Finding a lump on your breast can be a worrisome experience inducing sleepless nights. That’s how my 45-year-old patient, Mindy, felt when she discovered one on her left breast. During her office visit, she told me that the lump had become more tender, larger, and slightly painful in the preceding weeks.
Mindy correctly connected that lump with her menstrual cycle. She had been suffering from heavier, more irregular, and longer periods for a few months and had noticed the lump in the middle of her cycle, noting that it became more tender as her cycle progressed.
That lump only increased what she called “the pandemic panic.” Working 12-hour days from home with two kids and an out-of-work husband had increased her stress levels. She wasn’t sleeping well, requiring three or four cups of coffee to get moving in the morning and the midafternoon slump hit her hard, leaving her downing at least one espresso shot.
Mindy’s biggest concern was that the lump meant “the C word.” Adding to her fear, her gynecologist asked her to get a breast ultrasound and mammogram immediately. She had not done routine breast cancer screening in over 18 months. She was hoping I could put her mind at ease and give her some advice on optimizing breast health.
What is a Holistic Approach to Breast Health?
As I explained to Mindy, optimizing breast health all year long starts with working closely with your healthcare practitioner and making sure you’re taking effective preventative measures (like performing regular self breast exams) to help you identify early-stage breast cancer. Equally important, though, are the choices that you make every day for your health and well-being. This means a year-round commitment to the:
*which can accumulate in the body and become carcinogenic or cancer-causing
I’ve talked about many of these factors in past blogs. For example, I talked about how gut health can help prevent breast cancer and estrogen dominance by clearing excess estrogen from the body so it doesn’t reenter circulation and create problems.
Today, though, I want to talk about fibrocystic breast disease (FBD), which often gets confused with breast cancer. Many women, like Mindy, get very nervous about breast tenderness with a lump because they are afraid it may mean breast cancer. But what Mindy had and what many women similarly experience is actually FBD.
What is Fibrocystic Breast Disease?
First, let’s set the record straight on something: There is no such thing as having “normal breasts.”
Every person is unique, and that includes the size, shape, and other characteristics of her breasts.
Those variations include lumpy or uneven breasts. At certain times of your life – when you get your period, have a child, lose or gain weight, or take medications – the characteristics of your breasts can change, including the development of fibrocystic breasts.
When I say fibrocystic , I’m referring to the development of fibrous tissue — which is irregularly arranged connective tissue — in cystic spaces , which are sac-like pockets of membranous tissue filled with fluid, air, or other substances. Fibrocystic breasts are actually a condition , not a disease or disorder.
With FBD, healthy breast tissue feels lumpy and may become painful, often right before the menstrual cycle occurs. Symptoms will typically subside after your period ends. Usually, this condition occurs in both breasts, although one breast may have more fibrocystic changes. Over time, however, both breasts may become fibrocystic.
Characteristics of fibrocystic breast changes include:
- Thickening of breast tissue (fibrosis)
- Fluid-filled cysts that develop in one or both breasts
- Symptoms such as tenderness and nipple discharge
These breast changes may seem scary if you’re experiencing them for the first time, but the truth is, they are very common. In fact, 90 percent of women will experience fibrocystic breast changes during their lifetime, mostly between the ages of 20 and 50 because your body is also most prone to big hormone fluctuations during that time.
As Mindy experienced, symptoms of FBD tend to be worse just before menstruation. Why? Because during your menstrual cycle, fluctuating levels of estrogen and inadequate progesterone (your female superpower — the balancing hormone to estrogen ) can create areas of lumpy breast tissue that feel tender, sore, and swollen. Other hormone-related conditions such as diabetes and thyroid issues can also contribute to fibrocystic breast condition.
Is It Breast Cancer or Fibrocystic Breast Disease?
Breast cancer and fibrocystic breast disease often get confused. Like Mindy, many women get very nervous about breast tenderness and lumps because they are afraid it may mean breast cancer.
QUICK FACT: Fibrocystic breast changes do not increase your risk of breast cancer.
Having lumpy, nodular breasts and occasional breast pain that varies throughout the menstrual cycle is very common and not something to be worried about. In fact, only 3 to 6 percent of cases are due to breast cancer.
Fibrocystic breast disease (FBD) is the most common benign or non-cancerous type of breast disease. By “benign breast disease,” I am referring to various non-malignant lesions, such as benign lumps, trauma, mastalgia, and nipple discharge. Benign conditions usually go away on their own, or your physician can easily treat them.
When it comes to FBD, knowing the right thing to do is the difference between persistent breast pain and pain-free cycles.
Even so, I understand the concern: Fibrocystic lumps can very much resemble the lumps found in breast cancer, and can even make breast cancer more difficult to detect. The key to knowing the difference between the two and not panicking every time you feel a change in your breast is to:
- Know how your breasts normally feel
- Pay attention to changes and when they occur
- Communicate clearly with your healthcare practitioner about these changes
At the end of the day, any breast lump you notice is worth talking to your healthcare practitioner about; that way, they can do diagnostic tests to rule out breast cancer. That said, it’s also helpful to know the symptoms of breast cancer versus fibrocystic breast disease to help put your mind at ease.
Fibrocystic Breast Disease vs Breast Cancer
Signs and symptoms of fibrocystic breasts may include:
- Breast lumps or areas of thickening that blend into surrounding breast tissue
- Breast pain or tenderness
- Lumps that change in size with the menstrual cycle
- Clear, white, yellow or green non-bloody nipple discharge that tends to leak without pressure or squeezing
- Breast changes similar in both breasts
- Monthly increase in breast pain or lumpiness from ovulation to just before your period
Signs and symptoms of breast cancer may include:
- New, non-painful lump in the breast or underarm (armpit).
- Thickening or swelling of part of the breast.
- Irritation or dimpling of breast skin.
- Redness or flaky skin in the nipple area or the breast.
- Pulling in of the nipple or pain in the nipple area.
- Nipple discharge other than breast milk, including blood.
- Any change in the size or the shape of the breast.
- Pain in any area of the breast.
Now that we know the differences in the signs and symptoms of each condition, let’s talk about how I approached Mindy’s symptoms of fibrocystic breast disease from a holistic perspective.
Addressing Fibrocystic Breast Disease
As with any condition, I address every patient with FBD using an individualized, personalized functional medicine approach. Typically, I advise women to wait at least one menstrual cycle if they discover a new lump.
In other words, don’t panic! If the lump is still there, I recommend visiting your doctor for a breast exam. And if you’re not getting your period regularly, I recommend a breast exam if you notice a new lump.
For most patients, that exam plus a breast ultrasound put your mind at ease. Next, I focus on ways to relieve pain and other symptoms associated with FBD, including:
- Wearing a supportive bra.
- Asking your doctor to measure thyroid levels.
- Consuming at least 30 grams of dietary fiber daily, which will help the gut bind and excrete excess hormone levels .
- Talking with your doctor about managing the dose of a hormone replacement therapy regimen (if you are postmenopausal and taking bioidentical hormones).
- Trying 1000mg of evening primrose or borage oil orally, which is rich in gamma-linolenic acid (GLA), once or twice daily (with a total of 300mg of GLA per dose). Deficiencies in GLA may increase the sensitivity of breasts during the luteal phase of the menstrual cycle.
If breast pain persists over six months and/ or disrupts your daily routine, consultation with a breast health specialist is an important consideration. However, there is often one issue that goes unnoticed that may be triggering the FBD lumps to aggravate and get more painful.
The One Daily Habit That Could be Causing Breast Lumps & Tenderness + How to Fix It
Some of my patients note that when they reduce or eliminate caffeine – especially coffee – their breast pain symptoms lessen. This comes as a surprise to many, but when you dive into the science, this connection makes sense. For some people, coffee can increase inflammation , which wreaks havoc on the gut, as well as insulin resistance and stress hormone levels. Together, these factors create hormone issues, including fluctuations in estrogen that.
Researchers have studied the Coffee – Fibrocystic Disease Connection, but come up with mixed results. For example, one study published in 1984 found that caffeine consumption impacted how often this condition occurred. The women who drank more caffeine – specifically, between 31 and 250 mg a day (the equivalent of about ⅓ cup to 1 (12 oz.) cup daily – had a 1.5-fold increase in the odds of developing FBD. For those who consumed over 500 mg a day (approximately 3 cups of coffee daily), that became a 2.3-fold increase. (To put that into everyday perspective: A Starbucks grande (16-ounce) Blonde Roast contains 360 mg of caffeine.) Depending on the roast and quantity of coffee you drink, you may hit and surpass these daily numbers faster. More recent research did not find a connection and scientists have disputed whether caffeine can really cause breast tissue to undergo fibrocystic changes. However, time and time again in my clinical practice, I have found caffeine from coffee to be a big instigator of FBD.
Patients like Mindy are often unaware about just how much caffeine she was consuming daily in her dark roast (120 mg per 12 oz. cup) and espressos (64 mg in 1 fluid oz.). When she gradually removed that caffeine and made lifestyle changes (including boosting her gut health and detox pathways) to reduce the fatigue that was causing her to drink so much coffee, her symptoms improved.
How to Wean Yourself Off of Coffee
If you’ve relied on coffee to pull you through the morning or even your entire day, I know how tough giving it up can seem. But after I gave up coffee in January 2017 while leading a group through my Happy Gut® 28-Day Cleanse , I found my sleep got better, I experienced less stress, and counter to what you would think… my sluggish energy rebounded and I enjoyed sustained, all-day energy with just one cup of green tea daily (or honestly, none on some days when I simply forgot to have it, realizing by the middle of the day that I didn’t need it). I want you to experience the same awesome benefits!
Plus, cutting out coffee isn’t as hard as it sounds — as long as you have a plan. These five strategies have helped me and countless patients kick the caffeine habit for good.
5 Ways to Wean Yourself Off of Coffee
1. Determine Why You Need Caffeine.
The most important step in weaning yourself off caffeine is determining why you’re reaching for multiple cups of dark roast to get your day moving. Mindy didn’t sleep well, and coffee was her fuel that kept her going all day. Unfortunately, that came at a cost. She was in a never-ending loop of poor sleep needing more coffee, leading to more poor sleep. Many patients either aren’t getting enough shut-eye, or they meet their eight-hour sleep quota, but wake up frequently throughout the night. If you can relate to this, sustained-release melatonin is a great supplement to better manage the circadian rhythms that can help your sleep quality.
2. Know Your Caffeine Threshold.
Thanks to genetic differences — which determine whether you’re a slow or fast caffeine metabolizer (about half of you are slow metabolizers, by the way) — everyone responds to caffeine differently. It’s important to be mindful of how caffeine affects YOUR body. If you feel jittery after two cups of coffee, then dial it back to just one cup daily. Personally, I’m a slow metabolizer, so even just one cup of coffee will leave me feeling jittery for hours. When I help my patients realize if they are slow metabolizers, it’s an easy choice to put coffee aside. Once you’re aware of how coffee affects your body, you’ll be more motivated to not consume too much or, like me, not any at all! That doesn’t mean I don’t have some caffeine, but instead of coffee, I have it in the form of green or black tea, which have less caffeine per cup than coffee; plus, green tea contains l-theanine, which has a calming, balancing effect not found in coffee, helping slow metabolizers like me tolerate it better.
3. Try Decaf.
If you’re not going to budge on your morning java because you love the taste and ritual of a great cup of coffee, you can focus on decreasing the caffeine content. Start with half-regular coffee and half-decaf. Then, gradually taper to mostly decaf. By switching to decaf, you can still enjoy the taste, smell, and ritual of coffee without the negative consequences of too much caffeine. Just make sure you’re also drinking your coffee black or with just a touch of organic pure stevia or unsweetened coconut creamer. Sugar and dairy will only contribute to estrogen fluctuations and hormone imbalance!
4. Make a Simple Swap.
If you love having a hot morning drink but you’re not married to coffee, try swapping it out for an organic matcha, which also has powerful anti-cancer properties due to an antioxidant called epigallocatechin gallate (EGCG). A matcha latte is warm, creamy, and the caffeine content is easier on your body due to green tea’s calming l-theanine content. Other coffee alternatives include black tea, soothing peppermint tea, and Four Sigmatic® mushroom tea.
5. Use Magnesium To Minimize Effects.
Even if you follow the steps above, you may notice withdrawal side effects — like headaches and irritability — when you start weaning yourself off caffeine. In fact, if you wean off coffee too quickly (a mistake I often see, in spite of my advice to the contrary), you may find yourself dealing with a migraine for several days in a row. These symptoms typically only last for a few days but can cause many people to turn back to coffee. However, if you can get through this tough patch, the benefits you’ll glean will reward the effort. The good news is that there is a natural way to fend off caffeine withdrawal headaches: magnesium. Magnesium is a great way to combat headaches and many people are deficient in this critical mineral. I recommend a minimum of 400mg of magnesium glycinate once or twice daily, available in capsules or as a powder. In my medical practice , we offer intravenous magnesium as a solution for a migraine headache not responding to other therapies.
Detoxification: The Last (But Most Important!) Factor in FBD
So far we’ve talked about increasing fiber, decreasing caffeine, and wearing supportive clothing. These are all great ways to mitigate the symptoms of FBD but there’s one more factor that we can’t ignore — our increasingly toxic environment.
The toxins in our environment, food, water, and even the air we breathe can overwhelm and interfere with our liver’s ability to detoxify. Among many other repercussions, impaired detoxification (a reduced ability to neutralize and move toxins out of the body) means that your body can’t eliminate harmful hormone metabolites and chemicals from the body, which can increase your risk of breast-related problems, including FBD and breast cancer.
When I mention detoxing, you probably think about the liver. But the process also includes your gut, an often-overlooked, key organ of detoxification. Supporting your body’s detox processes requires all the organs that play a role in these processes, including the gut, which calls for a healthy balance of favorable and unfavorable microorganisms (your third “detox organ”).
Thankfully, I’ve designed a detox plan — my Happy Gut® RESET: 7-Day Detox — that delivers real, liver detox-supportive gut healing results in just one week . This is the same plan that I used with Mindy and many other patients with FBD and hormone imbalance, and I’m excited to say that it is now available to the public. In fact, from now until October 31st , in honor of Breast Cancer Awareess Month, use the code BCA50Off for $50 off your 7-Day Detox .
I formulated the Happy Gut® RESET: 7-Day Detox so that you can get amazing results in just one week. That means you can heal your gut, help your liver more effectively detoxify hormones, promote breast health, and drop those unwanted pounds… All in one week!
I want to offer you the same support that Mindy and my other in-person patients have received. Order the Happy Gut® RESET: 7-Day Detox today and before you know it, you’ll be on your way to a happier gut, balanced hormones, healthier breasts, boundless energy and so much more.