Breast Pain

Tenderness, throbbing, acute, stabbing, scorching pain, or tightness in the breast tissue are all examples of breast pain (mastalgia). Men, women, and transgender persons can all experience the pain, which can be ongoing or sporadic.

Mild to severe breast soreness is possible. It may happen −

• Only a couple of times a month, around the two to three days before a period. The discomfort is low to severe and affects both breasts normally.

• Beginning the day before a period and perhaps lasting during the menstrual cycle, for a week or longer each month. Both breasts are affected, and the discomfort can range from mild to severe.

• Not connected to a menstrual cycle; occurs throughout the month.

Gynecomastia, a condition, is the main cause of breast discomfort in males. This is used to describe an increase in breast gland tissue brought on by an estrogen and testosterone hormone imbalance. One or both breasts may be affected by gynecomastia, occasionally unevenly.

Hormone treatment may induce breast soreness in transsexual women. The small amount of breast tissue that may remain after a mastectomy in transgender males may be the source of their breast discomfort.

Breast discomfort seldom signifies breast cancer and often suggests a benign (noncancerous) breast disease. It is important to get a diagnosis for any unexplained breast discomfort that doesn't go away after one or two menstrual cycles, lasts after menopause, or doesn't appear to be caused by hormonal changes.

Breast Pain: Causes

The milk ducts or milk glands may alter as a result of changing hormone levels. Breast cysts are a common cause of cyclic breast discomfort and can be uncomfortable due to these changes in the ducts and glands. Trauma, past breast surgery, or other reasons may be to blame for noncyclic breast discomfort.

The precise reason for breast discomfort may not always be known, however, several conditions may raise the risk.

Breast Pain: Symptoms

Breast discomfort may or may not be cyclic. Cyclic refers to the discomfort that follows a predictable pattern. Noncyclic refers to persistent pain or the absence of a predictable pattern. There are certain traits that each form of breast discomfort possesses.

Breast Discomfort Outside the Breast

Extramammary refers to something that is "outside the breast." Extramammary breast discomfort appears to originate in the breast tissue, but its true origin is elsewhere. For instance, pulling a muscle in the chest might result in discomfort that radiates (moves from the chest wall or rib cage to the breast). Costochondritis, an arthritic condition that affects the cartilage in the chest, can also be painful.

Breast Pain: Risk Factors

While it can happen after menopause, breast discomfort is more prevalent in women who have not yet reached menopause. Moreover, males with gynecomastia and transgender persons undergoing gender transition may have breast discomfort.

Other elements that might raise the likelihood of breast soreness include −

• Breast volume − Large-breasted individuals may have noncyclic breast discomfort that is connected to their breast size. In addition to breast discomfort brought on by enormous breasts, neck, shoulder, and back pain may also be present.

• A breast operation − Even after wounds have healed, breast discomfort from breast surgery and scarring can occasionally persist.

• Unbalanced fatty acids − The sensitivity of breast tissue to circulating hormones may be affected by an imbalance of fatty acids inside the cells.

• Taking medication − Breast discomfort may be brought on by various hormonal drugs, including some infertility therapies and oral birth control pills. After menopause, estrogen and progesterone hormone therapy may cause breast discomfort as a side effect. Selective serotonin reuptake inhibitor (SSRI) antidepressants are among those that have been linked to breast discomfort. In addition, several antibiotics and medications for high blood pressure might induce breast soreness.

• Usage of caffeine in excess − Although additional study is necessary, some people find that cutting back or eliminating their coffee intake helps their breast discomfort.

Breast Pain: Diagnosis

To diagnose breast pain, your doctor may suggest the following tests −

• Clinical breast examination − Your doctor examines your breasts, as well as the lymph nodes in your lower neck and armpit, looking for any changes. To rule out the possibility that the discomfort is caused by another ailment, your doctor will likely listen to your heart and lungs, examine your chest, and feel your belly.

• Mammogram − You'll require an X-ray check of your breast to analyze the region of concern discovered during the breast exam if your doctor feels a breast lump, notices an unusual thickness, or notices a targeted area of pain in your breast tissue (diagnostic mammogram).

• Ultrasound −  Along with mammography, an ultrasound examination creates pictures of your breasts using sound waves. Even if the mammography looks to be normal, you may require an ultrasound to assess a specific location of discomfort.

• A breast biopsy − Before your doctor can diagnose suspicious breast lumps, thickening regions, or odd areas found during imaging exams, a biopsy may be necessary. Your doctor takes a tiny sample of breast tissue during a biopsy from the problematic region and sends it to the lab for examination.

Breast Pain: Treatment

Based on the severity of the condition, your doctor may suggest the following treatments −

• Get rid of a contributing aspect or underlying cause. This could just require a minor modification, like using a bra with added support.

• Use a nonsteroidal anti-inflammatory drug (NSAID) topical cream. If your pain is severe, you might need to use NSAIDs. Your doctor could advise you to directly apply an NSAID cream to the sore spot.

• Birth control dosage adjustments. If you use birth control pills, skipping the week without tablets or switching to another type of birth control may lessen breast discomfort sensations. However, before trying this, see your doctor.

• Menopausal hormone treatment dosage should be decreased. You could think about reducing or eliminating menopausal hormone treatment.

• Use a prescription drug. The Food and Drug Administration has only authorized Danazol as a prescription drug for the treatment of fibrocystic breasts. Danazol, however, poses the risk of potentially serious side effects, including weight gain, voice changes, and issues with the heart and liver. Tamoxifen, a prescription medicine used to treat and prevent breast cancer, may be helpful, but it also carries the risk of unpleasant side effects that might be more distressing than the breast discomfort itself.

Breast Pain: Prevention

The causes of breast discomfort may be avoided by taking the following measures, however further study is required to confirm their efficacy.

• If you can, avoid hormone treatment.

• Prescription drugs that are known to aggravate or induce breast discomfort should be avoided.

• While exercising, use a sports bra and a bra that is correctly fitting.

• Employ relaxation treatment to reduce the high levels of worry brought on by persistent breast discomfort.

• Although research on caffeine's impact on breast pain and other premenstrual symptoms has been inconsistent, some women find it useful to reduce or completely avoid caffeine in their diets.

• Avoid lifting for an extended period.

• Consume less fat and more complex carbs.

Conclusion

In about 20% to 30% of women, cyclical breast discomfort goes away on its own within 3 months after starting. Up to 60% of women experience recurring symptoms two years after receiving therapy, and the pain frequently recurs and then subsides. Although non-cyclical pain is difficult to manage, around 50% of women may experience spontaneous resolution.