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Breast Pain is either Non-Cyclic or Cyclic and can be a Symptom of Benign or Malignant Disease

Breast Pain

Breast pain is a common reason women will visit their health care provider. If you seek out an evaluation, your physician will be interested in exploring the following:

• Frequency of pain.

• Exact location of pain and severity.

• Whether the pain is associated with any hormone replacement or contraceptive use.

• Whether a concurrent physical problem such as neck strain exists.

• Whether systemic symptoms including fever exist.

• How the pain affects the patient's daily activities.

Most women complaining of breast pain will undergo a physical examination. During this exam your physician will be looking for signs of malignancy that may include skin changes, discharge or a lump in the breast. During this exam your physician will also be able to determine whether enlargement or swelling has occurred in the lymph nodes near the breast.

Overview of Breast Pain
Breast pain varies in nature from woman to woman. Some women may experience cyclical breast pain whereas others experience non-cyclical pain.

Cyclic Breast Pain
Cyclic breast pain comes and goes with your monthly periods, and can be described as follows:

• Is the most common form of breast pain.

• Associated with monthly hormonal fluctuation.

• Described as a fullness or heaviness.

• Most severe before menstrual flow.

• Relieved with the end of menstrual flow.

• Most common in younger women.

• Goes away without treatment.

Non-Cyclical Breast Pain
Non-cyclical breast pain is not associated with your monthly periods, and generally fits the following description:

• Common in women of ages 40 to 50.

• Occurs in one breast or the other.

• Sharp, constant discomfort in one area of the breast.

• Treatment of the cause of the pain required to relieve the pain.

Non-cyclical breast pain may be caused by physical trauma or injury. The chest wall can be affected via continuous movements or strenuous exercise, resulting in breast pain.

Occasionally, non-cyclic pain may be caused by breast lumps, such as a fibroadenoma or a cyst. A fibroadenoma is a hard noncancerous nodule that is round and may be found at your self breast exam. Breast cysts are fluid-filled sacs that are usually found in one breast or the other.

The Most Common Causes of Breast Pain that is not Associated with Breast Cancer

• Costochondritis-Inflammation between the ribs and breastbone (sternum).

• Muscle Strain.

• Physiologic changes including estrogen stimulation of breast glands.

• Spinal disorders.

• Mastitis or breast infection.

• Fibrocystic disease, where pain and nipple discharge are common.

• Non cancerous breast masses.

If your pain comes on suddenly, it is more likely that it is the result of an injury or specific trauma rather than the result of a more serious condition such as breast cancer. Nonetheless, any type of pain warrants thorough evaluation and possible treatment.

The Evaluation and Treatment of Breast Pain
The type of treatment recommended will depend in part on the findings of your physical examination. Women at high risk for breast cancer or a family history of breast cancer will typically be referred for ultrasonography and mammography.

Women over the age of 40 are generally routinely referred for mammography.

Most women are interested in ruling out breast cancer. Simple reassurance that a woman does not have breast cancer may be all the relief a woman needs when seeking care for breast pain.

If breast pain is associated with trauma or injury, several therapies including use of NSAIDs may be used to help reduce the pain.

Other non pharmacological approaches to therapy may include the use of warm compresses, cessation of smoking and adoption of a low carbohydrate diet, which may help alleviate premenstrual breast tenderness and swelling.

There is some evidence to suggest that supplementation with evening primrose and fish oils may benefit women who experience cyclical breast pain.

Severe breast pain, which interferes with your daily activities, may be treated with medications prescribed by your doctor. These medications are effective treatments but are also typically associated with significant adverse effects.

Because of this, they are traditionally only used if the pain did not respond to more conservative therapies. The most often used medications are Danzol, Bromocriptine, and Tamoxifen. The associated risks with these drugs should be explained prior to their use for breast pain.

The prognosis for women with breast pain will vary according to the type of pain they are experiencing, age of onset and whether or not the pain is cyclic or non cyclic. Cyclic pain comes and goes with your menstrual flow or hormonal changes and may resolve spontaneously. Non cyclic pain is continuous and treating the cause may relieve the pain.

If you are experiencing breast pain, visit your healthcare provider to discuss your symptoms and to undergo a complete medical evaluation. Your physician will be able to screen for breast cancer, and rule out underlying physical conditions that may be contributing to your symptoms.