As Dr. William Ghent, former Professor Emeritus of Surgery at Queen's University in Kingston, Ontario, used to say, "premenstrual breast pain and tenderness is not normal. If it's painful, premenstrually, it's sick. I am sure that males would not accept sore testicles for seven to ten days of each month as normal." Dr. Ghent also pointed out that fibrocystic breast disease did not necessarily disappear with menopause, particularly if estrogens were used. Twenty years of research in the field led him to believe that elemental iodine was essential for breast normalcy at any age.
According to the American Academy of Pathology, at least 50 percent but as many as 80 percent of North American women suffer from some form of fibrocystic breast disease.(FCBD) This condition causes women a lot of pain and discomfort as well as a great deal of anxiety. Although FCBD is a benign condition, it can sometimes be difficult for both women and their physicians to distinguish a cystic breast lump from a cancerous one.
What Is Fibrocystic Breast Disease
FCBD is a confusing term. Or, as Dr. Susan Love, Director of the Breast Cancer Clinic at University of California, says, "a wastebasket into which doctors throw every breast problem which isn't cancer."
FCBD actually covers a whole spectrum of changes that occur in women during their reproductive years. It refers to a wide variety of non-cancerous conditions of the breast, characterized by painful lumpy breasts, usually on a cyclical basis but can occur throughout the whole cycle, and the formation of breast cysts and scar tissue. The severity of the pain does not necessarily correlate with the amount of lumpiness.
Some women have breast tenderness and enlargement that occur only for a short time in the premenstrual period, and this can be considered within the limits of a normal physiological change.
Other women develop breasts that feel lumpy or irregular to the touch. These women can have considerable breast pain and discomfort often on a daily basis. Every once in while they can feel a larger or more clearly defined cyst. This cyst usually contains clear fluid, and can be drained in the office under local anesthetic. If the cyst does not disappear, then a mammogram and biopsy is usually indicated.
Then there is a significant group of women, as much as 30 percent of women with FCBD, who have an incapacitating problem with frequent formation of breast cysts and scar tissue, accompanied by severe pain that interferes with sleep and normal daily activities.
The constant underlying worry about breast cancer is one of the debilitating aspects of FCBD. In the past, it was thought that women with FCBD had a higher incidence of breast cancer than normal, but further research did not bear out that assumption.
Treating A Puzzling Disease
Dr. Ghent used to lament that modern treatment for FCBD consisted of "little more than reassurance and the recommendation for a good support bra."
Various researchers have suggested a hormonal imbalance, a decreased ratio of progesterone to estrogen in the second half of the cycle, an abnormality of prolactin regulation, a hypersensitivity to thyroid stimulating hormone and increased estrogen levels.
Dr. Mauvais-Jarvis found that a decreased progesterone to estrogen ratio in patients with mastalgia. His group of French researchers found that breast pain was relieved 95 percent of the time with a natural progesterone gel rubbed into the breasts. This gel is not yet available in North America.
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