Description

Breast pain (mastalgia) can be described as tenderness, throbbing, sharp, stabbing, burning, and pain or tightness in your breast tissue. The pain may be constant or it may occur only once in a while, and can occur in men, women, and transgender people.

Breast pain can vary from mild to severe. You may submit:

  • Only a couple of days of a month, in two or three days prior to menstruation. This is normal, mild-to-moderate pain affects both breasts.
  • A week or longer each month, starting before your period and sometimes continuing with the menstrual cycle. The pain may be mild or severe, and affects both breasts.
  • Throughout the month, not related to the menstrual cycle.

In men, breast pain is most commonly caused by a condition called "gynecomastia" (guy-nuh-koh-MAS-tee-uh). This refers to an increase in the number of mammary gland tissue that is caused by an imbalance of the hormones estrogen and testosterone. Gynecomastia can affect one or both breasts, sometimes unevenly.

In transgender women, hormone therapy can cause pain in the breast. In transgender men, pain in the breast can be caused by the minimal amount of breast tissue that may remain after a mastectomy.

Most of the times, the pain in the breasts of the signs of a non-cancerous (benign) breast condition and rarely indicates that the breast cancer. Unexplained chest pain that does not go away after one or two menstrual cycles, or that persists after menopause, or pain in the breast that does not seem to be related to the hormonal changes that should be evaluated.

Symptoms

Breast pain can be cyclical or non-cyclical. Cyclic means that the pain occurs in a regular pattern. Non-cyclic means that the pain is constant, or that there is a regular pattern. Each type of breast pain has different characteristics.

  • Clearly related to the menstrual cycle and the changes in hormone levels
  • Described as dull, heavy, or pain
  • Often accompanied by swelling of the breast, swelling or bulge
  • Usually affects both breasts, in particular the upper part, in the outer portions, and may radiate to the axilla
  • Intensifies during the two weeks prior to the start of the menstrual period, then relieved after
  • More likely to affect people in their 20s and 30s, as well as people in their 40 years of age who are in transition to menopause
  • Not related to the menstrual cycle
  • It is described as tight, burning, stabbing pain or a feeling of
  • Constant or intermittent
  • It usually affects one breast, in a localized area, but can spread more diffusely across the breast
  • In women, it is most likely to occur after the menopause

Extramammary breast pain

The term "extramammary" means "outside of the breast." Extramammary breast pain feels like it starts in the breast tissue, but its origin is in reality outside of the area of the breast. Pull a muscle in your chest, for example, can cause pain in the chest wall or rib cage that spreads (radiates) to the breast. The arthritis which involves the cartilage in the chest, also known as costochondritis, also can cause pain.

When to see a doctor

Make an appointment with your doctor if the pain of the breasts:

  • Follow on a daily basis for more than a couple of weeks
  • Occurs in a specific area of your breast
  • It seems to be getting worse with time
  • Interferes with daily activities
  • Wake up from your dream

Risk of breast cancer is very low in people whose main symptom is pain in the breast, but if your doctor recommends an evaluation, it is important to follow-up.

Causes

Changing hormone levels can cause changes in the milk ducts or the milk glands. These changes in the ducts and glands can cause breast cysts, which can be painful and are a common cause of cyclic breast pain. Non-cyclical breast pain can be caused by a trauma, prior surgery of the breast, or other factors.

Sometimes it is not possible to identify the exact cause of breast pain, but some factors can increase the risk.

Risk factors

Breast pain is more common among people who have not yet completed menopause, although it may occur after the menopause. Breast pain can also occur in men who have gynecomastia, and transgender people who are suffering from gender reassignment.

Other factors that may increase the risk of breast pain include:

  • The size of the breasts. People who have large breasts can experience non-cyclical breast pain related to the size of your breasts. Neck, shoulder and back pain may accompany the breast pain caused by large breasts.
  • The breast surgery. The pain associated with breast surgery breast and the formation of the scar can sometimes persist after the incisions have healed.
  • Fatty acid imbalance. An imbalance of fatty acids within the cells may affect the sensitivity of breast tissue to circulating hormones.
  • The use of drugs. Certain hormonal medications, including some of the infertility treatments and oral contraceptive pills, may be associated with pain in the breasts. Breast tenderness is a possible side effect of estrogen and progesterone, the hormone therapies used after menopause. Breast pain may be associated with certain antidepressants, including selective inhibitors of serotonin reuptake inhibitors (SSRIS), antidepressants. Other medications that can cause pain in the breasts, which include those used to treat high blood pressure and some antibiotics.
  • Excessive use of caffeine. Although more research is needed, some people notice an improvement in chest pain to reduce or eliminate caffeine.

Prevention

The following steps can help prevent the causes of breast pain, although more research is needed to determine its effectiveness.

  • Avoid hormone therapy , if possible.
  • Avoid medications that are known to cause breast pain or make it worse.
  • Wear a well-fitted bra, and wear a sports bra during exercise.
  • Try relaxation therapy, which can help control high levels of anxiety associated with severe pain in the breasts.
  • Limit or eliminate caffeine, a change of diet, some people find it useful, even though studies of caffeine's effect on the chest pain and other premenstrual symptoms have been inconclusive.
  • Avoid excessive or prolonged lifting activities .
  • Follow a low-fat diet , and eating more complex carbohydrates.
  • Consider the use of over-the-counter pain relievers, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others)— but ask your doctor how much to take, since the long-term use can increase your risk for liver problems and other side effects.

Diagnosis

Tests to evaluate your condition may include:

  • Clinical examination of the breast. Your doctor checks to see if there are changes in your breasts, examination of the breasts and lymph nodes in the lower part of the neck and the armpit. Your doctor will likely listen to your heart and lungs and check your chest and abdomen to determine if the pain can be linked to another disorder. If your medical history, and the breast and the physical examination will reveal nothing unusual, you may not need additional tests.
  • Mammogram. If your doctor feels a lump or thickening in or unusual, or detects a specific area of pain in the breast tissue, you will need an X-ray examination of the breast that evaluates the area of concern found during the breast examination (diagnostic mammogram).
  • Ultrasound. An ultrasound test uses sound waves to produce images of your breasts, and is often done in conjunction with a mammogram. You may need an ultrasound to evaluate a specific area of pain, even if the mammogram is normal.
  • Breast biopsy. Suspicious breast lumps, areas of thickening or unusual areas seen during imaging exams may require a biopsy before your doctor can make a diagnosis. During a biopsy, the doctor obtains a sample of tissue from the breast of the area in question and sends for laboratory analysis.

Treatment

For many people, chest pain resolves by itself over time. You may not need any treatment.

If you need help managing your pain, or if you need treatment, your doctor may recommend that you:

  • To delete an underlying cause or aggravating factor. This may involve a simple setting, such as the use of a bra with extra support.
  • The use of a topical nonsteroidal anti-inflammatory drugs (NSAID) of the medicine. You may need to use Nsaids when the pain is intense. Your doctor may recommend that you apply an NSAID cream directly on the area where you feel pain.
  • Adjust the birth control pills. If you take birth control pills, skipping the pill-free week, or the change of birth control methods may help breast pain symptoms. But don't try this without your doctor's advice.
  • Reduce the dose of hormone therapy for the menopause. You might consider the possibility of reducing the dose of the hormone therapy of the menopause, or stop it completely.
  • Taking a prescription drug. Danazol is the only prescription medication approved by the Food and Drug Administration for the treatment of fibrocystic breasts. However, danazol, carries the risk of possible serious side effects, such as heart disease and liver problems, as well as weight gain and changes in the voice. Tamoxifen, a medication prescribed for the treatment of breast cancer and prevention, can help, but this drug also has the potential for side effects that can be more annoying than the pain of the breast itself.

Alternative medicine

Vitamins and dietary supplements can reduce pain in the breasts of the symptoms and the severity of some people. Ask your doctor if any of these can help you — and ask about the dose and the possible side effects:

  • Evening primrose oil. This supplement can change the balance of fatty acids in cells, which can reduce the pain in the breasts.
  • The vitamin E. the First studies showed a possible beneficial effect of vitamin E in breast pain in premenstrual women who experience breast pain that fluctuates during the menstrual cycle. In one study, 200 international units (IU) of vitamin E twice a day for two months to improve symptoms in women with cyclic breast pain. There was no additional benefit after four months. For adults over the age of 18 years, pregnant and breastfeeding women, the maximum dose of vitamin E is 1,000 milligrams per day (or 1,500 IU).

The vitamin E. the First studies showed a possible beneficial effect of vitamin E in breast pain in premenstrual women who experience breast pain that fluctuates during the menstrual cycle. In one study, 200 international units (IU) of vitamin E twice a day for two months to improve symptoms in women with cyclic breast pain. There was no additional benefit after four months.

For adults over the age of 18 years, pregnant and breastfeeding women, the maximum dose of vitamin E is 1,000 milligrams per day (or 1,500 IU).

If you try a supplement for breast pain, stop taking if you do not notice any improvement in your chest the pain after a couple of months. Try to have only one supplement at a time, so that you can clearly determine which one helps to relieve the pain or not.

Preparing for your appointment

If you have breast pain that is new, that persistently affects only a particular part of your breast, or that it affects their quality of life, see your doctor for an evaluation. In some cases, when you call to schedule an appointment, you may be referred immediately to a breast health specialist.

Preparing for an appointment

The initial evaluation of chest pain focuses on the clinical history. Your doctor will ask you about the location of your pain in the sinuses, your relationship with your menstrual cycle and other relevant aspects of your medical history that could explain the cause of your pain. To prepare for this discussion:

  • Keep a journal, writing down when you experience breast pain and other symptoms, to determine if the pain is cyclical or non-cyclical.
  • Take note of all your symptoms, even if they seem unrelated to your pain in the breasts.
  • Rate your pain on a scale of 1 to 10 , with 1 being no pain and 10 is the worst pain imaginable.
  • Review key personal information, including major stresses or recent life changes.
  • List of all the medicines, vitamins, and supplements that you take regularly.
  • List of questions to ask your doctor, from most important to least important.

For breast pain, basic questions to ask your doctor include:

  • What is the most likely cause of my symptoms?
  • What kinds of tests might I need?
  • What treatment approach do you recommend for my condition?
  • There are home remedies that I could try?

What to expect from your doctor

Your doctor may ask you questions such as:

  • Where in your chest you feel pain?
  • How long have you had pain in your breasts?
  • On a scale of 10 points, how bad is your pain?
  • Do you have pain in one or both breasts?
  • Does the pain seem to occur in any kind of pattern?
  • Have you ever had a mammogram? When was the last?
  • Do you have any other signs or symptoms such as a lump in the breast, in the area of thickening or nipple discharge?
  • Have you noticed any change in the skin, such as redness or a rash?
  • Have you recently had a baby? Or has suffered a loss of a pregnancy or termination?
  • How does your pain impact on quality of life, for example, sleep, sexual activity, or the work? The pain that you are less able to perform their daily activities?
  • Have participated in any of the activities or had a recent injury to the chest that can contribute to breast pain?

Your doctor can also assess your personal risk of breast cancer, based on factors such as your age, health history of the family and of the previous history of pre-cancerous lesions of the breast.

Symptoms and treatment of Chest pain