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