Breast pain (mastalgia)
Many women have breast pain (mastalgia) at some time. Breast pain is usually associated with a benign breast condition; it is rarely a sign of breast cancer. However, breast pain should be checked by a doctor, especially if a woman has new pain or pain that doesn’t go away.
There are 2 types of breast pain:
- cyclical breast pain
- experienced around the time of a woman’s menstrual period, with the pain easing after the period ends
- usually occurs in both breasts
- more common in younger women and often disappears after menopause
- non-cyclical breast pain
- more common in women between 30 and 50 years of age
- may occur in or around only one breast
Pain occurring in the muscles and other tissues under the breast (chest wall) can be mistaken for breast pain. A burning or stabbing pain in one area may be chest wall pain.
The cause of breast pain is not well understood. Since cyclical breast pain occurs around a woman’s menstrual cycle, it may be related to the changes of hormones during the menstrual cycle.
Women taking oral contraceptives (birth control pills) or women taking hormone replacement therapy (HRT)hormone replacement therapy (HRT)Treatment that replaces female sex hormones ( estrogen, progesterone or both) when they are no longer produced by the ovaries. after menopause often have breast pain.
Other causes of breast pain may include:
- breast cysts
- fibrocystic breast changes
- breast infection (mastitis)
- an abscess (collection of pus) in the breast
- fat necrosis (a lump of dead fat cells that can occur after an injury)
- mammary duct ectasia (widened milk ducts)
Signs and symptoms
Pain may be felt in one or both breasts, or just in part of one breast. Pain may also be felt in the armpit or upper arm.
Breast pain may be described as:
- sharp, stabbing or shooting pain
- feeling of heaviness or fullness in the breast
If the signs and symptoms of breast pain are present, or if the doctor suspects an underlying cause of breast pain, tests will be done to make a diagnosis. Tests may include:
- clinical breast exam (CBE) (CBE)
- medical history, including questions about
- type, location and severity of the pain
- timing of the pain in relation to the menstrual cycle
- factors that increase or decrease the pain
- recent injury to the chest or excessive exercise
- documenting the pain on a daily breast pain chart
- used to look for a cyst
Breast pain may go away on its own, especially if it is related to menstrual periods. Treatment options for breast pain depend on its cause.
Treatment for breast cysts or lumps may include:
- fine needle aspiration – to relieve pain from a breast cyst
- surgery – sometimes done to remove a lump
Supportive therapy treats the symptoms of breast pain, but it does not treat the underlying cause of the breast pain. Supportive care options for breast pain may include:
- wearing a fitted, supportive bra
- over-the-counter pain medicines
- ibuprofen (Advil, Motrin)
- acetaminophen (Tylenol)
- diclofenac cream (Voltaren)
- adding flaxseed to the diet
- One small study suggested that eating 25 g daily may help with breast pain.
If supportive care measures do not relieve the pain, or if the pain is severe, other treatment options may be offered.
- oral contraceptives (birth control pills)
- Oral contraceptives may reduce pain for some women.
- For other women, oral contraceptives may increase pain.
- The pain may go away with time, or the doctor may prescribe a pill with a lower dose of estrogen and progesterone.
- drug treatment – rarely offered for breast pain due to concerns about side effects
- danazol (Danocrine, Cyclomen) – decreases the production of estrogen
- tamoxifen (Nolvadex, Tamofen) – blocks the effects of estrogen
While research has not shown that the following treatments are effective, some women may chose to:
- make changes to their diet
- avoid caffeine and other stimulants (coffee, chocolate, tea, soft drinks)
- reduce salt
- limit saturated fats
- use evening primrose oil or vitamin E