Fibrocystic Breast Disease

General

Clinical Manifestations	Lump(s) in the breast(s) that are of different sizes, or shapes Can have pain or no pain Can change in size with menstrual cycle and emotions Luteal phase = larger, follicular phase = smaller Patient should get mammogram, if lump is malignant it will be hard, fixed and feel like cauliflower and there may be an inverted nipple (significantly inverted- including areola), the edge of areola may not be distinct (fades to pale orangey), pink fluids may leak, check lymph nodes (axillary, 52-53 nodes).
Treatment Principle
Herb Formulas
Points

Spleen And Kidney Yang Deficiency

Clinical Manifestations	Slightly hard, mobile breast lumps Body cold Limbs icy Aversion to Cold White frothy sputum Anorexia Complexion white and shiny Weak voice Shortness of breath Low back, knees and abdomen feel cold and painful Lower abdomen feels cold and painful Loose stools containing undigested food “Cock-crow” diarrhea (occurs at about 5 am) Edema of face and limbs Dysuria Irregular menstruation Clear, white vaginal discharge Infertility Low sex drive Severe: Abdominal ascites T: Pale, moist and swollen C: Thin and white or White and greasy P: Deep, thready, weak and maybe slow
Treatment Principle	Warm and Reinforce the Spleen and Kidneys Eliminate lumps and swelling
Herb Formulas	Wen Bu Pi Shen Tang Jia Jian
Points	Moxa or moxa needle REN-4, REN-12, SP-6, SP-9, ST-36, UB-20, UB-23

Liver Qi Stagnation

Clinical Manifestations	Can start in puberty Can change size with cycle and/or emotions The Lumps are pliable without adhesion The outline of the lumps are not clearly definable Breast distention and pain before and during menses Pain and lumps worse with anger and depression Dysmenorrhea Infertility Irregular menses Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger T: Pink C: Thin and white P: Wiry
Treatment Principle	Soothe Liver Clear Stagnation Circulate Qi Dissolve lumps
Herb Formulas	Xiao Yao San modified Chai Hu Shu Gan Tangmodified Xiao Yao San + Er Chen Tang With Interior Heat and Qi and Blood Deficiency: Jia Wei Xiao Yao San With Heat and Blood Deficiency: Ping Gan Liu Qi Yin
Points	GB-40, GB-41, LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14, PC-6, SJ-6, SP-6, UB-18 REN-17, SI-11, ST-36, UB-18 For Liver Fire: + LIV-3 For Kidney and Liver Yin Deficiency: + UB-23 For Qi and Blood Deficiency: + REN-6 For irregular menstruation: + SP-6 For chest oppression: + LI-4 Alternate: A. LIV-4, REN-6, REN-17, SP-6, SP-15, ST-36 B. GB-21, LI-11, LIV-4, REN-6, SP-6, UB-18 For chest oppression: + LI-4 LIV-3, LIV-14, ST-18 GB-41, LIV-3, LIV-14, PC-5, SJ-6, ST-18, ST-40, UB-18

Liver Qi Stagnation Invades The Spleen

Clinical Manifestations	Abdominal distention and pain Gas Borborygmus Diarrhea Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Women: Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: White and greasy P: Slippery and wiry
Treatment Principle	Soothe the Liver Invigorate the Spleen
Herb Formulas	Xiao Yao San Hei Xiao Yao San
Points	LIV-3, LIV-13, SP-6, ST-25, ST-36, ST-37

Liver Qi Stagnation Invades The Stomach

Clinical Manifestations	Epigastric pain (worse when emotionally upset) Belching with acid regurgitation Nausea Vomiting Anorexia Epigastric distention Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink C: Thin and white P: Wiry
Treatment Principle	Soothe the Liver Harmonize the Stomach
Herb Formulas	Chai Hu Shu Gan Tang Xiao Yao San Hei Xiao Yao San With Heat: Si Ni San
Points	LIV-3, LIV-14, PC-6, REN-12

Liver Qi Stagnation With Damp-Heat

Clinical Manifestations	Premenstrual breast distention and pain Premenstrual chest oppression Heart vexation Easily angered Dry mouth Vexatious Heat in the chest and epigastrium Lower abdominal aching and pain Possible vaginal itching Possible excessive yellow vaginal discharge T: Red C: Thin and yellow P: Wiry and rapid
Treatment Principle	Dredge the Liver Resolve Stagnation Clear Heat Dispel Dampness
Herb Formulas	Jia Wei Xiao Yao San Yi Huang Tang San Miao Wan modified
Points

Liver Qi Stagnation With Yin Deficiency

Clinical Manifestations	Breast lumps that may feel hot Can start in puberty Can change size with cycle and/or emotions The Lumps are pliable without adhesion The outline of the lumps are not clearly definable Breast distention and pain before and during menses Pain and lumps worse with anger and depression Dysmenorrhea Infertility Irregular menses Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Night sweats Malar flush Low-grade afternoon fever Five Sole Heat Thirst Dark urine Constipation T: Red C: Little or None P: Thready, wiry and rapid
Treatment Principle	Dredge the Liver Regulate Qi Nourish Yin Clear Fire
Herb Formulas	Jia Wei Xiao Yao San + Yi Guan Jian + Zhi Bai Di Huang Wan + Er Zhi Wan
Points	GB-41, KI-3, LIV-3, LIV-14, PC-5, SP-6, SJ-6, ST-18, ST-40, UB-18, UB-23

Liver Qi And Blood Stagnation

Clinical Manifestations	Breast distention and pain before and during menses Premenstrual Heart vexation Occasional breast nodulation Facial color dark and dull Emaciation Sides and ribs distended on both sides (maybe with sharp pain) Enlargement of the Liver and Spleen Suffocating sensation in chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Possible scanty, rough menstruation Dark purple menstrual Blood with clots Dysmenorrhea Lower abdominal distention and pain which is worse with pressure T: Dark purple (maybe purple spots on edge of tongue) C: White P: Wiry, choppy and slow or Wiry andslippery
Treatment Principle	Activate Blood circulation Soften hardness
Herb Formulas	Jia Wei Xiao Yao San + Tao Hong Si Wu Tang  modified With Heat: Fibrocystic Breast Disease #1
Points	LIV-3, LIV-13, LIV-14, SP-6, UB-17

Liver Fire

Clinical Manifestations	Severe, splitting headaches with dizziness Sudden tinnitus or Sudden deafness Flushed face Red, swollen, painful eyes Irascibility with violent angry outbursts Dry mouth Bitter taste in mouth Thirst Vomiting sour or bitter liquid Insomnia Restlessness Constipation or dry stools Maybe rib pain In severe cases: Mania Hemoptysis Hematemesis Epistaxis Liver Fire Attacks the Lungs: Hemoptysis Rib pain which is severe when coughing Liver Fire Attacks the Stomach: Hematemesis T: Red tip and edges C: Thick, yellow, dry and rough P: Wiry, Excess and rapid
Treatment Principle	Clear the Liver Purge Fire
Herb Formulas	Long Dan Xie Gan Tang Long Dan Xie Gan Tang + Jia Wei Xiao Yao San
Points	Alternate: A. LIV-2, LIV-3, LIV-4, REN-6, REN-17, ST-15, ST-36 B. GB-21, LI-11, LIV-3, LIV-4, REN-6, UB-18 GB-42, LIV-2, SI-1 With Damp-Heat: + LIV-8, SP-9 With insomnia: + HT-7 With headaches: + GB-20

Liver Blood Stagnation With Heart Blood And Spleen Qi Deficiency

Clinical Manifestations	Mild, insideous breast pain or Slight sensations of breast distention Premenstrual chest oppression Heart vexation with chaotic thoughts Palpitations Dizziness Insomnia Excessive dreams Lack of strength in the entire body Spiritual exhaustion Poor appetite Excessive, pasty, white vaginal discharge T: Pale with teethmarks C: Thin and white P: Thready and wiry
Treatment Principle	Dredge the Liver Tonify the Spleen Resolve Dampness Harmonize the Stomach Nourish the Heart Calm the Shen
Herb Formulas	Gui Pi Tang modified
Points

Liver And Gall Bladder Heat With Stomach Cold

Clinical Manifestations	Alternating chills and fever Pronounced chills with light fever or Chills without fever Cold extremities Aversion to Wind Headache Thirst Sweating on the head Irritability Insomnia Dry cough Tuberculosis Diarrhea Palpitations Loose stools Hypochondriac pain A feeling of fullness and clumping in the chest and hypochondrium Rapid Heart palpitations Dysuria Night sweats Gastric distention T: Moist C: White and slippery P: Wiry and tight on the left or Wiry and slow on the right or Thin and rapid or Irregular
Treatment Principle	Harmonize and release the Shao Yang Disperse clumping Warm the Interior Dispel Cold Dispel water accumulation Clear Heat
Herb Formulas	Chai Hu Gui Zhi Gan Jiang Tang
Points

Liver And Kidney Deficiency

Clinical Manifestations	Premenstrual breast distention Mild, insideous pain Chest oppression Heart vexation with chaotic thoughts Dizziness Tinnitus Low Back and knee pain and weakness Lack of strength T: Pale C: Little P: Deep and wiry
Treatment Principle	Dredge the Liver Tonify the Spleen Tonify and Nourish the Liver and Kidneys
Herb Formulas	Jia Wei Xiao Yao San  modified
Points

Kidney Yin Deficiency With Liver Qi Stagnation

Clinical Manifestations	Chronic, small sand/bean plentiful lumps Irregular menses Infertility Dark eye circles Weak back and knees T: Red or Darkish C: Little or None P Thready, wiry and rapid
Treatment Principle	Nourish the Kidneys Soothe the Liver Regulate the Jing Luo Dissolve lumps
Herb Formulas	Ding Jing Tang modified
Points	GB-40, GB-41, KI-3, KI-6, LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14, LU-7, PC-6, SJ-6, SP-6, UB-18 UB-23

Kidney And Liver Yin Deficiency

Clinical Manifestations	Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis (Wei syndrome), weakness Tinnitus Deafness Forgetfulness Low back and knees sore and painful Throat dry and painful Five sole Heat Low-grade fever Night sweats Irritability Insomnia Stools difficult to pass Constipation Men: Spermatorrhea Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Liver and Kidneys
Herb Formulas	Liu Wei Di Huang Wan
Points	Alternate: A. LIV-4, REN-6, REN-17, SP-6, ST-15, ST-36, UB-18, UB-23 B. GB-21, LI-11, LIV-4, REN-6, SP-6, UB-18, UB-23

Qi And Blood Stagnation

Clinical Manifestations	A sensation of oppression in the chest A feeling of distention in the hypochondrium The chest pain is worse just prior to and after menstruation The pain is worse with emotional upset Breast masses that are moderately hard and painful on palpation Pale red or Blood-tinged secretions from the nipple Pain that is fixed, stabbing and/or severe or Pains that move around Distention Depression Irritability Pan is worse with pressure Dark complexion Fixed, palpable masses Bleeding with clots Purple lips Purple nails Dry skin Blue, dark or purplish discoloration of skin in small or large areas, Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots C: White P: Choppy or Wiry and choppy
Treatment Principle	Invigorate the Blood Move Qi Break up Stagnation
Herb Formulas	Xiao He San Hei Xiao Yao San
Points	GB-40, GB-41, LIV-3, LIV-14, PC-6, SJ-6, SP-6, SP-10, ST-36, UB-17, UB-18, UB-40

Qi Blood And Phlegm Stagnation

Clinical Manifestations	Noxious swellings Abscesses Flat abscesses Red face Chest pain Ulceration of the tumor Maybe a bloody secretion Foul odor Short urine T: Reddish purple C: Little or Yellow P: Wiry and rapid or Flooding or Tight or Thin
Treatment Principle	Move Qi Invigorate the Blood Break up Stasis Clear Heat Resolve toxicity
Herb Formulas	Shi Liu Wei Liu Tang
Points

Qi And Blood Deficiency

Clinical Manifestations	Slightly hard, permanent, mobile masses in the breast Non-discernable outline of the masses Fatigue Loose stools Poor appetite Dizziness Pale face Weak voice Shortness of breath Sweating with little or no exertion Palpitations Insomnia Dry skin Dry hair Poor memory Paleness Scanty periods Slight edema of the legs T: Pale or Pale, thin and dry C: Thin and white P: Weak or Thin and empty
Treatment Principle	Tonify Qi Nourish the Blood Drain the channels Eliminate Stasis
Herb Formulas	Ba Zhen Tang modified Si Jun Zi Tang
Points	Alternate: A. LIV-4, REN-6, REN-17, SP-6, ST-15, ST-36, UB-18 B. GB-21, LI-11, LIV-4, REN-6, SP-6, UB-18 KI-3, LIV-3, LU-9, SP-6, ST-36, UB-11, UB-17 KI-6, LU-7

Phlegm And Qi Stagnation

Clinical Manifestations	Soft lumps like a hard boiled egg (smooth) No significant pain Does not necessarily change with cycle Usually in younger women Dizziness Nausea Chest fullness and pain Dyspnea Shortness of breath Severe pain radiating to the back Severe wheezing Severe cough Disturbed sleep Breast distention and pain before and during menses Dysmenorrhea Infertility Irregular menses Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger T: Normal C: White and greasy P: Deep and wiry or Tight
Treatment Principle	Soothe the Liver Invigorate the Spleen Eliminate Phlegm
Herb Formulas	Xiao Yao San+ Hai Zao Yu Hu Tang Gua Lou Xie Bai Ban Xia Tang
Points	GB-40, GB-41, LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14, PC-5, PC-6, SJ-6, SP-6, ST-40, UB-18

Disharmony Between The Chong And Ren Channels

Clinical Manifestations	Breast distention and pain before and during menses Pain in the breast and nipple Dislike of having them covered Small nodules Epigastric pain (worse when emotionally upset) Belching with acid regurgitation Nausea / vomiting Anorexia Epigastric distention Distention and pain in the sides or flanks Suffocating sensation in the chest Edema Aversion to Cold and Wind Tendency to sigh Melancholy Depression Insomnia Dream-disturbed sleep Night sweats Irritability Agitation Inappropriate anger Very irregular menses Pale flow Maybe scanty or copiuos menstruation Dysmenorrhea Maybe amenorrhea Low back and knee weakness and pain Maybe infertility Tired spirit Blurred vision Tinnitus Dizziness T: Pink or Pale C: Thin and white P: Wiry and thready or Frail and deficienct
Treatment Principle	Harmonize the Chong and Ren Soften hardness Resolve lumps
Herb Formulas	Tian Chong Hua Jian Tong Er Xian Tang + Er Zhi Wan + Xiao Yao San modified
Points	ST-12, ST-36, ST-40, ST-30, LIV-3, LIV-14 LIV-3, LIV-14, PC-6, REN-12 REN-17, SI-11, ST-36, UB-18 For Liver Fire: + LIV-3 For Kidney and Liver Yin Deficiency: + UB-23 For Qi and Blood Deficiency: + REN-6 For irregular menstruation: + SP-6 For chest oppression: + LI-4 GB-41, KI-3, KI-6, LIV-3, LIV-14, PC-6, REN-17, SP-6, UB-23