What fibrocystic breast changes (mastopathy) are and whether they can be cured

What happens in the breasts with fibrocystic changes

Breast tissue responds to the hormones of your cycle every month. In the second half of the cycle it swells, and after your period it returns to its usual state. Over the years, areas of thickening (fibrosis) and small fluid-filled sacs (cysts) can form in it. These changes usually affect both breasts and come and go over time depending on hormone levels.

Symptoms of fibrocystic breast changes

Women most often notice that:

• a few days before a period, the breasts swell, feel tender or hurt, and the pain eases once the period starts;
• both breasts hurt, and the pain may spread to the armpit;
• lumps, a grainy texture or cord-like areas can be felt in the breasts, more often in the upper outer part;
• smooth, movable lumps appear that grow and hurt before a period, which is often how cysts feel.

For some women, fibrocystic changes cause no pain at all and are found by chance during an exam or ultrasound.

When to show a breast lump to a mammologist

A benign lump can’t always be told apart from other changes by touch, so the mammologist draws a conclusion after an exam and ultrasound. Book an appointment within the next few days if:

• a new lump has appeared and hasn’t gone away after your period;
• the lump is hard, barely moves under your fingers or is growing;
• the shape of the breast has changed, or the skin is pulled in, red or looks like orange peel;
• the nipple has turned inward, is flaking or has a sore on it;
• fluid comes out of the nipple, especially if it contains blood;
• a lump has appeared in your armpit.

If your breast turns red, hot and very painful and you have a fever, see a doctor the same day. This can happen with mastitis, especially while breastfeeding.

Breast pain before a period that goes away when the period starts is rarely a sign of a dangerous condition. See a mammologist if the pain is disrupting your life, is constant or is always in the same spot.

How breasts are examined

An appointment with a mammologist starts with a conversation: the doctor will ask about your symptoms, your cycle, any breast conditions in your family and previous tests. Then they will examine and feel your breasts and armpits.

After the exam, a breast ultrasound is the most common next step. It can tell a fluid-filled cyst from a solid lump, and for younger women with dense breast tissue it is done first. For women over 40, the doctor may also recommend a mammogram when indicated: an X-ray that shows tiny calcium deposits. If a lump needs a closer look, a fine-needle aspiration or biopsy may be ordered, in which a thin needle is used to take cells or tissue for testing.

Routine exams and ultrasounds are easier in the first half of your cycle, when the breasts are less swollen. Which days to book is covered in when to have a breast ultrasound.

Mammologist appointments at Viva Clinic in Slavuta take place at 27a Sobornosti St or 3 Danyla Halytskoho St; the exact address is confirmed when you book. Breast ultrasounds are done at the polyclinic at 27a Sobornosti St, and any lab tests the doctor orders are done at Diagnost-Lab. Bring the results of previous tests so the doctor can compare. You can book by phone or on Viber.

How fibrocystic breast changes are treated

For most women, fibrocystic changes are a feature of breast tissue during the reproductive years. After menopause, when hormone levels fall, they often ease on their own. Treatment therefore has two goals: relieving pain if it bothers you and spotting changes that need attention in time. Depending on the situation, the doctor may recommend:

• monitoring and follow-up ultrasounds at set intervals;
• a comfortable bra that supports your breasts well, including during exercise;
• pain relief on days when the pain is bad;
• draining a large, painful cyst;
• hormonal medicines if severe pain doesn’t go away.

Don’t use hormones, “resolving” remedies, compresses or heat without seeing a doctor first. That way it’s easy to put off the exam at which the doctor would have spotted something new in time.

Once a month, check your breasts yourself so you know what’s normal for you and notice anything new sooner. A convenient time is a few days after your period, or the same day each month after menopause. First look in the mirror at the shape of your breasts, the skin and the nipples, with your arms down and then raised. Then use the pads of your fingers to feel each breast and armpit in small circles, standing and lying down. You still need regular check-ups with a mammologist.