Breast Pain : Causes, Diagnosis, Treatment and Symptoms

Breast pain or mastalgia is rarely a sign of breast cancer, but it’s important to consult your specialists in the case of experiencing unexplained pain accompanied by fever and changes in the breast. Breast pain is often associated with puberty or pregnancy, but can also arise due to injuries or infections (mastitis). Most commonly related symptoms of breast pain may depend on the causes, including discomfort or aching in the breast, usually identified as a dull ache. It is typically categorised into two categories, namely cyclic and non-cyclic breast pain.

Here are some of the most common breast pain symptoms:

• Tightness – feeling full or tight in the breast tissues.
• Tenderness in the breast or around the chest area, making it sensitive to touch.
• Sharp or burning pain – a stabbing sensation that can come and go.
• Aching, throbbing, or heaviness in the left side breast pain or both breasts.
• Radiating pain to the underarm area.

Causes of Breast Pain

There are several reasons for breast pain, including hormonal changes, non-hormonal changes, medications, and structural and referred pain. If the patient has been experiencing pain for the past few days, they are advised to consult a specialist.

Here are a few breast pain causes:

• Puberty
• Improper bra fitting.
• Breastfeeding
• Menstruation – Where the estrogen and progesterone levels fluctuate before periods, causing premenstrual breast pain and/or breast pain during the period.
• Breast pain during pregnancy – Early pregnancy may lead to sore breasts due to hormonal changes.
• Menopause – Hormone replacement therapy may lead to tenderness.
• Fibrocystic breast changes – Benign, fluid-filled lumps present in the breast.
• Costochondritis – Where the cartilage in the rib cage gets inflamed and presents as breast pain.
• Hormonal medications – Birth control pills and estrogen replacement therapy.
• Certain medications – Diuretics or blood pressure medications
• Engorgement – Swollen breasts filled with milk right after delivering a baby.
• Huge breast size (Macromastia) – Leads to the straining of the neck and back muscles, often causing breast pain.

When to Seek a Specialist for Your Breast Pain?

As most breast pains are benign and not serious, seek a specialist’s help if the pain persists and the discomfort doesn’t subside with the medication or other treatments.

Don’t wait for signs to grow severe. Consult our Gynecology Specialists today.

Visit your specialists in the cases of:

• Persistent lump for a longer period of time with unexplained pain.
• Constant non-cyclic pain that lasts for a few weeks.
• Pain accompanied by fever, redness of the skin, and swelling.
• Changes in the appearance of the nipple and the skin surrounding the nippular area.
• Constant fluid discharge from the nipple.

Diagnostic Approach for Breast Pain

The diagnostic approach depends on several key considerations, including age, type of breast pain, and extramammary pain, while younger patients benefit from an ultrasound from the get-go, and older patients undergo the mammogram test. The specialists take a thorough medical history, a clinical breast exam to assess lumps, followed by various imaging tests to determine concerning findings.

Here’s the Specialist-Approved Diagnostic Approach:

• Medical history: The specialist will ask about the duration, locations, and type of pain you have been experiencing, and confirm whether the pain is related to your menstrual pain or not (non-cyclic).
• Clinical breast exam: The specialist will examine the breast, neck, and underarm for lumps or any unusual thickening, and also check for nipple discharge, skin changes or inflammation.
• A mammogram is recommended for women over 40 years old.
• In case imaging doesn’t work, a biopsy is taken to confirm whether the lump or cyst is cancerous or benign.
• Breast MRIs are suggested to deeply categorize their lesions.
• Hormonal assessment for premenopausal women.

Types of Breast Pain

Typically, there are three types of breast pain categorized based on common hormonal changes and deep, intricate issues that may require medical or surgical intervention.

Here are the three types of breast pain:

• Cyclical Breast Pain: typically present in the premenstrual phase of the menstrual cycle and arises from the fluctuation in the hormones, and changes in progesterone and estrogen.
• Non-Cyclical Breast Pain: Shows an irregular pattern that arises from muscle strain, breast cyst, or physical stress and does not involve the menstrual cycle.
• Extramammary Breast Pain: when the pain is located in the breast area but does not originate from the breast tissues and may arise due to the injury or trauma to the chest wall or breast area, a pulled muscle, or inflammation.

Treatment for Breast Pain

Breast pain relief may vary depending on the cause and type of pain, which usually involves hormonal therapy, lifestyle adjustments, and prescription or OTC medication by specialists.

Here are several common breast pain treatment approaches:

• Over-the-counter medicines to reduce pain and inflammation.
• Making adjustments to the birth control pills and hormonal replacement therapy.
• Deep breathing and meditation to manage stress.
• Impose dietary changes, such as reducing salt and caffeine consumption.
• Refrain from a diet high in saturated fats and alcohol 
• Wearing an athletic bra provides support and reduces pain.
• The doctor may prescribe a topical non-steroidal anti-inflammatory drug (NSAID) cream.
• Wearing warm or cold compresses based on the type of pain.
• Surgical excision of the pain-causing cysts or lumps.
• There may be an immediate effect against cyclic breast pain with evening primrose oil (EPO) supplements or vitamin E.

What if Breast Pain is Left Untreated?

Untreated breast pain could lead to potential complications, where the severity and type of complication depend on the cause of the pain. You must visit a doctor if the pain is persistent and worsens if you lump, skin changes like dimpling, or nipple changes like fluid discharge.

Here are the potential complications of untreated breast pain:

• Breast abscess – breast infection (mastitis), causing accumulation of pus or abscess.
• Scar tissue formation in the breast due to severe and repeated infections alters its appearance.
• Worsening conditions that become severe and metastasise.
• Delay in the diagnosis of a serious condition.

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