Noncancerous lumpy breast tissue plagues up to 20% of American women. This disorder, or set of disorders, is often diagnosed as fibrocystic breast disease, mammary dysplasia, or fibrous mastopathy—general terms that subsume every kind of benign histological alteration and are rejected by some investigators as "catchall" (N Engl J Med 299:381-385, 1978).
Women with at least some types of fibrocystic breast disease are thought to be at a twofold to eightfold greater risk of development of breast cancer, and even those whose lumps remain benign often experience extreme discomfort. Long before scar tissue develops around the cysts and sclerosing adenosis occurs, a woman may have such severe premenstrual aching and tenderness that she cannot tolerate breast stimulation or sleep without wearing a bra.
"Some of our patients fly in from other parts of the country because they're so symptomatic," says Robert S. London, MD, director of reproductive endocrinology at