Breast pain: causes, symptoms and treatments

Breast pain: causes, symptoms and treatments

Breast pain, also known as mastalgia, mammalgia and mastodynia, is common and may include a dull ache, heaviness, tightness, a burning sensation in the breast tissue, or breast tenderness. If the pain is linked to the menstrual cycle, it is known as cyclical mastalgia (cyclical breast pain).

According to the Breast Cancer Foundation, breast pain includes any pain, tenderness or discomfort in the breast or underarm region, and can occur for a number of different reasons. In most cases, the Foundation adds, breast pain is not a sign of breast cancer. The National Health Service, UK, says that cyclical breast pain is not linked to a higher risk of developing breast cancer.

In most cases, breast pain affects the upper, outer area of both breasts - the pain can sometimes spread to the arms.

In the majority of cases, mastalgia starts between one and three days before a woman's period starts, and gets better by the end of her period. For some women, the pain starts many more days before the beginning of their periods.

Although older (postmenopausal) women can have breast pain, it is much more common in perimenopausal (around the menopause) and premenopausal females.

The California Pacific Medical Center estimates that between 50% and 70% of women have breast pain in the USA. Health Authorities in the UK say that up to 66% of women between 30 and 50 years of age experience breast pain.

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Here are some key points about breast pain. More detail and supporting information is in the main article.

  • Breast pain can be referred to as mastalgia, mammalgia or mastodynia.
  • In the majority of cases, breast pain is not a sign of breast cancer.
  • Breast pain commonly affects the upper, outer area of both breasts, though pain can spread to the arms.
  • Breast pain is most common in perimenopausal and premenopausal females.
  • Breast pain is normally defined as "cyclic" (cyclical) or "non-cyclic" (non-cyclical).
  • Clinical breast examination can determine whether there are any lumps, changes in nipple appearance, or nipple discharges.
  • Further tests can be requested if a lump or unusual thickening of tissue is detected, or a specific area of breast tissue is particularly painful.
  • Sometimes it may not be possible to determine precisely why breast pain occurs.
  • It is usually possible to solve cyclical breast pain by wearing well-fitted bras and taking simple painkillers.
  • Doctors may recommend a prescription drug if suggested therapies are unable to alleviate the symptoms.

Symptoms of breast pain

A symptom is felt by the patient and described to the doctor, nurse, friends or family. A sign can be seen or detected by other people. An example of a symptom is pain, while a sign could be a skin rash.

Breast pain is usually classified as "cyclic" (cyclical) or "non-cyclic" (non-cyclical).

Symptoms of cyclical breast pain

Breast pain, also known as mastalgia, mammalgia and mastodynia, is common and may include a dull ache, heaviness, tightness, a burning sensation in the breast tissue, or breast tenderness.

  • The pain comes cyclically, just like the menstrual cycle
  • The breasts may become tender
  • Patients describe the pain like a heavy, dull ache. Some women describe it as a soreness with heaviness, while others say it is like a stabbing or burning pain
  • The breasts may swell
  • The breasts may become lumpy (not with a single, hard lump)
  • Both breasts are typically affected, especially the upper, outer portions
  • The pain can spread to the underarm
  • Pain becomes more intense a few days before a period begins. In some cases, pain may start a couple of weeks before menstruation
  • It is more likely to affect younger women. Postmenopausal women may experience similar pains if they are on HRT (hormone replacement therapy).

Symptoms of non-cyclical breast pain

  • It affects just one breast, usually just within a quadrant of the breast, but may spread across the chest
  • It is common among post-menopausal women
  • The pain does not come and go in a menstrual cycle time-loop
  • The pain may be continuous or sporadic
  • Mastitis - if the pain is caused by infection within the breast, the woman may have a fever, feel ill (malaise), some breast swelling and tenderness and the painful area may feel warm. There may be redness. The pain is usually described as a burning sensation. For lactating mothers, the pain is more intense while breastfeeding
  • Extramammary pain - pain that feels as if the source is within the breast, but it is elsewhere. Sometimes called "referred pain." This may occur in some chest wall syndromes, such as costochondritis (inflammation where the rib and the cartilage meet).

You should see your doctor if:

  • One or both breasts change in size or shape
  • There is a discharge from either nipple
  • There is a rash around the nipple
  • There is dimpling on the skin of the breasts
  • You feel a lump or swelling in one of your armpits
  • You feel pain in your armpits or breast that is not related to your menstrual cycle
  • You notice a change in how your nipple looks
  • You notice an area of thickened tissue, or a lump in your breast.

On the next page we look at the diagnosis and the common causes of breast pain. On the final page we discuss the treatment options for breast pain, including prescription medications, and whether breast pain is a cause for concern.

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Section Issues On Medicine: Women health