For Your Health: Breast Health

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Perfect, healthy breast tissue is smooth, of even thickness throughout, and pain-free. Unfortunately, such flawless breasts are hard to find. Most women experience at least some degree of swelling, tenderness, lumpiness, or ropelike tissue in their breasts.

Why? One common reason is fibrocystic breast disease, a noncancerous condition that affects up to 50 percent of women in the United States aged thirty-five to fifty. Yet this estimate may be conservative—some gynecologists assert that fibrocystic breast tissue, or cystic mastitis, occurs to some degree in virtually all women.

Although fibrocystic breast disease (FBD) is not cancer, nor a definitive risk factor, the conditions that favor the development of FBD also favor the development of breast cancer. In the opinion of many practitioners, FBD should be viewed as a wake-up call and, hopefully, should motivate healthy changes. Naturopathic management of FBD combines lifestyle changes, nutritional supplementation, and phytoestrogenic and detoxifying herbs—all contributors to overall breast health.

Defining the problem

The term fibrocystic breast disease is actually a misnomer. ­Although called a disease, it’s considered a benign breast disorder. It generally refers to breast tissue with poorly defined thickness or palpable lumps accompanied by pain. The lumpiness and pain fluctuate with the menstrual cycle. Symptoms include:

• multiple soft, tender masses that vary in size and occur mostly in the upper outer quadrant of both breasts
• ropey, irregularly shaped, tender masses that occur diffusely in both breasts
• a combination of the above two
• swollen, diffusely tender breasts that are more tender just before the menstrual period
• each cyst or fibrous mass merges at some point into the surrounding breast tissue.

If one divides each breast into four quadrants, intersecting at the nipple, the most common location for the lumps are in the upper outer quadrants of each breast extending all the way up into the underarm areas. The lumps may feel soft and fluid-filled or thickened and ­fibrous. All these changes can occur without the woman noticing. However, these changes can also produce pain in the breasts.

Breast pain associated with FBD is usually cyclical, worse just before menses and then disappearing afterward. This cycle is most likely due to the changes in hormone levels throughout menstruation. Both estrogen and prolactin, a pituitary hormone, cause fibrocystic changes in the breast tissue. As the relative concentration of estrogen (and prolactin) increases in the second half of the menstrual cycle, the breast tissue, already sensitized to estrogen, responds by retaining more fluid. Water accumulation is accentuated in the areas of fibrocystic changes; this causes the tissues to swell, compress nerve endings, and produce pain. Inflammation is another effect of increased estrogen activity.

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