Fibrocystic breast disease (FBD) is a term given to a group of benign conditions affecting the breast. As it really isn’t a disease, it is now more commonly called Fibrocystic Breasts. 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. 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.
For many women, fibrocystic breasts are 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 5000 women in the book Dressed to Kill: The Link Between Breast Cancer and Bras (ISBN 0 89529 664 0, Avery Publishing Group, 1995, also available from Amazon Books, www.amazon.com). 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 braless 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.
Signs, symptoms & indicators of Fibrocystic Breasts
Breast soreness during cycle
Risk factors for Fibrocystic Breasts
Low Progesterone or Estrogen Dominance
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.
Low Adrenal Function / Adrenal Insufficiency
[The Safe Uses of Cortisol, William Mck. Jefferies, MD 1996, p.156]
EFA (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]
Liver Detoxification / Support Requirement
Impaired liver function can result in excess circulating estrogens and a worsening of breast tenderness.
History of cysts in breasts
Recommendations for Fibrocystic Breasts
Dong Quai (Angelica Sinensis)
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 to 3gm of dong quai capsules or tablets per day. Nonetheless, research has yet to link dong quai to a reduction in symptoms of fibrocystic breasts.
Vitex
Since many women with fibrocystic breasts 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 breasts.
Vitex has been shown to help reestablish 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.
Evening Primrose Oil / GLA
In double blind research, evening primrose oil (EPO) has reduced symptoms of fibrocystic breasts. 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 the symptoms of fibrocystic breasts.
EPO or fish oil was no better than corn or corn with wheat germ oil for treating chronic mastalgia. [Evening primrose oil and fish oil for severe chronic mastalgia: a randomized, double-blind, controlled trial. Am J Obstet Gynecol 2002;187: pp.1389-94.]
Caffeine/Coffee Avoidance
Dietary changes may be helpful: Long term and complete avoidance of caffeine reduces symptoms of fibrocystic breasts. Caffeine is found in coffee, black and green tea, cola drinks, chocolate, and a number of OTC 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.
Low Fat Diet
Fibrocystic breasts have been linked to excess estrogen. When those with this condition 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.
Gluten-free Diet
In the US, flour and bread is still being supplemented with bromine. Bromine is an iodine antagonist and should be avoided in the diet, just like fluorine.
Change 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.
In year 2000, two breast surgeons started a study including 100 women at two breast clinics (all of whom had breast pain) and found that over half of the premenopausal women with pain found relief when they quit wearing bras for three months. For some the pain relief was very dramatic, changing their lifes. When they resumed bra wearing for the last three months of the study, the pain returned. Besides the pain data, the doctors also showed video thermography footage that dramatically demonstrated the heat build-up from bra wearing, and they discussed the possible connections with cancer causation.
They also made a documentary film that was shown on nationwide television in Britain.”
Fibrinolytic Enzymes
Serrapeptase has been used in the successful treatment of fibrocystic breasts. In a double-blind study, 70 patients complaining of breast engorgement randomly were divided into a treatment group and a placebo group. Serrapeptase was superior to the placebo for improvement of breast pain, breast swelling and induration (firmness). 85.7% of the patients receiving serrapeptase reported moderate to marked improvement. No adverse reactions to serrapeptase were reported and the researchers concluded that “serrapeptase is a safe and effective method for the treatment of breast engorgement.” [Singapore Med J. 1989;30(1): pp.48-54]
Aerobic Exercise
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.
Progesterone
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 fibrocystic breasts 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 breasts.
Iodine
For reasons that are not known, supplemental iodine appears to help with cyclic mastalgia also known as cyclic mastitis or fibrocystic breasts. In animals, iodine deficiency can cause the equivalent of fibrocystic breasts. 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.
One hundred-eight women with fibrocystic breasts were treated with a preparation containing molecular (diatomic elemental) iodine at a dose of 0.08 mg per kg of body weight per day orally for nine months. Ninety-eight percent of the women were pain-free by the end of the study and objective improvement was seen in 71.8% of cases. Sixty-five percent of the women had a reduction in breast size coincident with clinical improvement. In a larger series of women (n = 1,365) treated with molecular iodine, side effects (usually minor) occurred in 10.9% of cases; these included acne, nausea, diarrhea, hair thinning, hyperthyroidism (0.1% incidence), hypothyroidism (0.3% incidence), skin rash, headache, or transient increase in breast pain (5.7% incidence).
Two other groups of women were treated with Lugol’s solution (a preparation containing 95% sodium iodide and 5% free iodine) and iodized casein, respectively. The response rate with Lugol’s solution was 70%, and with iodized casein was 40%. Molecular iodine was associated with a lower incidence of thyroid dysfunction than the other preparations. [Townsend Letter for Doctors and Patients, Nov, 2004 by Alan R. Gaby]
Study of radioiodine uptake in normals and women with fibrocystic breasts reveals that the fibrocystic breasts were able to take in 12.5% of the iodine dosage compared to only 6.9% in normal breasts. This proves the existence of considerable iodine depletion in fibrocystic breasts.
Vitamin 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)
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 |
| Strong or generally accepted link |
| May do some good |
| Likely to help |
| Highly recommended |
Glossary
Benign
Literally: innocent; not malignant. Often used to refer to cells that are not cancerous.
Premenopause
The period when women of childbearing age experience relatively normal reproductive function (including regular periods).
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Cysts
A closed pocket or pouch of tissue; a cyst may form within any tissue in the body and can be filled with air, fluid, pus, or other material. Cysts within the lung generally are air filled, while cysts involving the lymph system or kidneys are fluid filled. Cysts under the skin are benign, extremely common, movable lumps. These may develop as a result of infection, clogging of sebaceous glands, developmental abnormalities or around foreign bodies.
Lymph Glands
Located in the lymph vessels of the body, these glands trap foreign material and produce lymphocytes. These glands act as filters in the lymph system, and contain and form lymphocytes and permit lymphatic cells to destroy certain foreign agents.
Hormones
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Fatty Acids
Chemical chains of carbon, hydrogen, and oxygen atoms that are part of a fat (lipid) and are the major component of triglycerides. Depending on the number and arrangement of these atoms, fatty acids are classified as either saturated, polyunsaturated, or monounsaturated. They are nutritional substances found in nature which include cholesterol, prostaglandins, and stearic, palmitic, linoleic, linolenic, eicosapentanoic (EPA), and decohexanoic acids. Important nutritional lipids include lecithin, choline, gamma-linoleic acid, and inositol.
Essential Fatty Acid
(EFA): A substance that the human body cannot manufacture and therefore must be supplied in the diet.