Breast pain, also known as mastalgia, mammalgia, and mastodynia, is common and may include a dull ache, heaviness, tightness, a burning sensation in the breast tissue, or breast tenderness.
If the pain is linked to the menstrual cycle, it is known as cyclical mastalgia (cyclical breast pain).
According to the Breast Cancer Foundation, breast pain includes any pain, tenderness or discomfort in the breast or underarm region, and can occur for a number of different reasons. In most cases, the Foundation adds, breast pain is not a sign of breast cancer.
In most cases, breast pain affects the upper, outer area of both breasts – the pain can sometimes spread to the arms.
The California Pacific Medical Center estimates that between 50 percent and 70 percent of women have breast pain in the United States.
Fast facts on breast pain
Here are some key points about breast pain. More detail and supporting information is in the main article.
In the majority of cases, breast pain is not a sign of breast cancer.
Breast pain is most common in perimenopausal and premenopausal females.
Breast pain is normally defined as “cyclic” (cyclical) or “non-cyclic” (non-cyclical).
Sometimes it may not be possible to determine precisely why breast pain occurs.
Doctors may recommend a prescription drug if suggested therapies are unable to alleviate the symptoms.
Symptoms of breast pain
Breast pain is usually classified as “cyclic” (cyclical) or “non-cyclic” (non-cyclical).
Symptoms of cyclical breast pain
The pain comes cyclically, just like the menstrual cycle.
The breasts may become tender.
Patients describe the pain like a heavy, dull ache. Some women describe it as a soreness with heaviness, while others say it is like a stabbing or burning pain.
The breasts may swell.
The breasts may become lumpy (not with a single, hard lump).
Both breasts are typically affected, especially the upper, outer portions.
The pain can spread to the underarm.
Pain becomes more intense a few days before a period begins. In some cases, pain may start a couple of weeks before menstruation.
It is more likely to affect younger women. Postmenopausal women may experience similar pains if they are on HRT(hormone replacement therapy).
Symptoms of non-cyclical breast pain
It affects just one breast, usually just within a small section of the breast, but may spread across the chest.
It is common among post-menopausal women.
The pain does not come and go in a menstrual cycle time-loop.
The pain may be continuous or sporadic.
Mastitis – if the pain is caused by infection within the breast, the woman may have a fever, feel ill (malaise), some breast swelling and tenderness and the painful area may feel warm. There may be redness. The pain is usually described as a burning sensation. For lactating mothers, the pain is more intense while breastfeeding.
Extramammary pain – pain that feels as if the source is within the breast, but it is elsewhere. Sometimes called “referred pain.” This may occur in some chest wall syndromes, such as costochondritis (inflammationwhere the rib and the cartilage meet).
What causes breast pain?
It is not always possible to determine exactly why breast pain occurs. The following factors can be associated with breast pain:
Acid reflux.
Alcoholismwith liver damage.
Angina.
Anxiety, stress, and depression.
Benign breast tumors.
Bornholm disease.
Breast cancer.
Breast cysts.
Breast trauma – e.g. previous breast surgery.
Breastfeeding related – possible infection.
Cervical and thoracic spondylosis/radiculopathy.
Chest wall pain.
Coronary artery disease.
Cyclical breast pain.
Diet – especially caffeine.
Fibromyalgia.
Herpes
Medications – including digitalis, chlorpromazine, oxymetholone, some diuretics, spironolactone, and methyldopa.
Peptic ulcer.
Pleurisy.
Puberty.
Pulmonary embolism.
Rib fracture.
Shingles.
Shoulder pain.
Sickle cell anaemia.
Trauma to the chest wall.
Treatment options
In the majority of cases, it is possible to solve cyclical breast pain by taking OTC (over-the-counter) painkillers and wearing well-fitted bras. Cyclical breast pain is often unpredictable — it may well just go away in time, and then come back periodically.
Being diagnosed with cyclical breast pain, as opposed to something more serious, can reassure many patients who then decide their condition is easier to live with.
Women with non-cyclical breast pain may need therapy to treat the underlying cause, for instance, with infectious mastitis, the patient will be prescribed a course of antibiotics.