Fibrocystic Breast Changes
Signs and Symptoms
Tenderness, fullness, and pain that wax and wane throughout the menstrual cycle are characteristic symptoms of fibrocystic changes. The pain of fibrocystic changes may be experienced as dull, throbbing, or burning. It is often present in both breasts and is usually not localized, and may radiate to the arm or armpit. The pain can range from mild to severe, and when cyclical is generally worse before the menstrual period and relieved within a few days of the onset of menses (Vaidyanathan 2002; Sugg 2014; Jones 2011).
Breast lumps are another characteristic sign of fibrocystic changes. The breast lumps associated with fibrocystic changes often become progressively more tender and are usually present symmetrically in both breasts, though they may be felt in one specific location or on only one side. The lumpiness is often felt in the upper outer part of the breast, though this also happens to be a common location of breast cancer tumors. Growth and regression of benign breast lumps are more likely to be cyclical in younger women. When a single mass is prominent it is called a "dominant mass," and will ordinarily require more detailed medical evaluation to rule out other conditions, including cancer (Jones 2011; Sugg 2014; Vaidyanathan 2002).
Benign breast lumps are usually mobile, which means they can be moved about freely. The lumps may also increase in size prior to menstruation. A breast cancer tumor, on the other hand, is usually fixed and immobile because it forms many attachments to the surrounding tissues (Sharma 2010; CGRDU 2005; Sugg 2014).
In benign breast disease, as many as 15% of women have nipple discharge, whereas nipple discharge is present in only 2.5–3.0% of breast cancer cases. Even when nipple discharge is considered suspicious, only 5% of these cases are actually cancer. Nipple discharge associated with fibrocystic changes occurs only when the nipples are compressed and is often present on both sides. Discharge that occurs spontaneously, without compression, is potentially a sign of a serious condition and should be evaluated promptly; the same is true for bloody or watery discharge or discharge that is present in large amounts. Nipple discharge associated with benign breast diseases tend to be present in only small amounts, and can be clear, white, milky, gray, yellow, or even black or dark green. The discharge may come from one or both breasts (Jones 2011; Sugg 2014; Vaidyanathan 2002).