Breast Center
Breast Pain Common and Concerning Causes
Breast pain is a common reason that women come to their doctor. Breast pain is usually not associated with breast cancer, but it is worth having a medical exam to see if the cause of the pain can be found.
Cyclic Pain
This pain occurs about a week before the onset of the menstrual period. There is an increase of fluid in the breast causing pressure and an inflammation. The pain increases as the period approaches and lessens as the period ends. Cyclic pain occurs in both breasts. It is felt in the upper, outer quadrant of the breast where most glandular tissue is found. The pain may radiate to the armpit or elbow and feels like a pulling or aching. It is common in premenopausal women and goes away after menopause.
Treatment of cyclic pain includes:
Life style changes Changes in diet decreasing caffeine and fat, and increasing fiber and seafood, have been shown to help some women. Quitting smoking A supportive bra, such as a sports bra, helps Therapeutic breast massage may relieve the fullness and pressure in the breasts Non-prescription and prescription drugs Over-the-counter supplements such as Evening Primrose Oil, Vitamin E, Vitamin B complex, and Beta Carotene have been shown to help some women because of their anti-inflammatory effects.
It may take a few months before relief is noticed. If these methods do not relieve the pain, a prescription drug may be ordered such as a non-steroidal anti-inflammatory drug, low dose oral contraceptives, or hormones such as progesterone or testosterone. Thyroid tests may reveal an underactive thyroid and thyroid hormone replacement may help. Finally, an estrogen hormone blocking drug called tamoxifen may be ordered. Every woman responds differently, so it may take a while to find the right therapy.
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Breast Center
Non-Cyclic Pain
Non-Cyclic pain is pain that is continuous. The pain is in one breast and often the woman can point to where it hurts. It is described as sharp or burning. There are many causes. A breast infection or a cyst may cause pain. Duct ectasia, an enlargement of the ducts filled with debris and dead cells, produces an inflammatory reaction or becomes infected. An injury to the breast causing a collection of blood in the breast tissue, a hematoma, can cause a lump that hurts. An inflammation of a breast vein, Mondor’s syndrome, causes pain. Shingles, a disease caused by the reactivation of Herpes Zoster virus, will produce breast pain if the breast is affected. Costochondritis is when the cartilage attaching the ribs to the breast bone gets inflamed. Sometimes a pinched nerve causes breast pain. Low thyroid hormone has also been associated with breast pain.
Cancer
Cancer is usually not painful, but pain in one breast may be a symptom. A clinical breast exam should be performed to look for other symptoms such as a lump, changes in skin texture or color, a change in the nipple, dimpling of the skin, or change in size of the breast. If the test is positive for a mutated gene that increases risk, there are preventive treatments. Close monitoring with mammogram and MRI, preventive medication, or preventive surgery to remove the breasts and/or ovaries can be done. Your doctor and genetic counselor will best be able to explain your options.
This handout is intended to provide general educational material to assist you in making informed decisions regarding your medical care. Specific questions about your unique medical conditions should be referred to your primary care physician.
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