Mastalgia, pain or discomfort in the breast, is a common cause for many females seeing their doctor. In the vast majority of individuals the cause is often benign, but in a few cases it might indicate a serious underlying pathology.
What is mastalgia?
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 may be constant or it may occur only occasionally. This pain might be cyclical, occurring at specific times, or non-cyclical with no pattern at all. Cyclical pain is the most common type of breast pain. Most times, breast pain signals a noncancerous (benign) breast condition and rarely indicates breast cancer. Still, unexplained breast pain that does not go away after one or two menstrual cycles, or that persists after menopause, needs to be evaluated by your doctor.
Cyclic breast pain
Is usually related to the menstrual cycle. It may be caused by the normal monthly changes in hormones. This pain usually occurs in both breasts. It is generally described as a heaviness or soreness that radiates to the armpit and arm. The pain is usually most severe before a menstrual period and is often relieved when a period ends. Cyclic breast pain occurs more often in younger women. Most cyclic pain goes away without treatment and usually disappears at menopause.
Noncyclic breast pain
This type of pain is unrelated to the menstrual cycle. It can be constant or intermittent and usually affects one breast, in a localized area, but may spread more diffusely across the breast. Noncyclic breast pain is most likely to affect women after menopause.
What are some causes of mastalgia?
In some cases, it is difficult to find the exact cause of breast pain. Contributing factors may include one or more of the following:
Reproductive hormones. Cyclic breast pain appears to have a strong link to hormones and the menstrual cycle. Cyclic breast pain often decreases or disappears with pregnancy or menopause.
Breast structure. Noncyclic breast pain often results from changes that occur in the milk ducts or milk glands. This can result in the development of breast cysts. Breast trauma, prior breast surgery or other factors localized to the breast, can lead to breast pain. Breast pain may also start outside the breast — in the chest wall, muscles, joints or heart, for example — and radiate to the breast.
Fatty acid imbalance. An imbalance of fatty acids within the cells may affect the sensitivity of breast tissue to circulating hormones.
Various medication. Certain hormonal medications, including some infertility treatments and oral birth control pills, may be associated with breast pain. Breast pain may be associated with certain antidepressants.
Breast size. Women with large breasts may have noncyclic breast pain related to the size of their breasts. Neck, shoulder and back pain may accompany breast pain due to large breasts.
Breast surgery. Breast pain associated with breast surgery and scar formation can sometimes linger after incisions have healed.
Pregnancy. Sore, tender breasts are sometimes an early sign of pregnancy.
Diagnosis
It is a good idea to see your doctor for advice if:
• the breast pain is particularly severe and stops you from doing your normal activities
• the pain gets worse or does not go away
• you have symptoms of an infection, such as swelling, redness or warmth in your breast, or a fever
• you have symptoms of breast cancer
Your doctor will examine your breasts and ask about your symptoms to try to determine what is causing your pain.
If doctors are not sure about the cause, they might arrange for various tests such as an X-ray or ultrasound scan. Once the diagnosis is made treatment can be arranged.
Treatment
For many women, breast pain resolves on its own over time. You may not need any treatment. If the pain is severe your doctor will discuss with you several treatment options some of which might just involve slight adjustments to medications, while others might mean the use of various medications. Vitamins and dietary supplements may lessen breast pain symptoms and severity for some women. Ask your doctor if one of these might help you — and ask about doses and any possible side effects.
Some women feel they have less breast pain when they decrease the amount of caffeine they consume.
You may be able to prevent breast pain, tenderness, or discomfort by wearing a sports bra during exercise. It is important that the sports bra fit properly.
Conclusion
Breast pain (mastalgia) is a common complaint among women. The term is used to describe breast tenderness, sharp burning pain or tightness in your breast tissue. The pain may be constant or it may occur only occasionally. In most women, the pain in the breast has no serious underlying problem and is not usually associated with breast cancer in the absence of other breast findings. If the pain is severe and does not go away after a few months, you should see your doctor for an evaluation.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
