I see fibrocystic breast changes frequently in clinical practice and treat with a high success rate with various strategies involving acupuncture, herbal medicine, qi gong, and dietary therapies. Let’s focus on some key ideas concerning the use of acupuncture in the presentation of fibrocystic breast changes, and how the TCM concepts of the liver and phlegm play an important role in treatment protocols.
Although patients rarely present with a single pattern underlying their health imbalances, the pattern of liver qi stagnation and the issue of phlegm play extremely important roles when it comes to treatment of fibrocystic breast changes. The Liver, Gallbladder, Spleen, Stomach, and Kidney Meridians all influence the chest and breast area, and these organs can also play a role in the treatment of fibrocystic breast issues.
Liver Qi Stagnation and the Liver Channel
The smooth flow of qi throughout the entire body is a key activity for the liver. If this becomes compromised, qi stagnation can manifest throughout the body and entire Liver Channel. The free flow of qi also influences the flow of blood and body fluids; therefore, liver qi stagnation can have systemic effects. This can all influence the presentation of fibrocystic breast changes. If the liver qi remains stagnant consistently, the patterns of blood stasis and phlegm will also always eventually present throughout the body and meridian.
The free flow of liver qi also influences the actions of the spleen / stomach, and these organs / meridians can also be involved in fibrocystic breast changes and the formation of damp, leading to phlegm nodules in the breast tissue. The following is what I refer to as a “skeleton” point prescription for practitioners to “flesh out” as needed to customize based upon the unique presentations of the patient. The acupuncure prescription focuses on the underlying liver qi stagnation and meridians which pass through / near the chest area.
LI 4 + Liv 3 + Ren 17 + GB 41 + Kid 23
LI 4 strongly regulates the flow of qi, especially in combination with Liv 3 (The Four Gates), which courses the liver qi and influences liver blood. Ren 17 is the front mu point of the pericardium and the meeting point of the Conception Vessel with the Spleen, Kidney, Small Intestine, and San Jiao Channels, and has the actions of regulating the qi, unbinding the chest, descending rebellious qi, and benefiting the breasts.
GB 41 is the shu stream and wood point of the Gallbladder Channel and has the actions of spreading the liver qi, benefiting the chest, lateral costal region and the breasts, and transforming phlegm and dissipating nodules. Kid 23 unbinds the chest, lowers rebellious qi, and benefits the breasts.
This formula can easily be modified with points that target the other unique patterns a respective patient may experience depending upon the tongue, pulse, symptoms, etc.
Phlegm
Long-term liver qi stagnation will frequently lead to blood stasis and consequent stasis of other body fluids. Over time, this leads to formation of dampness, and eventually phlegm and nodules throughout the body. In almost all cases of fibrocystic breast changes, qi stagnation, blood stasis, and damp / phlegm leading to nodules are apparent. The following are “skeleton” formulas I use in conjunction for such complicated issues underlying fibrocystic breast changes.
Back Treatment:
BL 17 + BL 18 + BL 20
BL 17 invigorates blood and dispels stasis, cools blood and stops bleeding, nourishes and harmonizes the blood, harmonizes the diaphragm / chest area, and descends the qi. BL 18, the back shu point of the liver, spreads the liver qi, regulates and nourishes liver blood, pacifies wind, cools fire and clears damp-heat, and benefits the eyes / sinews. BL 20, the back shu point of the spleen, tonifies spleen qi and yang, resolves dampness, and regulates the qi of the middle jiao.
The above point prescription can be administered to the patient first, followed by the following prescription:
LI 4 + Liv 3 + Sp 10 + St 40 + GB 41 + Ren 17
LI 4 and Liv 3 strong course the qi and invigorate blood. Sp 10 strongly invigorates the blood, dispels stasis and cools the blood. St 40, the luo connecting point of the Stomach Channel, transforms phlegm and dampness, benefits the chest, clears phlegm from the lungs and heart, calms the spirit, and stops pain. GB 41 strongly courses the qi and uniquely benefits the breasts; and Ren 17 acts in the same manner, coursing the qi and benefiting the breasts.
Clinical Pearls
These “skeleton” formulas for liver qi stagnation and phlegm, respectively, with complicating factors, can easily be integrated and modified by savvy clinicians as needed to uniquely fit the patterns of the patient. When treating fibrocystic breast changes, always keep in mind that the patterns of liver qi stagnation with phlegm complications may be present and weave in and out of other patterns.
