Fibrocystic Breast Disease

As mentioned above about 40% of breast lumps are caused by fibrocystic disease. This diagnostic term is misleading as it implies that it would be the opposite of health and should be treated. The term "breast nodularity" is often used now by clinicians instead. It is often symptomatic in the premenstrual period of the menstrual hormone cycle
when progesterone from the ovaries increases blood flow to the breasts. This leads to more nodularity in a woman who has this tendency (Ref. 9, p. 1083).

The important part is to screen for the small number of women in this group who have breast cancer. Depending on the clinical findings the doctor may elect to follow-up and observe only or to do tests when there is suspicion of cancer. Mammography is usually not recommended in a woman younger than 30 except for a high risk setting with a family history of genetic breast cancer or prominent symptoms on only one breast. Digital infrared thermal imaging (=thermography) can be utilized where available to help distinguish between fibrocystic breast tissue and early breast cancer.

There has been a theory that perhaps caffeine could be blamed as a cause of fibrocystic breast disease. However, a recent thorough review of dietary factors that may play a role in causing fibrocystic disease failed to show evidence to condemn caffeine (Ref. 24). Instead these authors found that a low fat, high fiber diet with socalled soy isoflavone (found in soy products or soy protein powder) will give relief for this condition. Primrose oil, vitamin E, or pyridoxine (Vit. B6) were not found to be effective contrary to many flyers from health food stores. To stop cigarette smoking and stop drinking alcohol has general health benefits and in my opinion contributes to some reduction in breast pain.

Iodine deficiency is something that has been known to be the case for fibrocystic disease for several decades. However, it was belittled by organized medicine as being not valid. However, it is a fact that Japanese women who get about 10-times the amount of daily iodine in their diet than the North American woman have hardly any fibrocystic disease of their breasts. Dr. Eugene Shippen who was interviewed by Suzanne Somers in chapter 14 of her book (Ref. 28) stated that In the US where less than 1 mg of iodine per day is consumed. Some women are more sensitive than others and they develop fibrocystic disease. Dr. Shippen explains further that with 50 mg of iodine per day fibrocystic disease gets cured (page 211 of Ref. 28).

Finally, Dr. Lee et al. (Ref.29) has pointed out that in France fibrocystic disease was already treated successfully with progesterone cream in the 1970's. Research in the past has shown that when estrogen is not balanced by enough progesterone in the system, the resulting estrogen dominance leads to cyst development in the breasts. The logical treatment therefore is to give natural progesterone cream that is absorbed through the skin (note: this will not work with progestins, the synthetic progesterone derivatives that have side-effects of heart attacks and strokes).

Treatment:

1. Treatment must be individualized. Drugs like danazol, tamoxifen and bromocriptine are not recommended by the FDA (see Ref. 9, p.1083) because of the longterm side effects. Simple steps such as the zone diet plan (Ref. 2) are redommendable and often effective (Ref. 24, also see "breast pain" under the link "common breast problems"). General life style changes as mentioned above will be helpful. As explained above, 50 mg of iodine supplementation, by taking 8 drops of Lugol solution diluted in water, can work wonders. This link states that different forms of iodine supplementation were effective in women with fibrocystic breasts.

2. Dr. John Lee (Ref.29 and Ref. 30) describes that fibrocysts develop because of overgrowth of normal breast tissue under the influence of excessive estrogen (estrogen dominance). Fibrocysts will often shrink when 15 to 20 mg of a bioidentical progesterone cream is applied to the breast skin during the second half of the cycle (day 12 to 26 of the cycle, Ref. 29). According to Ref. 30 fibrocystic disease will be cured within 2 to 3 cycles when taking 20 mg to 25 mg of bio-identical progesterone cream daily from day 12 to 26 of the menstrual cycle. This was pioneered more than 30 years ago in France. After 3 to 4 months the breast tissue returns to normal. A complicating factor can be when the woman is under a lot of stress. Cortisol, the stress hormone blocks the action of progesterone as it competes for the progesterone receptor. In these women the initial dose needs to be adjusted to 30 to 40 mg per day from day 12 to 26 of the menstrual cycle, but several months later can be reduced to a 20mg daily maintenance application of progesterone from day 12 to 26 of the cycle.

Dr. Lee recommends in addition to take 400 IU of vitamin E at bedtime, 300mg of magnesium and 50 mg of vitamin B6. He also recommends to reduce sugar and starch intake. For maintenance it is recommended to taper the natural progesterone cream to the minimum amount that will control the breast pain. The progesterone cream can be ordered through a compounding pharmacy.

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 235.

2. B. Sears: "Zone perfect meals in minutes". Regan Books, Harper Collins, 1997.

3. Ryan: Kistner's Gynecology & Women's Health, 7th ed.,1999 Mosby, Inc.

4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 245.

5. AB Diekman et al. Am J Reprod Immunol 2000 Mar; 43(3): 134-143.

6. V Damianova et al. Akush Ginekol (Sofia) 1999; 38(2): 31-33.

7. Townsend: Sabiston Textbook of Surgery,16th ed.,2001, W. B. Saunders Company

8. Cotran: Robbins Pathologic Basis of Disease, 6th ed., 1999 W. B. Saunders Company

9. Rakel: Conn's Current Therapy 2001, 53rd ed., W. B. Saunders Co.

10. Ruddy: Kelley's Textbook of Rheumatology, 6th ed.,2001 W. B. Saunders Company

11. EC Janowsky et al. N Engl J Med Mar-2000; 342(11): 781-790.

12. Wilson: Williams Textbook of Endocrinology, 9th ed.,1998 W. B. Saunders Company

13. KS Pena et al. Am Fam Physician 2001; 63(9): 1763-1770.

14. LM Apantaku Am Fam Physician Aug 2000; 62(3): 596-602.

15. Noble: Textbook of Primary Care Medicine, 3rd ed., 2001 Mosby, Inc.

16. Goroll: Primary Care Medicine, 4th ed.,2000 Lippincott Williams & Wilkins

17. St. Paul's Hosp. Contin. Educ. Conf. Nov. 2001,Vancouver/BC

18. Gabbe: Obstetrics - Normal and Problem Pregnancies, 3rd ed., 1996 Churchill Livingstone, Inc.

19. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 251.

20. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 250.

21. Ignaz P Semmelweiss: "Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers" ("Etiology, the Understanding and Prophylaxis of Childbed Fever"). Vienna (Austria), 1861.

22. Rosen: Emergency Medicine: Concepts and Clinical Practice, 4th ed., 1998 Mosby-Year Book, Inc.

23. Mandell: Principles and Practice of Infectious Diseases, 5th ed., 2000 Churchill Livingstone, Inc.

24. Horner NK et al. J Am Diet Assoc Nov-2000; 100(11): 1368-1380.

27. Suzanne Somers: "Breakthrough" Eight Steps to Wellness-- Life-altering Secrets from Today's Cutting-edge Doctors", Crown Publishers, 2008

28. Suzanne Somers: "Ageless - the naked truth about bioidentical hormones", Three Rivers Press, NY, 2006

29. Dr. John R. Lee, David Zava and Virginia Hopkins: "What your doctor may not tell you about breast cancer - How hormone balance can help save your life", Wellness Central, Hachette Book Group USA, 2005. On page 254 and 255 Dr. Lee describes how progesterone can be used as a cream to treat fibrocystic disease.

30. Dr. John R. Lee: Natural Progesterone- The remarkable roles of a remarkable hormone", Jon Carpenter Publishing, 2nd edition, 1999, Bristol, England.

Last modified: March 4 , 2012