Lumps and Fibrocystic Change

QUESTION: For the past couple of months, my wife has been getting a lump on the left side of her left breast near her armpit. The lump comes up before her period and goes away after she has finished her cycle. The lump has just returned for the third month in a row. We have read where this might just be associated with her period. Should we worry about it?

ANSWER: In almost all instances, lumps that appear prior to the menstrual period and disappear or reduce in size substantially after the cycle are not worrisome. These types of changes are sometimes referred to as fibrocystic change. They are, in fact, more common in the upper outer aspect of the breast but may occur at any location. There is also a tendency for these changes to recur frequently during the pre-menopausal years. The exact cause of these changes is unknown, but probably represents an exaggerated abnormal response of the breast to the female hormones estrogen and progesterone. Lymph nodes in the armpit can also vary in size, as they respond to the day-to-day changes that occur in the breast, your arm (a bug bite, cut or rash), and the armpit itself (if you shave that area). If your wife has symptoms such as a specific area or lump in the breast that persists or enlarges progressively, further evaluation is recommended with physical exam, ultrasound, and possible mammography, and removal of fluid or tissue for analysis.

Even though your wife's cyclic breast changes do not seem to be worrisome it is still important to have her evaluated by a doctor with expertise in breast cancer. Just having the chance to check it out, understand her situation, and have a plan of follow-up can be VERY reassuring and therapeutic for both of you.

—Alan Stolier, M.D. and Marisa Weiss, M.D.