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School of Medicine
Fibrocystic Breast Tissue
Fibrocystic breast tissue is NOT fibrocystic breast disease. This incredibly common condition simply means that your breasts have denser breast tissue and that “lumps and bumps” are common to the feel of your breasts.
Screening Options for Fibrocystic Breast Tissue
Women with fibrocystic breast tissue should be just as diligent about performing breast self-exams as women who do not have lots of “lumps and bumps.” Women should examine themselves for a change in the breast from the previous month. If a change is found, it should be reported to their doctor right away.
At the Johns Hopkins Breast Center, our nurse practitioners teach women how to give themselves proper monthly breast exams. One technique they use is to teach you “the geography of your breast” by making a map of your breasts so you can check it each month to ensure the geography has remained the same.
Women with fibrocystic breast tissue should be aware that their mammograms may be difficult to read and interpret. Likened to “finding a polar bear in a snowstorm,” both lumpy breast tissue and masses can show up in white on a traditional mammogram.
We recommend women with fibrocystic breast tissue choose a breast center that offers digital mammography. Digital mammograms address breast tissue density by allowing the radiologist to change the contrast of light and dark on the computer. It also allows the radiologist to enlarge an area of the breast tissue on the screen to more closely examine any areas of concern. Digital mammography is quickly becoming the gold standard for detecting breast changes. It can detect the presence of breast cancer 28 percent more often than traditional analog film mammograms.
When used in conjunction with digital mammography, ultrasound is a useful tool for further differentiating normal findings from abnormal findings and solid masses from liquid-filled masses.
Your radiologist may also recommend that your breasts be examined with magnetic resonance imaging (MRI). Like ultrasound, MRI is a tool for investigating abnormal findings. MRIs are not a substitute for mammography; they are done in addition to the mammogram. MRIs are also useful for women with a strong family history of breast cancer, or who are identified as high-risk. Women may be at high risk if they have atypical duct hyperplasia (ADH) or lobular carcinoma in situ (LCIS), among other reasons.