Breast Pain

Introduction

Breast pain (also called mastalgia or mastodynia) is the most common breast related complaints among women. The severity does vary by individual but about 10% is related to a breast cancer. However, although most women with breast pain do not have a cancer, all women who experience breast pain or other breast problem should notify their healthcare provider for evaluation. Most breast pain is either categorized as Cyclic Pain on Non-Cyclic Pain. If you are breastfeeding, most women will experience mild breast pain at first but usually subsides. Chronic breast pain while nursing should be reported to your healthcare provider.

Cyclic Pain

This type of pain appears to be a breast tissue response to female hormones estrogen and progesterone. After ovulation, breast tissue may swell since hormones are stimulating the breast milk glands and ducts. The pain is often relieved when the menstrual period is completed. Even though both breasts are usually sore, one may be more painful than the other. Ask your healthcare provider if dietary, supplement, or other medication recommendations may be helpful for you. Many women wear a well fitting supportive bra to reduce movement of the breast during the painful period.

Non-Cyclic Pain

This type of pain is less common but has no relation to the menstrual cycle. Many times pain is located in one breast and even one specific location of the breast. Sometimes the pain can be related to arthritic, musculoskeletal or other injuries that involve the breast area. Also an improper fitting bra, weight change, prescription and over the counter medications or herbal supplements may be triggering the onset of breast pain.

Your Action Plan

If you experience breast pain, notify your healthcare provider. It may be helpful to keep a calendar of your pain to share at the time of your appointment. They will evaluate your pain by taking a detailed history including onset, duration and intensity of pain and performing a clinical breast exam. Depending on your individual situation, additional breast imaging testing may be recommended. Most common testing involves mammogram with an ultrasound. Remember 90% of breast pain is unrelated to cancer but may be related to other non cancer breast problems. Reassurance that a cancer is not present may make the pain more tolerable.

Breast Changes

Many breast problems — such as a prominent breast lump, breast pain or infection — are usually benign/non-cancerous. All the same, if you have any of the breast changes listed on the front or back of this fact sheet, be sure to have your breasts checked by your health care provider.

Fibrocystic breast changes

Have you ever felt a bumpy texture or “lumpiness” in your breasts? This lumpiness, plus tenderness or pain at certain times of the month, is called fibrocystic [FI-bro-sis-tic] breast changes. These changes are a normal part of the menstrual cycle. You are most likely to notice them in the premenstrual phase of your cycle, or if you are past menopause, when taking hormones. Fibrocystic changes do not increase your chance of getting breast cancer. In contrast, a breast change that should be checked is one that does not change with your cycle. Any persistent lump or thickening should be checked by your health care provider.

Have you found a new breast lump?

Do not panic, but have it checked by a health care provider right away. Even if you have had cysts or fibroadenomas in the past, do not assume that a new lump will be the same. The lump may not turn out to be cancer, but it is best to make sure.

Warning signs you need to know

If you notice any of these things in your breast, see your health care provider:

• lump, hard knot or thickening
• unusual swelling, warmth, redness or darkening
• change in the size or shape
• dimpling or puckering of the skin
• an itchy, scaly sore or rash on the nipple
• pulling in of the nipple or other parts
• nipple discharge that starts suddenly
• pain in one spot that does not vary with your monthly cycle

Certain breast problems, such as infections, nipple discharge or itchy nipples usually are not cancer, but can look just like symptoms of some rare types of breast cancer.

On the other hand, a more uncommon form of breast cancer, inflammatory breast cancer, often appears with swelling and redness of the breast without a distinct lump. It is sometimes mistaken for an infection.

No matter what the diagnosis, if you feel that something is wrong, ask for a biopsy or get a second opinion. After all, no one knows your body better than you. For more details, call Susan G. Komen for the Cure at 1-877 GO KOMEN (1-877-465-6636) or visit www.komen.org.