Taking The Dis-Ease Out Of Fibrocystic Breasts

What Are Fibrocystic Breasts

      Fibrocystic breast changes (formally known as fibrocystic breast disease) are the most commonbenign breast condition and include a histologic picture of fibrosis, cyst formation, and epithelial hyperplasia. Women with fibrocystic breast changes have "lumpiness" or excessive nodularity in their breasts, which are frequently associated with pain and tenderness. These signs and symptoms typically, but not always, fluctuate with a woman's menstrual cycle and tend to be more pronounced premenstrually. Fibrocystic breasts are most common in women between the ages of 20 and 50 and usually resolve after menopause.

What About My Risk of Breast Cancer?

Contrary to popular belief, having fibrocystic breasts does not increase your risk of breast cancer. However, not all types of fibrocystic changes are the same. Women with breast changes associated with atypical hyperplasia (atypia) do have a slightly increased risk of breast cancer compared to the general population. Atypia is defined as the appearance and overgrowth of cells lining breast lobules and ducts and and is often diagnosed following a breast biopsy to evaluate an abnormality found on  mammogram or during a clinical breast exam.

     It is important to note that although having fibrocystic breasts with atypia can lead to cancerous changes, only 5% of women with fibrocystic breasts have hyperplasia.  Furthermore, although when compared to the general population, these woman have a 2 to 6 fold increased lifetime risk of breast cancer, the exact risk depends on the degree of hyperplasia and whether atypical cells are present.  In addition, this is a total risk accumulated over a lifetime, meaning that a woman with atypia really has a very low yearly risk of breast cancer. Furthermore, there are many other factors to consider when generating breast cancer risk.

    What Does This Mean?

     It means that if you have fibrocystic breasts, it is strongly suggested that you pay attention to them, and do what you can to treat what is causing them.  Even though having fibrocystic breast changes is very common and very rarely increases your risk of breast cancer, it may interfere with your ability to detect new breast lumps or other abnormal changes that might need to be evaluated by your doctor. Therefore it is important to become familiar with how your breasts normally feel so that you'll know when something doesn't feel quite right.  Furthermore, some of the factors believed to be related to fibrocystic breast changes may also cause other health concerns in the future, so it is recommended to determine the source of the condition and have it treated. 

Alternative Medical View and Treatment Suggestions: 

 Although the cause of fibrocystic breast changes is not fully understood, it is believed to be due to hormonal imbalances, such as an excess ratio of estrogen to progesterone or increased production of prolactin. Naturopathic medical doctors have also considered a long list of other possible causes, based both on science, as well as on what has been successfully used to treat this condition. Although conventional therapy typically includes the use of oral contraceptives, diuretics, painkillers, and synthetic hormone therapy such as danazol, naturopathic treatments include a long list of other approaches with very few side effects.

Causes: 

• Increased estrogen to progesterone ratio
• High estradiol and low testosterone
• Imbalance in the ratio of estrone to estriol (too much estrone, too little estriol) 
• Accumulation of estrogenic chemicals in breast tissue (parabens, PCBs, dioxin, phthalates, bisphenol-A, PBDEs) 
• Underactive thyroid, which can lead to increased prolactin levels
• Excess meat, dairy and unhealthy dietary fats
• Nutritional deficiencies in vitamin E, iodine, vitamin B-6, essential fatty acids and coenzyme Q10
• Liver toxicity and stagnation of liver blood and energy
• Bowel toxicity and constipation
• Heavy metal toxicity (specifically lead, mercury, and cadmium)
• Poor lymphatic circulation, possibly from underwire bras and lack of exercise
• Methylxanthine consumption 

Naturopathic Treatment:

• Constipation: Women who have a bowel movement less than three times a week have a 4-5 time greater risk of having fibrocystic breasts than those women who have at least one bowel movement a day. This is due to two reasons. Firstly, a diet high in fat and meat causes certain bacteria to form in our intestines that can break apart an estrogen complex that would typically be excreted in the stool. Once it is broken down, instead of being excreted, it is reabsorbed through the wall of the large intestine and then becomes active in the body again.  Secondly, bacteria present in feces can create three types of estrogen (estrone, estradiol, and 17-methoxyestradiol) from dietary cholesterol, which is the precursor of estrogen hormones. These estrogens can then be reabsorbed by the body. Fatty foods (meat in particular) actually promote the growth of this these types of bacteria in the large intestine, which will also decrease bowel transit time. This can be prevented by eating a plant-based diet high in fiber.

• Caffeine and other Methylxanthines: Methylxanthines (caffeine, theobromine, and theophylline) can be found in foods and beverages such as tea, coffee, colas, chocolate and some medications. These compounds inhibit the phosphodiesterase enzyme. This is important because inhibition of this enzyme causes intracellular accumulation of cyclic AMP and cyclic GMP, which can lead to fibrocystic changes in breast tissue. Although avoidance of caffeine and methylxanthines seems to help some women and not others, it would be worthwhile to try a complete elimination for a period of 3-8 months before determining it ineffective.   

• Low Fat Diet: Hormone metabolism may be affected by the intake of fat which, in turn, could influence the severity of fibrocystic changes. Some experts suggest that the best way to remedy this is through the proper use of a healthy vegetarian or vegan diet.  For those who are not interested in going this extreme, it has been suggested to reduce the intake of dietary fat to no more than 20 percent of total calories, with the greatest emphasis being on the elimination of unhealthy fats.

• Evening Primrose/Flax Seed/Fish Oil: Promotes beneficial prostaglandins and may therefore reduce breast pain.

• Vitamin B6 with a B Complex: Improves estrogen metabolism. In addition, vitamin B6 promotes the production of dopamine in the hypothalamus, which subsequently inhibits the release of prolactin. Research has shown that increased levels of prolactin causes breast swelling. Furthermore, having sufficient amounts of B6 helps increase progesterone levels.

•  N-Acetyl Cysteine (NAC): Helps the liver deal with estrogen and toxins.

• Beta-Carotene: Science supports the use of beta-carotene by demonstrating the presence of retinoid receptors in breast tissue.  These receptors are capable of modulating our genetic predisposition, thereby having the potential to decrease the risk for both malignant and benign breast changes. 

• Iodine:  Although the exact mechanism of action is not yet fully understood, studies have determined that the breast has an affinity for both thyroid hormone and iodine. Without adequate amounts of iodine, breast tissue becomes more sensitive to estrogenic stimulation, which leads to the production of fibrocystic changes. Experts have declared “Lugol’s” iodine as being the most effective, but due to potential side effects of this treatment, it should be used only when dietary modifications and other supplements have failed. 

•  Coenzyme Q10: Increases cellular oxygen.

• Botanical Medicine:  Dandelion leaf (Taraxacum officinale) has been documented as being the most effective herbal diuretic available to decrease breast swelling and the associated discomfort. Additionally, the topical use of Phytolacca Americana has been well established in the reduction of painful lumps. Herbs traditionally used to support the liver are also important and include dandelion root (not the leaf) and burdock (Arctium lappa). Vitex agnus castus (Chaste tree) can also have a crucial role to play with its ability to shift the ratio of estrogen to progesterone in favor of progesterone. 

•  Indole-3-Carbinol or DIM: Aids in estrogen metabolism.

• Other Considerations: Vitamin E, Daily exercise, Homeopathic Remedies, Castor Oil Packs (over the liver and breasts), Liver and Bowel Cleanses, Stress Reduction (through yoga, meditation, etc.).

As always, please see a qualified health care practitioner who can accurately diagnose your condition and use alternative medical care appropriately. 

Sources:

Berek & Novak's Gynecology; Berek, MD

Nutritional Medicine; Alan R Gaby, MD

Women's Encydlopedia of Natural Medicine; Tori Hudson, ND
The Complete Natural Medicine Guide to Breast Cancer; Sat Dharam Kaur, ND  
The Complete Natural Medicine Guide to Women's Health; Sat Dharam Kaur, ND

www.hopkinsmedicine.org

www.mayoclinic.com

www.medicinenet.com