Fibrocystic Breast Changes: When to Consider Surgery

Fibrocystic changes

Hello, doctor.
A few years ago, I discovered a hard lump in my breast that was quite noticeable.
It was only two years ago that I started getting it checked and found out it was a fibrocystic cyst.
I have several on both sides, and the one I can feel is the largest (over two centimeters).
The doctor advised me to have regular follow-ups every six months.
During this winter break, I had another check-up and found that the lump had grown, seemingly to three centimeters.
I initially thought I would need surgery to remove it, but the doctor said to wait another six months to see if it grows further.
Six months later (today), I had another ultrasound, and the doctor said it hadn't increased in size, so I can follow up once a year instead.
He mentioned that if it doesn't cause any issues, surgery isn't necessary, and I can opt for removal if I feel uncomfortable.
However, I've read online that most recommendations suggest removal for cysts over three centimeters.
I know mine is also over two centimeters, so I have a few questions: 1.
Is it really okay not to remove a lump of this size? 2.
I often experience breast tenderness (even outside of my menstrual period), and sometimes I feel pain from the fibrocystic cyst.
Is this normal? 3.
If I were to have it removed, would there be any noticeable difference in appearance? I apologize for having so many questions.
Thank you!

Jia Jia, 20~29 year old female. Ask Date: 2017/08/08

Dr. Li Zhonghuai reply Surgery

Hello! Fibrocystic changes do not require surgery, and the risk of malignant transformation is minimal; regular follow-up is sufficient.
If you are experiencing breast tenderness, consider whether you are taking contraceptive pills.
External environmental hormones can also play a role.
It's advisable to limit fried foods and beverages from hand-shaken cups, as well as reduce coffee and tea intake.
Surgery has little impact on appearance, but there is a possibility of recurrence after the procedure.
Take care! Changhua Hospital cares about you!

Reply Date: 2017/08/08

More Info

Understanding fibrocystic breast changes, particularly when it comes to the decision of whether or not to consider surgery, can be quite complex and often requires a nuanced understanding of the condition, patient symptoms, and the potential risks and benefits of surgical intervention.

1. Is it safe not to remove a fibrocystic lesion that is over 3 cm?
In general, fibrocystic breast changes are considered benign and do not typically require surgical intervention unless they cause significant discomfort or show signs of atypical changes. The fact that your doctor has recommended monitoring rather than immediate surgery suggests that they believe the lesion is stable and not indicative of malignancy. The size of 3 cm, while larger than average, does not automatically necessitate removal unless it is symptomatic or shows changes that warrant concern. Regular monitoring, as advised by your healthcare provider, is a common approach for managing benign breast conditions.

2. Is it normal to experience breast tenderness and pain associated with fibrocystic changes?
Yes, it is quite common for individuals with fibrocystic breast changes to experience breast tenderness and pain, which can occur at any time during the menstrual cycle, not just during menstruation. This discomfort is often due to hormonal fluctuations that can cause the breast tissue to swell and become more sensitive. If the pain becomes severe or changes in nature, it is important to discuss this with your healthcare provider, as they may want to reassess the lesion or consider other management options.

3. Will surgery affect the appearance of my breasts?
Surgical removal of a fibrocystic lesion can potentially alter the appearance of the breast, especially if the lesion is large or if multiple lesions are removed. However, many surgeons strive to minimize cosmetic changes by using techniques that preserve as much surrounding tissue as possible. The impact on breast size and shape will depend on the size and location of the lesion, as well as the surgical technique used. It is advisable to discuss your concerns about appearance with your surgeon, who can provide insights into what to expect based on your specific situation.

In summary, the decision to pursue surgery for fibrocystic breast changes should be made collaboratively with your healthcare provider, considering factors such as the size of the lesion, symptoms, and personal preferences. Regular monitoring is often a safe and effective approach for managing benign breast conditions, especially when there are no alarming changes. If you have ongoing concerns or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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