Breast Pain – “Mastalgia”

Breast pain can affect many women at some time in their lives. It is very common indeed and only in very rare cases is it associated with breast cancer.

Symptoms of Breast Pain

Breast pain varies in its intensity ranging from mild to severe and can affect women of any age. It generally presents as

  • soreness,
  • sharp burning pain or
  • a feeling of tightness in the breast tissues.

Types of Breast Pain

The two most common types of Breast Pain are:

  • Cyclical Mastalgia, and
  • Non-Cyclical Mastalgia.

Cyclical Pain

Cyclical Pain is the typical breast discomfort which occurs prior to menstruation on a monthly basis and is relieved when the period begins.

Non-Cyclical Pain

Breast pain that does not vary with the menstrual cycle is called non-cyclical. The pain can come and go or may be continuous.

Sometimes the pain may be felt in the breast but does not always come from the breast tissue. It may commonly arise from the large muscles of the chest wall, and only ‘appear’ to arise from the breast. This is termed a ‘myofascial pain’.

Causes of Breast Pain

Causes of breast pain not related to the breast include musculoskeletal pain and the exact cause of breast pain is not known, however certain factors that may be involved in mastalgia include:

  • Pain after an injury or physical activity
  • Hormonal changes that occur during the menstrual cycle
  • Cysts
  • Hormonal medications
  • Breast size: A large breast size is more prone to non-cyclic breast pain

Breast Pain Assessment

Keep a Pain Chart

Mapping the pattern of pain will determine whether the breast pain is related to your cycle and on which days relief from the symptoms may be required.

Breast Pain Diagnosis

The diagnosis of mastalgia includes

  • clinical breast examination and
  • use of imaging techniques such as mammogram or ultrasound
  • biopsy or samples of any breast lumps can be taken and sent to pathology in some cases,

Breast Pain Treatments

Wear a Well-Fitting Bra

Breast pain may be helped by wearing a well-fitting, supportive bra particularly if you are sensitive to movement or your breasts feel heavy.

Over the Counter Medications

  • Application of a topical non-steroidal gel can definitely help, and there is some evidence supporting this.
  • Many women feel that Evening Primrose Oil capsules help, but there isn’t really any proper evidence that this definitely helps.

Pain Medication

Simple pain medication such as paracetamol, ibuprofen or anti-inflammatory tablets may help to make musculoskeletal or other non-cyclical breast pain less severe.

Oral Contraceptive Pill

Some women with breast pain related to their cycle find that their symptoms improve on a low dose oral contraceptive pill. Other women find that the contraceptive pill makes their symptoms worse.

Other Medication

When breast pain is so severe that it interferes with lifestyle, hormonal medications such as danazol, bromocriptine and tamoxifen are available. However,  these may have significant and severe side effects and their use needs to be strictly monitored. Their use is generally not recommended.

  • Breast Surgeons of Australia and NewZealand
  • The University of Sydney
  • Royal North Shore Hospital
  •  Australian Society Of Breast Disease
  • Mater Hospital A facility of ST Vincent's Health Australia
  • Fellow of the Royal Australasian College of Surgeons
Breast & Surgical Oncology At The Poche Centre

40 Rocklands Rd,
North Sydney, NSW 2060

  • Tel:
  • Fax: (02) 9954 9938
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