Fibrocystic Breast Changes: To Remove or Not?

Regarding the breasts..?

Hello Dr.
Lin: I previously consulted you about my condition, and I have since undergone examinations at the hospital.
The doctor diagnosed it as a fibrocystic breast condition.
However, I am unsure whether I need to have it surgically removed.
If I do have it removed, will it grow back? If I don't have it removed, what will happen? The cyst is located near the left areola and is approximately 0.9 cm in size.
If I undergo surgery, will it affect my appearance? Will there be any scarring? Additionally, is there anything I can eat to improve this condition? Are there any medications that are effective? Regarding breast size, I didn't notice a significant difference before, but recently, my left breast has become noticeably larger than my right.
Is this related to the fibrocystic condition? Thank you!

Liao Xiaojie, 20~29 year old female. Ask Date: 2004/05/21

Dr. Lin Kecheng reply Surgery

Fibrocystic changes are benign tumors of the breast.
If a cyst measures 0.9 centimeters, it is recommended to perform a breast aspiration for cytological examination to confirm the diagnosis as a fibrocyst or something else.
Generally speaking, if surgically removed, it is unlikely to recur.
If the incision is made carefully near the areola, the scar should be minimal and not affect appearance.
If it is a malignant tumor, surgery is certainly indicated.
If it is benign, careful monitoring is also an option; however, if it continues to grow, excision is preferable.
Medications are typically ineffective and will not lead to resolution.
It is advised to avoid smoking and limit the intake of Western-style high-fat, high-calorie diets, as well as to refrain from hormone consumption.
A 0.9-centimeter fibrocyst is unlikely to cause a significant size difference between the breasts, and other reasons should be investigated further.
Wishing you good health.

Reply Date: 2004/05/21

More Info

Fibrocystic breast changes are a common condition that many women experience, characterized by the presence of lumps or cysts in the breast tissue. These changes are often influenced by hormonal fluctuations, particularly during the menstrual cycle. In your case, you mentioned having a fibrocystic cyst approximately 0.9 cm in size located near the left nipple. Let's explore whether surgical removal is necessary, the implications of leaving it untreated, and other related concerns.

To Remove or Not to Remove?
1. Surgical Removal: The decision to surgically remove a fibrocystic cyst often depends on several factors, including the size of the cyst, whether it is causing discomfort, and the results of imaging studies. In many cases, if the cyst is small, asymptomatic, and benign (which is typically the case with fibrocystic changes), doctors may recommend monitoring it rather than immediate surgical intervention. Surgical removal is usually considered if the cyst is large, painful, or if there are concerns about its nature.

2. Recurrence: If you choose to have the cyst removed, there is a possibility that new cysts may develop in the future, as fibrocystic changes are often a chronic condition. However, the specific cyst that is removed will not return.
3. Consequences of Not Removing: If you opt not to have the cyst removed, it is essential to monitor it regularly. Most fibrocystic changes do not lead to cancer, but any changes in size, shape, or associated symptoms should be reported to your healthcare provider. Regular self-examinations and follow-up imaging can help ensure that any significant changes are caught early.

Impact on Appearance and Scarring
Surgical removal of a cyst can leave a scar, but the extent of scarring depends on the surgical technique used and the skill of the surgeon. Many surgeons use minimally invasive techniques that can minimize scarring. Discuss your concerns about appearance and scarring with your surgeon, as they can provide options that may help reduce visible scars.

Dietary and Medicinal Considerations
While there is no specific diet that can eliminate fibrocystic changes, some women find that reducing caffeine and fat intake may help alleviate symptoms. Additionally, maintaining a balanced diet rich in fruits, vegetables, and whole grains can support overall breast health. Some studies suggest that vitamin E and evening primrose oil may help reduce breast pain associated with fibrocystic changes, but more research is needed to confirm their effectiveness.

Breast Size Changes
You mentioned that your left breast appears larger than your right, which can be related to the presence of the fibrocystic cyst. Cysts can cause localized swelling and changes in breast size. However, it is also common for women to have slight asymmetries in breast size, which can be entirely normal. If the size difference is significant or accompanied by other symptoms, it is advisable to consult your healthcare provider for further evaluation.

Conclusion
In summary, the decision to remove a fibrocystic cyst should be made in consultation with your healthcare provider, considering your symptoms, the cyst's characteristics, and your personal preferences. Regular monitoring and self-examination are crucial if you choose not to have it removed. Additionally, maintaining a healthy lifestyle and discussing any dietary changes with your doctor can be beneficial. If you have further concerns about breast size or other symptoms, do not hesitate to reach out to your healthcare provider for personalized advice and management options.

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