Mastalgia is a common complain in women. Fortunately, most of the causes are benign but if the pain persists the woman should be evaluated by a doctor to rule out more serious disorders. The pain is often mild, but in some women it is more severe and can affect their quality of life.
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.
Types of breast pain
Most women (up to 7 in 10 women) develop breast pain at some stage in their life. In about 2 in 3 women the pain develops in the days just before a period – cyclical breast pain. In the remainder the pain is not related to periods – non-cyclical.
Cyclical mastalgia
Cyclical breast pain is very common. It can occur at any age after periods start, but most commonly occurs between the ages of 30 and 50. It does not occur in women past the menopause when the periods have stopped.
What are the symptoms of cyclical breast pain?
In many women the symptoms are mild. In some women the pain can be severe and/or last longer – up to 1-2 weeks before a period. The 3-5 days prior to a period are usually the worst. The pain usually eases soon after a period starts. The severity can vary from month to month. Typically, the pain affects both breasts. It is usually worse in the upper and outer part of the breast, and may travel down the arms.
What causes cyclical breast pain?
It is thought that women with cyclical breast pain have breast tissue which is more sensitive than usual to the normal hormone changes that occur each month. It is not due to any hormone disease, or to any problem in the breast itself.
Treatment of cyclical breast pain
Treatment will depend on the severity of the pain and the individual’s history. In mild cases no treatment might be needed following a complete evaluation by the doctor. There is a wide range of treatment options available for treating moderate to severe mastalgia. You and your doctor will decide on a treatment option.
Non-cyclical breast pain
This type of breast pain is not related to periods and is most common in women over 40. The pain may be in just one breast, and may be localised to one area in a breast. Sometimes the pain is felt all over one or both breasts.
Causes of non-cyclical breast pain
There are a number of causes of non-cyclical breast pain. They include the following:
• Pain coming from the breast tissue itself in the absence of any lumps, tumours, or other abnormality being detected.
• Pain coming or radiating from the chest wall under the breast rather than the breast itself. Muscular or bony problems of the chest wall account for some cases.
• Infection.
• previous surgery to the breast.
• a side effect from a drug treatment such as certain antidepressant drugs, and some herbal remedies such as ginseng.
• having larger breasts.
• Breast cancer is a very uncommon cause of breast pain.
Treatment of non-cyclical breast pain will depend on the cause of the breast pain and the severity of the breast pain. Non-cyclical breast pain often goes away by itself over time.
Chest wall pain
Chest wall pain may feel as though it is coming from the breast, but really it comes from somewhere else.
It can have a number of causes such as pulling a muscle in your chest.
Breast pain and breast cancer
Women with breast pain often worry that the pain is caused by breast cancer. In most cases, the first symptom of breast cancer is usually a painless lump. If there is a cancer associated with pain it is likely that another symptom, such as a breast lump, breast enlargement, distortion of the skin or redness of the skin, will also be noticed. These changes should be easily spotted on assessment by a doctor or by a mammogram.
When to see a doctor
Many women experience breast pain, but if the symptom is interfering with your life you should seek advice.
Make an appointment with your doctor if your breast pain:
• Continues daily for more than a couple of weeks
• Occurs in one specific area of your breast
• Seems to be getting worse over time
• Interferes with daily activities
Although breast cancer risk is low in women whose main symptom is breast pain, if your doctor recommends an evaluation, it is important to follow his or her advice.
Conclusion
Breast pain is very common in women of all ages. Having painful, sore or tender breasts can cause a lot of anxiety. Breast pain on its own is not a usual sign of breast cancer. Many women experience breast pain as part of their normal menstrual cycle. Pain in the breast that’s not related to periods is known as non-cyclical breast pain. This is usually goes away on its own. If you have concerns about breast pain make an appointment to see your doctor for a complete evaluation.
Ask Your Dr 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 with over thirty-six years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5928).
