The main hormones implicated in the worsening of breast symptoms premenstrually include estrogen, the main female hormone, and prolactin, the milk release hormone secreted by the pituitary gland. Dietary factors have also been implicated. These include caffeine intake from coffee, black teas, colas, and chocolate, as well as excessive saturated fat and salt. Usually the symptoms of pain and swelling do not persist once menstruation begins, and most women notice significant relief at this time. The difference in the breast swelling can be so marked between the first and second half of the menstrual cycle that some women actually change bra size.
With repeated cycles of hormonal stimulation, the breast cysts may become chronically inflamed and surrounded by fibrous tissue which can harden and thicken the cysts. It is then more difficult for the fluid trapped in the cysts to escape and be reabsorbed by the body. This condition occurs most frequently in women in their late thirties and forties. To distinguish these hardened cysts from cancer, physicians often perform a simple office procedure called a needle aspiration. In this procedure, a needle is used to remove fluid from the cyst. This helps relieve pressure from the cyst on the surrounding tissue if it is causing pain, as well as rule out breast cancer. A mammogram will also help distinguish a breast cyst from breast cancer.
However, if there is a lingering concern about making an accurate diagnosis, a surgical biopsy might be performed. This is done under a local anesthetic in a physician's office or clinic or under general anesthesia in a hospital setting. A biopsy allows the physician to remove the entire breast mass so that the cells can be examined microscopically for any cancerous changes. Fortunately, most masses are benign.
Besides eliminating certain foods from the diet (caffeine, saturated fats, and salt), a high-fiber diet, including many plant-based foods, fruits and vegetables, beans and peas, raw seeds and nuts, and whole grains may help prevent cyclical fluctuations in cyst size and tenderness. The addition of seafood to the diet, particularly fish, may be useful in preventing breast cysts due to the iodine content and healthy oils contained in certain fish. The best fish for female health include those high in the Omega-3 fatty acids like salmon, trout, and mackerel.