Fibrocystic Breast Disease

Fibrocystic Breast Disease: Overview

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 and 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 and 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.

Fibrocystic Breast Disease

Information On This Page

Signs, symptoms & indicators of Fibrocystic Breast Disease:

Symptoms - Reproductive - Female Cycle

Conditions that suggest Fibrocystic Breast Disease:

Hormones

Symptoms - Female

Cysts in breasts strongly suggests Fibrocystic Breast DiseaseCysts in breasts
The most common cause of breast cysts is fibrocystic breast disease.

Risk factors for Fibrocystic Breast Disease:

Hormones

Progesterone Low or Estrogen Dominance often increases risk of Fibrocystic Breast DiseaseProgesterone Low or Estrogen Dominance
The administration of natural progesterone is suggested by Dr. John Lee, MD and others to be a protective therapy that can reduce breast tenderness and the fibrocystic changes seen in FBD.
Low Adrenal Function / Adrenal Insufficiency often increases risk of Fibrocystic Breast DiseaseLow Adrenal Function / Adrenal Insufficiency
[The Safe Uses of Cortisol, William Mck.  Jefferies, MD 1996, p.156]

Nutrients

EFA (Essential Fatty Acid) Requirement may increase risk of Fibrocystic Breast DiseaseEFA (Essential Fatty Acid) Requirement
Fatty acid profiles may be abnormal in women with fibrocystic breast disease.  Treatment with essential fatty acids may help to normalize this.  [Plasma fatty acid profiles in benign breast disorders.  Br J Surg, 1992 May, 79:5, pp.407-9]

Organ Health

Liver Detoxification / Support Requirement often increases risk of Fibrocystic Breast DiseaseLiver Detoxification / Support Requirement
Impaired liver function can result in excess circulating estrogens and a worsening of breast tenderness.

Symptoms - Female

History of cysts in breasts often increases risk of Fibrocystic Breast DiseaseHistory of cysts in breasts
The most common cause of breast cysts is fibrocystic breast disease.

Recommendations for Fibrocystic Breast Disease:

Botanical

Evening Primrose Oil may help with Fibrocystic Breast DiseaseEvening 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.

Diet

Caffeine/Coffee Avoidance is highly recommended for Fibrocystic Breast DiseaseCaffeine/Coffee Avoidance
Long-term and complete avoidance of caffeine reduces symptoms of fibrocystic disease.  Cutting out coffee has been found to generally reduce or even eliminate the lumps and pain of fibrocystic breasts.  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.

Methylxanthines are a component of coffee, chocolate, black tea, and cola drinks.  Some women's breast tissue seems to produce cysts as a result of caffeine intake.  In one study, 97% of women who completely avoided methylxanthines showed reduction in size and sensitivity of breast cysts.  Positive results were seen after 4 months of caffeine avoidance.
Increased Fruit/Vegetable Consumption is highly recommended for Fibrocystic Breast DiseaseIncreased Fruit/Vegetable Consumption
A diet high in fiber from natural sources such as raw fruits and vegetables, whole grain products and beans increases elimination of estrogen from the body.  Foods that promote breast health are flaxseed oil, garlic, cabbage, rosemary and tumeric.  Eat foods that promote liver health and detoxify the body such as onions, leeks, carrots, kale, beets, lemons, artichokes, cauliflower and broccoli.
Increased Water Consumption often helps with Fibrocystic Breast DiseaseIncreased Water Consumption
Drink plenty of pure water to prevent constipation and reap the benefits of high-fiber foods.
Cabbage Family Vegetables often helps with Fibrocystic Breast DiseaseCabbage Family Vegetables
Cruciferous vegetables interfere with estrogen's ability to bind to breast tissue.
Low/Decreased Fat Diet may help with Fibrocystic Breast DiseaseLow/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.

Environmental

Change In Clothing Habits is highly recommended for Fibrocystic Breast DiseaseChange 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."

Habits

Personal Hygiene Changes often helps with Fibrocystic Breast DiseasePersonal Hygiene Changes
Avoid conventional antiperspirants because they prevent drainage of toxins through the sweat glands and cause them to drain into the breasts instead.  Natural deodorants don't contain parabens, which are linked to breast cancer.
Aerobic Exercise often helps with Fibrocystic Breast DiseaseAerobic Exercise
Regular exercise will improve circulation and help detoxify the body.

Hormone

Natural Progesterone is highly recommended for Fibrocystic Breast DiseaseNatural Progesterone
Natural progesterone can be effective in treating fibrocystic breast disease.

Mineral

Iodine often helps with Fibrocystic Breast DiseaseIodine
Iodine has been found to reverse cystic breast disease and restore cystic spaces to their normal size.  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.

Nutrient

Vitamins

Vitamin E often helps with Fibrocystic Breast DiseaseVitamin 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) may help with Fibrocystic Breast DiseaseVitamin 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.

KEY

Weak or unproven link: may suggest; may increase risk of
Weak or unproven link:
may suggest; may increase risk of
Strong or generally accepted link: is often a sign or symptom of; often increases risk of
Strong or generally accepted link:
is often a sign or symptom of; often increases risk of
Definite or direct link: strongly suggests
Definite or direct link:
strongly suggests
May be useful: may help with
May be useful:
may help with
Moderately useful: often helps with
Moderately useful:
often helps with
Very useful: is highly recommended for
Very useful:
is highly recommended for