Breast Pain

Pain in the breast or mammary gland, which is medically termed as mastalgia or mastodynia is a common problem faced usually by young women, though it affects women of all ages. Because of increased awareness about breast cancer, women with mastalgia get panicked easily that pain in the breast may be due to breast cancer, and seek medical advice. Less than 10% of women with breast cancer have pain. It is estimated that about 2/3rd of women experience some sort of pain in their breast at various stages of their life, which range from mild to extreme pain.

However, it is very important that all breast pain should be checked with doctor to find out the exact cause of the pain. You may experience pain either in one or in both the breasts. Mastalgia may come and go or it may persist for several weeks or months.

There are many possible causes of mastalgia. It may be related to many factors such as

  • Pregnancy and menstruation
  • Hormonal changes during menstruation
  • Menopause
  • Pregnancy may cause breast tenderness to some extent
  • Breast pain may occur in teenagers undergoing puberty
  • Breast feeding may also cause pain in the breast

Pain, swelling and tenderness few days before periods is usually normal but abnormal pain for no reason that persists for many weeks or months is for sure a reason to worry.

Other causes of breast pain are:

  • Infection or injury to breast tissues
  • Fibrocystic breast changes (painful and lumpy breast just before your periods)
  • Shingles caused by chicken pox virus (painful, blistering skin rashes on one of your breast, months or years after you were affected with chicken pox)
  • Breast cancer can also cause breast pain (rare cases)

There are two types of breast pain in women- cyclic and non cyclic.

Cyclic mastalgia: About 40% of women experience a cyclic mastalgia a week or few days before having periods. It is related to menstrual cycle. During a cyclic mastalgia, you may experience a burning, stabbing, pricking pain in one or both the breasts. This may also cause pain in the arm pits, arms, and shoulders. During menstrual cycle change in the hormone level increases the sensitivity of breast tissues. There is a fluid retention in the breast before your periods, as the breasts are prepared for changes during pregnancy. This fluid retention results in swollen, enlarged, and painful breasts that resolve during menstruation. Still no particular hormone has been identified as a contributor to cyclic mastalgia.

Non-cyclic breast pain is common in older women. Non-cyclic breast pain may be in turn divided into two types. First, the pain that actually originates in the breast but is completely not related to menstrual cycle. This is common in older women before and after menopause. The sharp and stabbing pain is confined to a single spot. If you experience sudden, continuous pain it is better to consult your doctor. The second type of non-cyclic mastalgia actually originates elsewhere but the pain is felt in the breast. Pain usually originates in the bones, joints, and muscles called as musculoskeletal pain. Pain in chest wall and spine may also result in non-cyclic mastalgia

During your visit to the doctor, he may ask about your previous medical history and family history. The doctor will tell you to describe your pain and the area where you exactly feel it.

Visual and manual examination of your breast will be done to check for any lumps, skin rashes or any other abnormality. Lymph nodes located in your underarms and lower neck will also be examined. Your doctor will listen to your heart and lung; check your chest wall and abdomen to be sure that the pain is originated from your breast and not from any other source.

If you are less than 35 years of age and your physical examination and medical history doesn’t show any abnormal results than no more additional tests are needed. But if you are above 35 years, and your physical examination is normal, your doctor may still want you to get a mammogram done.

If any lump or unusual thickening of the breast tissue is detected your doctor may ask you to do a mammogram. This is an X-ray examination of your breast tissue. An ultrasound may be needed. If lumps are detected on your breast, then your doctor might suggest for a breast biopsy, where a small piece of your breast tissue will be taken and examined under the microscope.

There are many treatment options for reducing breast pain. Depending on what exactly is causing the pain your doctor may decide on one of the treatment options.

  • Wearing a comfortable underwear and clothing that fits you properly may reduce pain in some women
  • A non-steroid anti-inflammatory medicines for non-cyclic breast pain
  • An oral contraceptive can help, if you are already taking contraceptive then your doctor may change the dose accordingly
  • Adjust the dosage of your hormone replacement therapy, either by reducing it or by completely stopping it, which your doctor will decide
  • The only approved medicine for treating breast pain and breast tenderness is Danazol, but it has many androgenic (male characteristic) side-effects like acne, weight-gain, change in voice, thereby limiting its use. Another drug Tamoxifen used for treating breast cancer is prescribed for some women but it also has many potential side-effects that are even more troublesome than breast pain
  • Change your diet as being over-weight produces excess amount of estrogen hormone causing breast pain
  • Cyclic mastalgia: Some say reducing salt consumption may help, but many times this doesn’t help as cyclic mastalgia is associated with hormonal change and not fluid retention.
  • Exercise regularly as physical activity produces endorphin, a natural pain-killer produced in our body

Though there are minimum researches supporting these home remedies, they may help few women to manage their breast pain. Some tips are really worth trying

  • Try hot and cold compresses on your breast
  • Wear proper fitting clothing and inner-wear
  • If anxiety is the cause of pain the try some relaxation therapy at home
  • Make changes in your diet and try to shed few kilos
  • Try a pain reliever
  • Limit consumption of caffeine

Mastalgia is caused by various factors; it can be cyclic or non-cyclic. Generally a cyclic mastalgia is more effectively treated than non-cyclic mastalgia. Many patients worry more about breast cancer than the actual pain caused by mastalgia. Remember that breast cancer is very rarely related with breast pain. But however, it is very important that breast pain needs to be checked to make sure and rule out the presence of cancer. Any pain that lasts longer is difficult to deal with therefore consult your doctor and learn ways to manage your pain in addition to doctor’s plan.