Fibrocystic Breast Syndrome
Multiple names exist to describe cyclical breast tissue changes and the clinical symptoms that occur monthly under the hormonal influence of the menstrual cycle. The names include: cyclic mastalgia, fibrocystic disease, aberrations of normal development (ANDI), benign breast disease, fibrous disease, benign breast syndrome, cystic breast disease, and mammary dysplasia. In this nutritional handout this phenomenon will be referred to as Fibrocystic Breast Syndrome (FBS), as this term coins the two most common breast changes which occur (cystic, fibrous), and defines the condition as a syndrome and not a disease. The condition of fibrocystic breasts has been labeled a syndrome, and is no longer recognized or properly referred to as an actual disease manifestation. Indeed, Hutter in 1985 posed the question, “Is it reasonable to define as a disease any process that occurs clinically in 50% and histologically in 90% of women?” Additionally, the fibrocystic breast was classified as a manifestation disease, based upon the spurious belief that women with this condition were at 2 to 4 times the risk of developing breast carcinoma. This is currently not considered to be the case. Most women with cyclical fibrocystic breast changes are not at increased risk of cancer. Rather it is a special subset of these women who are at risk. Dupont and Page, in 1985, demonstrated in a study of 10,366 breast biopsies over a period of 17 years, that women are at increased risk of cancer only if the breast syndrome is histologically atypical hyperplasia and/or there is a familial risk factor; the majority of women (70%) who underwent breast biopsy were not at risk. The incidence of FBS peaks in 30 to 40 year old women, occurring more frequently in the left breast. In most women it is experienced as a mild to moderate aching, burning, or intermittent sharp discomfort in one or both breasts during the premenstruum, at any time from ovulation to the onset of the menses.
A naturopathic approach to treating someone with fibrocystic breast syndrome most often consists of assisting the body with the detoxification of estrogen. Estrogen is detoxified through the same p450 enzymatic pathway as caffeine and alcohol so one way to maximize the detoxification of estrogen is to eliminate caffeine and alcohol from the diet. Clinical nutrition may also be added to assist. Increased insulin due to insulin resistance also contributes to the estrogen dominance, therefore a low glycemic, high protein meal plan may be recommended to help address the underlying insulin resistance. Iodine may be recommended to help bind up the estrogen receptor sites in the breast tissue to “bump” the estrogen off and minimize the symptoms of FBS. Castor oil packs and proteolytic enzymes may also be prescribed to help manage the symptoms and address the underlying cause(s).