Breast Pain - Causes, Diagnosis and Treatment

Introduction:

In women, a breast is a tissue present over the pectoral muscle (also known as the chest muscle). It consists of fat tissues and a special tissue known as glandular tissue. The glandular tissues are responsible for the production of milk, whereas the fat tissue determines the shape and size of the breast. Breast development begins during the ages of 9 to 13, and in most women, they become fully developed by the age of 17 to 18.

The breast starts to develop during puberty and is due to the increase in the level of a hormone called estrogen. This hormone, along with various other hormones, plays an important role during the menstrual cycle and affects the breast tissues. Though breast pain is not a serious condition, it is safe to be aware of the conditions that might be associated with breast pain.

What Is Breast Pain?

The term mastalgia, also known as breast pain, is very common in women. The balance between the hormones might lead to occasional breast pain or discomfort in some women. Though breast pain is common, the severity and other pain-related factors vary widely from one woman to another. Generally speaking, breast pain is classified into two categories, namely cyclical and non-cyclical.

• Cyclical Pain: This type of breast pain occurs due to the menstrual cycle and the hormone fluctuation in the body. Cyclical breast pain is more common, and they typically tend to reduce after the menstrual period.

• Non-Cyclical Pain: Non-cyclical type of breast pain is rare, and the cause behind the pain might differ. In some cases, it might be due to an injury, or the pain itself might be from other surrounding muscles rather than the breast tissue.

What Are the Causes of Breast Pain?

Breast pain is most commonly caused by hormone fluctuation. The other causes of breast pain are listed below.

1) Hormonal Fluctuation:

During the menstrual cycle, the estrogen and progesterone levels fluctuate based on the stage of the cycle. The fluctuation in the hormone level makes a woman's breast feel swollen, lumpy, and painful in some cases. This type of breast pain generally worsens as the woman ages since the body becomes more sensitive to the hormone.

If the breast pain is caused due to hormone changes during the menstrual period, they tend to stop once the woman reaches menopause. In order to know if the pain is related to the menstrual cycle, it is advised to note the time of breast pain and the menstrual cycle to look for the pattern.

It has been reported that the pain will be worse two or three days before the start of the period, and then it gradually decreases towards the end of the cycle. Other developmental stages that also cause hormone fluctuation in women include:

• Puberty.

• Pregnancy.

• Menopause.

2) Breast Cysts:

As a woman gets old, the breasts undergo a change known as involution. Involution means the breast tissue (glandular tissue) gets replaced by the fat tissue after a certain age. Sometimes, this might lead to a side effect where cysts develop during involution and are called fibrocystic breast tissue.

The fibrocystic breast does not always cause pain, but there are chances that it can cause pain. However, it is important to note that this is not a concern. Fibrocystic breasts usually become lumpy and have increased tenderness on the outer and the upper portion of the breast.

3) Breastfeeding:

Though breastfeeding is the most nutritional way of feeding the newborn, it also has its own difficulties. Different factors are associated with breastfeeding that might lead to breast pain. They include:

• Mastitis - Infection of the milk duct, which causes itching, pain, or burning sensation on the nipples.

• Improper Latch - If the baby does not latch properly to the breast while feeding, it also leads to cracking and soreness of the nipples.

• Engorgement - This happens when the breasts become full with milk and enlarge along with the skin to be tight and painful.

Some other causes might also cause breast pain. They are:

• Breast size.

• Diet choices.

• Smoking.

• Certain medications.

• Breast surgery.

Is Breast Pain a Cause for Breast Cancer, and How Is It Diagnosed?

Breast pain is not generally associated with breast cancer, and having breast pain or fibrocystic breasts does not increase the risk of breast cancer. However, one minor difficulty of having a lumpy breast is that it makes it difficult to identify tumors on a mammogram.

If the pain is localized to a particular region and there is no fluctuation in the severity of the pain throughout the month, it is important to consult a doctor. The doctor will conduct a physical examination initially to check and feel for any tumors. If the doctor suspects the presence of any tumors, the following diagnostic tests will be performed to help diagnose the tumor.

• Ultrasound - This will penetrate the breast tissue and help locate the tumor without radiation exposure.

• Mammogram - This test helps in identifying any breast tissue abnormalities.

• MRI (Magnetic Resonance Imaging) - If the ultrasound is not clear, an MRI is used to get a more detailed image of the breast tissue.

• Biopsy - The doctor will remove a small portion of the breast tissue to study under a microscope to identify the presence of any cancerous cells.

How Is Breast Pain Treated?

The treatment of breast pain will be based on the type of pain that is cyclical or non-cyclical. The doctor will assess the patient's age, the severity of the pain, and medical history before suggesting any treatment options.

Cyclical Breast Pain:

The following are the treatment measures recommended by the doctor if a woman is diagnosed with cyclical breast pain.

• Take oral contraceptives to level the hormone.

• Reduce the intake of sodium.

• Take estrogen blockers.

• Take calcium supplements.

• Suggest using supportive bras during the menstrual period.

• Take pain relievers like NSAIDs (non-steroidal anti-inflammatory drugs).

Non-Cyclical Breast Pain:

In the case of non-cyclical breast pain, the treatment will focus on finding the exact cause behind the pain and planning the treatment methods to address the underlying cause. The most common factor for non-cyclical breast pain to occur is the other medications that the patient might be taking. Hence, it is important to discuss the patient's medical condition and current medications with the doctors.

Conclusion:

Though breast pain is common among women, it is important to be cautious about the various conditions associated with it. There are various self-check techniques for breast tissues, and they are helpful to ensure that the breast tissues are healthy and lump-free. Hormone supplements are also known to cause breast pain; always consult a doctor before using them. If the breast pain does not subside and persists for more than five days or if you begin to feel lumps in the breasts, consult a doctor immediately.