Breast Pain

breast pain

Most women develop breast pain at some stage in life. In most cases the pain develops in the days just before a period. In some cases the pain is not related to periods. The pain is often mild but in some women it is more severe and can affect the quality of your life.

Breast pain (mastalgia) is usually classed as either:

  • Cyclical breast pain - where the pain is related to periods. Typically, it occurs in the second half of the monthly cycle, getting worse in the days just before a period; OR
  • Noncyclical breast pain - where the pain is not related to periods.

Record the days when you have breast pain, and highlight the days when the pain is severe enough to affect your lifestyle.

What are the symptoms of cyclical breast pain?

In many women the symptoms are mild. Indeed, it can be considered normal to have some breast discomfort for a few days before a period. The 3-5 days prior to a period are usually the worst. The pain usually eases soon after a period starts. The severity usually varies from month to month. Typically, the pain affects both breasts. Your breasts may also feel more swollen and lumpy than usual.

What causes cyclical breast pain?

It is thought that women with cyclical breast pain have breast tissue which is more sensitive than usual to the normal hormonal changes that occur each month.

What are the treatment options for cyclical breast pain?

No treatment may be needed if the symptoms are mild. Studies have shown that cyclical breast pain goes away within three months of onset in about 3 in 10 cases.

Support your breasts. Wear a well supporting bra when you have pain. It is best to avoid underwired bras. Wear a sports bra when you exercise.

Painkillers such as paracetamol or ibuprofen. Take regularly on the days when the breasts are painful.

Topical (rub-on) non-steroidal anti-inflammatory drugs (NSAIDs). For example, topical diclofenac or topical ibuprofen.

Drugs to block hormones. Drugs such as danazol, bromocriptine, tamoxifen and goserelin injections can ease pain in most cases. These drugs work by reducing the level, or blocking the effect of, female hormones such as oestrogen. However, significant side-effects are common with these drugs.

Noncyclical breast pain

This type of breast pain is not related to periods and is most common in women aged over 40. The pain may be in just one breast, and may be localized to one area in a breast.

  • Pain coming from the breast tissue itself in the absence of any lumps, tumours, or other abnormality being detected. The reason why this type of pain occurs is not known.
  • Pain coming or radiating from the chest wall under the breast rather than the breast itself. Muscular or bony problems of the chest wall account for some cases.
  • Infection is a cause in a small number of cases.
  • Shingles may cause pain before a rash develops.
  • Breast tumors, cancer and lumps are a very uncommon cause of breast pain.

What is the treatment for noncyclical breast pain?

In many cases the pain goes after a few months without any treatment. NSAIDs such as ibuprofen may ease the pain. Topical NSAIDs may also work.

Breast pain and breast cancer

Women with breast pain often worry that the pain is caused by breast cancer. However, the first symptom of breast cancer is usually a painless lump. Pain is not usually an early symptom. However, even though breast pain is not likely to be caused by cancer, you should see your doctor if you have any concerns about breast pain or any other breast symptoms.

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