decrease breast tenderness. In one study, women who ran forty-five miles per menstrual cycle reported less breast tenderness as well as improvement in other symptoms such as anxiety.
Nutritional supplements that may be helpful: Several studies report that 200-600 IU of vitamin E per day, taken for several months, reduces symptoms. Most double blind research has not found vitamin E to relieve FBD symptoms, however. Nevertheless, many women take 400 IU of vitamin E for three months to see if it helps.
As with vitamin E, the effectiveness of vitamin B6 remains unclear. Some, but not all, studies find that B6 reduces symptoms. Women with premenstrual syndrome in addition to breast tenderness should discuss the use of vitamin B6 with their nutritionally oriented doctor.
Some doctors of natural medicine use iodine for fibrocystic symptoms, either orally or intravaginally. In animals, iodine deficiency can cause the equivalent of fibrocystic disease. What appears to be the most effective form - diatomic iodine - is not readily available. It may be that the iodine makes the breast tissue less sensitive to the effects of estrogen. Because some people are sensitive to iodine and high amounts can alter thyroid function, it should not be taken without a doctor's involvement.
FBD may be caused by excessive estrogenic stimulation of the breasts due to abnormal hormone levels or by an exaggerated response by hypersensitive tissues to normal hormone levels. The administration of natural progesterone is discussed by John Lee, MD in his book What Your Doctor May NOT Tell You About Premenopause. It can be a protective therapy that can reduce breast tenderness and fibrocystic changes. He also mentions adrenal exhaustion as another factor that can contribute to FBD.
In double blind studies, evening primrose oil (EPO) has been found to reduce symptoms of fibrocystic disease. However, the amount of improvement produced by EPO appears to be slight. One group of researchers have reported that EPO normalizes blood levels of fatty acids in women with fibrocystic disease. However, even these scientists had difficulty correlating the improvement in lab work with an actual reduction in symptoms. Nonetheless, most reports continue to show at least some reduction in symptoms resulting from EPO supplementation. As a result, many nutritionally oriented doctors recommend a trial of 3gm per day of EPO for at least six months to alleviate symptoms of FBD.
Herbs that may be helpful: Since many women with FBD and cyclical breast tenderness also suffer from premenstrual syndrome (PMS), there is often an overlap in herbal recommendations for these two conditions despite a lack of research dealing directly with fibrocystic disease.
Vitex has been shown to help re-establish normal balance of estrogen and progesterone during a woman's menstrual cycle. This is important because some women may suffer from PMS and other menstrual irregularities due to underproduction of the hormone progesterone during the second half of their cycle. Vitex stimulates the pituitary gland to produce more luteinizing hormone, and this leads to a greater production of progesterone. Studies have shown that using vitex once in the morning over a period of several months will help normalize hormone balance and alleviate symptoms of PMS.
Doctors who use herbal medicine will typically suggest 40 drops of a liquid, concentrated vitex extract or one capsule of the equivalent dried, powdered extract to be taken once per day in the morning with some liquid. Vitex should be taken for at least four cycles to determine efficacy.
In traditional Chinese medicine, Dong quai, or Angelica sinensis, is often referred to as the "female ginseng". Dong quai helps promote normal hormone balance and is particularly useful for women experiencing premenstrual cramping and pain. Many doctors of natural medicine recommend 2-3 grams of dong quai capsules or tablets per day but research has yet to link dong quai to a reduction in symptoms of fibrocystic disease.
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Signs, symptoms & indicators of Fibrocystic Breast Disease:
Conditions that suggest Fibrocystic Breast Disease:
Risk factors for Fibrocystic Breast Disease:
Recommendations and treatments for Fibrocystic Breast Disease: | | | | | Botanical |  Evening Primrose Oil | In double blind research, evening primrose oil (EPO) has reduced symptoms of fibrocystic disease. However, the amount of improvement caused by EPO appears to be slight. One group of researchers have reported that EPO normalizes blood levels of fatty acids in women with fibrocystic disease. However, even these scientists had difficulty correlating the improvement in lab work with an actual reduction in symptoms. Nonetheless, most reports continue to show at least some reduction in symptoms resulting from EPO supplementation. As a result, many nutritionally oriented doctors recommend a trial of 3 grams per day of EPO for at least six months to alleviate symptoms of fibrocystic breast disease. |
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Diet |
 Caffeine/Coffee Avoidance| | Long-term and complete avoidance of caffeine reduces symptoms of fibrocystic disease. Research into whether cutting out coffee reduces or eliminates the lumps and pain of fibrocystic breasts has usually found that it does. Some of coffee's components have a mild estrogen-like effect on the body. Since estrogen is responsible for premenstrual syndrome and breast tenderness, this may be one reason why coffee aggravates these conditions. |
Low/Decreased Fat Diet| | Fibrocystic disease has been linked to excess estrogen. When those with fibrocystic disease are put on a low-fat diet, their estrogen levels decrease. After three to six months, the pain and lumpiness also decrease. The link between fat and symptoms appears to be most strongly related to saturated fat. Foods high in saturated fat include meat and dairy products. Fish, nonfat dairy, and tofu are possible replacements. |
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Environmental |
 Change In Clothing Habits| | Sydney Singer and Soma Grismaijer (authors of Dressed to Kill, Avery Press, 1995) suggest that some 80% of bra-wearers who experience lumps, cysts or tenderness will see those symptoms vanish, "within a month of getting rid of the bra."
Upon discovering a lump, Soma began regular breast massage, going bra-less for all occasions, bicycle riding, vitamin and herbal supplementation, and drinking only purified water. Two months later, her lump disappeared. "At the first frightening sign of a lump," Singer says, "women should take their bras off before they take their breasts off." |
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Hormone |
Natural Progesterone| | Natural progesterone can be effective in treating fibrocystic breast disease. |
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Mineral |
Iodine| | Some doctors of natural medicine use iodine for fibrocystic symptoms. In animals, iodine deficiency can cause the equivalent of fibrocystic disease. What appears to be the most effective form - diatomic iodine - is not readily available. Because some people are sensitive to iodine and high amounts can alter thyroid function, it should not be taken without a doctor’s involvement. |
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Vitamins |
Vitamin E| | Several studies report that 200-600 IU of vitamin E per day, taken for several months, reduces symptoms. Most double blind research has not found vitamin E to relieve fibrocystic breast disease symptoms, however. Nevertheless, many women take 400 IU of vitamin E for three months to see if it helps. |
Vitamin B6 (Pyridoxine)| | Some, but not all, studies find that B6 reduces symptoms. Women with premenstrual syndrome in addition to breast tenderness should discuss the use of vitamin B6 with their nutritionally oriented doctor. |
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KEY | | Weak or unproven link |  | | Strong or generally accepted link |  | | Proven definite or direct link | | | May do some good | | | Likely to help | | | Highly recommended |
GLOSSARY
Adrenal Insufficiency (Adrenal Exhaustion, Low Adrenal Function)
A condition in which the adrenal gland is compromised in its production of epinephrine, norepinephrine, cortisol, corticosterone or aldosterone. Symptoms include primarily fatigue, weakness, decreased appetite with ensuing weight loss, as well as nausea, vomiting, abdominal pain, diarrhea or constipation, or increased pigmentation of the skin. Cortical insufficiency (low or no corticosteroids) produces a more serious condition called Addison’s Disease, characterized by extreme weakness, low blood pressure, pigmentation of the skin, shock or even death.
Anxiety
Apprehension of danger, or dread, accompanied by nervous restlessness, tension, increased heart rate, and shortness of breath unrelated to a clearly identifiable stimulus.
Benign
Literally: innocent; not malignant. Often used to refer to cells that are not cancerous; they tend to grow slowly and don't spread (metastasize) like cancer tumors do.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Cortisol
A hormone. Its most important function is to help the body respond to stress. It also helps regulate your body's use of protein, carbohydrates and fat; it helps maintain blood pressure and cardiovascular function; it stems inflammation.
Cramp (Cramping, Cramps)
A sudden, involuntary, painful muscular contraction.
Cysts (Cyst)
A closed pocket or pouch of tissue; a cyst may form within any tissue in the body and can be filled with air, fluid, pus, or other material. Cysts within the lung generally are air-filled, while cysts involving the lymph system or kidneys are fluid filled. Cysts under the skin are benign, extremely common, movable lumps. These may develop as a result of infection, clogging of sebaceous glands, developmental abnormalities or around foreign bodies.
Essential Fatty Acid (EFA, EFAs, Essential Fatty Acids)
A substance that the human body cannot manufacture and therefore must be supplied in the diet.
Estrogen (Oestrogen)
One of the female sex hormones produced by the ovaries.
Fatty Acids (Fatty Acid)
Chemical chains of carbon, hydrogen, and oxygen atoms that are part of a fat (lipid) and are the major component of triglycerides. Depending on the number and arrangement of these atoms, fatty acids are classified as either saturated, polyunsaturated, or monounsaturated. They are nutritional substances found in nature which include cholesterol, prostaglandins, and stearic, palmitic, linoleic, linolenic, eicosapentanoic (EPA), and decohexanoic acids. Important nutritional lipids include lecithin, choline, gamma-linoleic acid, and inositol.
Gram (gm, gms, Gramme, Grammes, Grams)
A metric unit of weight, there being approximately 28 grams in one ounce.
Herbs (Herb, Herbal)
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with one teaspoon herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Tinctures may be used singly or in combination as noted. The high doses of single herbs suggested may be best taken as dried extracts (in capsules), although tinctures (60 drops four times per day) and teas (4 to 6 cups per day) may also be used.
Hormones (Hormone)
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Iodine
A essential mineral that is an integral part of the thyroid hormones, thyroxin and triiodothyronine which have important metabolic roles and govern basal metabolism. The best known iodine deficiency symptom is goiter. Other iodine deficiency problems are reduced vitality, hypothyroidism, inability to think clearly, low resistance to infection, loss of control of the muscles of the mouth resulting in mouth contortion and drooling, defective teeth, tendency to obesity and cretinism which is a congenital abnormal condition marked by physical stunting and mental deficiency.
IU (mIU, uIU)
International Unit: An arbitrarily defined but agreed upon unit that depends on what is being measured.
mIU: 0.001 or one thousandth of an IU.
uIU: 0.000001 or one millionth of an IU.
Liver (Hepatic)
The largest and one of the most complex organs of the body, the liver is responsible for much of the metabolism of fats, proteins and carbohydrates. It is the site of much of the body's detoxification. It is connected very closely with digestion and the regulation of blood sugar, among many other functions. Found behind the ribs on the right side of the abdomen, it has many important functions such as removing harmful material from the blood, making enzymes and bile that help digest food, and converting food into substances needed for life and growth. Hepatic: Pertaining to the liver.
Luteinizing Hormone
Anterior pituitary hormone stimulating estrogen production by the ovary; promoting formation of progesterone by the corpus luteum in women and stimulating testosterone release in men.
Lymph Nodes (Axillary Nodes, Inguinal Nodes, Lymph Gland, Lymph Glands, Lymph Node, Lymphatic)
Small, bean-shaped nodes at various points throughout the body that function to filter the lymph fluid and attempt to destroy the microorganisms and abnormal cells which collect there. The most common locations are the neck (both sides and front), armpit (axillary) and groin (inguinal), but also under the jaw and behind the ears. Swollen or painful lymph nodes generally result from localized or systemic infection, abscess formation, or malignancy. Other causes of enlarged lymph nodes are extremely rare. Physical examination for lymph nodes includes pressing on them to check for size, texture, warmth, tenderness and mobility. Most lymph nodes can not be felt until they become swollen, and then will only be tender when pressed or massaged. A lymph node that is painful even without touching indicates greater swelling. Lymph nodes can usually be distinguished from other growths because they generally feel small, smooth, round or oval-shaped and somewhat mobile when attempts are made to push them sideways. Because less fat covers the lymph nodes in children, they are easier to feel, even when they are not busy filtering germs or making antibodies. Childrens' nodes enlarge faster, get bigger in response to an infection and stay swollen longer than an adult's. Also known (incorrectly) as lymph glands.
Menstruation (Menses, Menstrual, Menstrual Cycle, Menstrual Cycles, Menstrual Flow, Menstrual Phase, Monthly Cycle)
The periodic discharge of blood, tissue fluid and mucus from the endometrium (lining of the uterus) that usually lasts from 3 - 5 days. It is caused by a sudden reduction in estrogens and progesterone.
Over-The-Counter (OTC, Over The Counter)
A drug or medication that can legally be bought without a doctor's prescription being required.
Pituitary (Pituitary Gland)
The pituitary gland is a small (half-inch), bean-shaped organ that hangs down from the lower center of the brain on a stalk attached to another gland, the hypothalamus. Weighing less than one gram, the pituitary gland is often called the "master gland" since it controls the secretion of hormones by other endocrine glands. It regulates many body activities, and is partitioned into front and back lobes. The front lobe is stimulated by the hypothalamus, and produces any one of six different hormones that in turn stimulate the thyroid, adrenal and reproductive glands, and also breast milk production.
Premenopause (Premenopausal)
The period when women of childbearing age experience relatively normal reproductive function (including regular periods).
Premenstrual Syndrome (PMS)
PMS consists of various physical and/or emotional symptoms that occur in the second half of the menstrual cycle, after ovulation. The symptoms begin about midcycle, are generally the most intense during the last seven days before menstruation and include: acne; backache; bloating; fatigue; headache; sore breasts; changes in sexual desire; depression; difficulty concentrating; difficulty handling stress; irritability; tearfulness.
Progesterone
This is the hormone secreted after ovulation by the corpus luteum. It is a steroid (similar to a cholesterol), enters receptive cells to stimulate their growth, and acts as an anabolic agent. Estrogen should be viewed as the primary coat underneath all the cycles during a woman's reproductive years, with progesterone, its antagonist, surging for ten or twelve days in ovulatory months. Most of the actions of progesterone cannot occur without estrogen having previously induced the growth of progesterone-receptive binding sites.
Saturated Fat (Saturated Fats)
A type of fat that is readily converted to LDL cholesterol and is thought to encourage production of arterial disease. Saturated fats tend to be hard at room temperature. Among saturated fats are animal fats, dairy products, and such vegetable oils as coconut and palm oils.
Syndrome
A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).
Thyroid (Thyroid Gland)
The thyroid gland is an organ with many veins, anchored around the front of the throat near the voice box. It is essential to normal body growth in infancy and childhood. It absorbs iodine from the diet and releases thyroid hormones - iodine-containing compounds that help govern the rate of the body's metabolism (its total life processes), affecting body temperature, and regulating protein, fat and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor. To a high degree, metabolism is regulated by the hormone thyroxine, which can be made by the thyroid if enough organic iodine is available. An enlarged thyroid gland that is not cancer is sometimes called goitre.
Vitamin B6 (B6, B-6)
Influences many body functions including regulating blood glucose levels, manufacturing hemoglobin and aiding the utilization of protein, carbohydrates and fats. It also aids in the function of the nervous system.
Vitamin E
An essential fat-soluble vitamin. As an antioxidant, helps protect cell membranes, lipoproteins, fats and vitamin A from destructive oxidation. It helps protect red blood cells and is important for the proper function of nerves and muscles. For Vitamin E only, 1mg translates to 1 IU.
Vitex
Vitex agnus castus. Common name: chaste tree berry.
Last updated: Jul 19, 2008
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