If you have breast pain, you are not alone. Breast pain, known as mastalgia, accounts for 45-70% of breast-related health care visits. The good news is that most causes of breast pain are benign (non-cancerous) and usually related to hormonal changes in your body or something as simple as the wrong bra. Breast pain varies from person to person and can be a dull ache, tenderness, burning sensation, sharp pain, or just an uncomfortable feeling of fullness. In order to understand what causes breast pain and what to do about it, it is important to understand a little about the different types of breast pain.
Types of breast pain
There are two main types of breast pain. The first type is cyclical and changes with your body’s hormonal changes. Cyclic breast pain usually involves both breasts and may involve the entire or upper outer breast and may radiate to the armpit. The main thing is that it varies according to the menstrual cycle. Cyclical breast pain usually worsens in the week before your period starts. The pain usually lessens or improves after menstruation. With cyclical breast pain, it is common for your breasts to become enlarged in the week before your period. Cyclic breast pain is the most common form of breast pain and usually does not require any treatment or medical evaluation.
The second major type of breast pain is non-cyclical breast pain. Non-cyclical breast pain usually affects only one breast and is not related to your menstrual cycle. It can be constant or periodic, not related to any particular pattern. Determining the cause of non-cyclical breast pain is often difficult. As with cyclical breast pain, most causes of non-cyclical breast pain are benign. The most common reason is the wrong bra. Other causes include pregnancy, trauma, muscle strain, and previous surgery. Breast cancer is usually painless, but if it does cause pain, the pain is non-cyclical and usually single-focal. Because of this, non-cyclical breast pain requires a little more evaluation to determine the cause.
When should I talk to my doctor?
A lump in the painful area that does not go away after menstruation.
You have redness, swelling, and drainage (signs of infection).
You have discharge from your nipples.
Your breast pain is not clearly related to your menstrual cycle or lasts longer than two weeks.
Your breast pain is only in one spot and not all over the breast.
Your breast pain is getting worse.
Pain affects your life and limits what you can do.
Even if you don’t fall into these categories, it’s safe to talk to your doctor about your symptoms.
What will my doctor do?
Your doctor will likely ask questions about your breast pain. In: How long have you been there? Is the pain related to other changes in your lifestyle or body? Have you noticed a lump or other change in your breast? How bad is the pain? What does pain feel like? Does your family have breast cancer?
Your doctor will check your breasts for lumps, skin changes, focal tenderness, and nipple discharge. Depending on the exam and the answers to the questions, your doctor may order imaging tests.
What kind of imaging tests will my doctor order?
Your doctor may order a mammogram, which is an X-ray of the breast. The technologist will take at least two x-rays of your breasts as they compress your breasts. If you haven’t had a mammogram in over a year, they can take a painless x-ray of your breast. While you wait, a breast radiologist will look at your X-rays and determine if you need additional X-rays or a breast ultrasound.
If you are under 40, breastfeeding, or pregnant, your doctor may order a breast ultrasound instead of a mammogram. During a breast ultrasound, a technologist or breast radiologist will apply ultrasound gel to your breast and use a handheld ultrasound machine to scan the area for pain. A breast radiologist may decide to do a mammogram to evaluate the area of your pain.
Before you leave, the technologist or breast radiologist will discuss the results with you and send the report to your doctor.
What types of things can a radiologist see?
75-88% of women diagnosed with breast pain find mammograms and ultrasounds to be completely normal. In approximately 10% of women, the radiologist will find a benign cause of the pain. The most common benign cause of pain is a breast cyst. A breast cyst is a sac of fluid inside the breast that many women are unaware of. They can become painful when your body’s hormones change or increase in size. Women’s
y what it is. A breast biopsy is an outpatient procedure where a small piece of tissue is removed from your breast to be evaluated under a microscope. Very few women with breast pain have breast cancer and some studies show that your chance of having breast cancer is the same whether you have breast pain or not.
What can I do to get rid of the pain?
Wear a properly fitted bra without underwire.
Wear a sports bra while exercising.
Some changes in diet have been shown to reduce symptoms of breast pain, such as decreasing your intake of fatty foods and caffeine.
Some over-the-counter, herbal and prescription medications have been shown to help. Ask your doctor about these options and if any are right for you.
Some women find that ice packs or heating pads help their pain, and you can try these to see if one works for you.
Stress reducing and relaxation techniques may also help alleviate symptoms of breast pain.
The bottom line
Breast pain is common and usually not associated with anything bad. Cyclical breast pain comes and goes with your menstrual cycle and is related to hormonal changes in your body. Non-cyclical breast pain has a wide variety of causes and the cause is harder to determine but also usually related to benign processes in the breast. Talk to your doctor about your breast pain if you are worried, particularly, if you have a lump in the area of pain that does not go away after your period, redness, swelling, drainage from the area (signs of infection), nipple discharge , or if your breast pain is not clearly associated with your menstrual cycle, lasts more than two weeks, is just in one spot, keeps getting worse or is affecting your life and limiting what you can do.
Your doctor may order imaging tests to evaluate your breast pain. Although these are usually normal, they may help find a cause for the pain or identify something that needs to be biopsied. There are several treatments for breast pain, but there is not a single one that works for everyone, and you should talk to your doctor about anything that might be right for you.