Mastalgia is the medical term for pain in the breasts. Breast pain is very common, happening to roughly 70% of women at some point during their lifetime. Many women have breast pain every month with their menstrual cycles with a lot of women reporting breast pain more than five days per month. Breast pain is most common in younger women who are menstruating, though it can occur after menopause as well. Breast pain can have a major impact on a woman’s life, including her relationships at work and home. It is uncommon for breast pain to be the only symptom of breast cancer, but your doctor may want to do some additional testing for breast cancer to make sure that this is not the cause of your breast pain. Some factors that contribute to breast pain in women include hormones, abnormalities within the breast (cysts, cancer), abnormalities in structures near the breast (problems with the underlying muscle or nerve), not enough of certain types of fatty acids in the body, use of certain medications (oral contraceptives, other hormonal treatments, some anti-depressants), previous breast surgery, and larger breast size (often associated with neck and back pain).
Pain in the breast, tightness in the breast, burning in the breast, aching in the breast
Diagnosis of breast pain begins with a thorough history by your doctor. He or she will want to know when your breast pain comes on, how long it lasts, what its relation is to your menses, and if anything makes it better or worse. After taking this history, your doctor will want to do a physical exam focusing on the breast and chest wall to look for a source of your pain. At this point, your doctor may not think any additional testing is necessary. However, your doctor may want to do some additional imaging which can include a breast ultrasound (sonogram), mammogram, or breast magnetic resonance image (MRI). If you have a focal area of pain, your doctor may recommend removing a small sample of that tissue (taking a biopsy) to send to the pathologist to see if something more serious may be causing your pain in your breast.
Most often, breast pain either resolves with the menstrual cycle or lasts only a few months. However, if breast pain does not go away on its own, several treatment options are available. First, you will want to remove any factors that may be aggravating your breast pain. These factors include caffeine, high fat diet, poorly supportive bra, or a change in certain medications like birth control. Wearing a good, supportive bra always and a sports bra for extra support when sleeping and when exercising can help to cut down on pain. You can try to decrease the fat in your diet and applying hot or cold compresses to relieve pain. You may also try either topical non-steroidal anti-inflammatory medication applied to the breast directlyor pain medication taken by mouth like acetaminophen (Tylenol) or ibuprofen (many brand names) as needed for pain. Your doctor may recommend beginning an oral contraceptive (birth control) to help regulate hormone levels in the body and decrease pain. If you are on hormone replacement therapy, your doctor may decrease your dose or recommend stopping the medication altogether. Many experts recommend evening primrose oil or vitamin E to help restore the fatty acid balance in the body and help alleviate breast pain. Other medication options are available for severe breast pain including danazol, bromocriptine and tamoxifen. These options are generally tried when others have failed. You should discuss all of your treatment options with your doctor.
