Breast pain Information | Mount Sinai

Pain – breast; Mastalgia; Mastodynia; Breast tenderness

Breast pain is any discomfort or pain in the breast.

The female breast is either of two mammary glands (organs of milk secretion) on the chest.

Breast pain can be due to many possible causes. Most likely breast pain is from hormonal fluctuations from menstruation, pregnancy, puberty, menopause, and breastfeeding. Breast pain can also be associated with fibrocystic breast disease, but it is a very unusual symptom of breast cancer.

Considerations

There are many possible causes for breast pain. For example, changes in the level of hormones during menstruation or pregnancy often cause breast pain. Some swelling and tenderness just before your period is normal.

Some women who have pain in one or both breasts may fear breast cancer. However, breast pain is not a common symptom of cancer.

Causes

Some breast tenderness is normal. The discomfort may be caused by hormone changes from:

• Menopause (unless a woman is taking hormone replacement therapy)
• Menstruation and premenstrual syndrome (PMS)
• Pregnancy — breast tenderness tends to be more common during the first trimester
• Puberty in both girls and boys

Soon after having a baby, a woman’s breasts may become swollen with milk. This can be very painful. If you also have an area of redness, call your health care provider, as this may be a sign of an infection or other more serious breast problem.

Breastfeeding itself may also cause breast pain.

Fibrocystic breast changes are a common cause of breast pain. Fibrocystic breast tissue contains lumps or cysts that tend to be more tender just before your menstrual period.

Certain medicines may also cause breast pain, including:

• Oxymetholone
• Chlorpromazine and other antipsychotic medicines
• Water pills (diuretics)
• Digitalis preparations
• Methyldopa
• Spironolactone
• Oral contraceptives
• Estrogen replacement therapy
• Selective serotonin reuptake inhibitors, such as fluoxetine

Shingles can lead to pain in the breast as there is a painful blistering rash that appears on the skin of your breasts.

Home Care

If you have painful breasts, the following may help:

• Take medicine such as acetaminophen or ibuprofen
• Use heat or ice on the breast
• Wear a well-fitting bra that supports your breasts, such as a sports bra

There is no good evidence to show that reducing the amount of fat, caffeine, or chocolate in your diet helps reduce breast pain. Vitamin E, thiamine, magnesium, and evening primrose oil are not harmful, but most studies have not shown any benefit. Talk to your provider before starting any medicine or supplement.

Certain birth control pills may help ease breast pain, although in other cases it may cause breast pain. Ask your provider if this therapy is right for you.

When to Contact a Medical Professional

Contact your provider if you have:

• Bloody or clear discharge from your nipple
• Given birth within the last week and your breasts are swollen or hard
• Noticed a new lump that does not go away after your menstrual period
• Persistent, unexplained breast pain
• Signs of a breast infection, including redness, pus drainage, or fever

What to Expect at Your Office Visit

Your provider will perform a breast examination and ask questions about your breast pain. You may have a mammogram or ultrasound.

Your provider may arrange a follow-up visit if your symptoms have not gone away in a given period of time. You may be referred to a specialist.

Family Practice Notebook website. Medication causes of mastalgia: breast pain due to medication. fpnotebook.com/Gyn/Sx/Mstlg.htm. Accessed January 1, 2023.

Klimberg VS, Hunt KK. Diseases of the breast. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 35.

Sandadi S, Rock DT, Orr JW, Valea FA. Breast diseases: detection, management, and surveillance of breast disease. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 15.

Sasaki J, Geletzke A, Kass RB, Klimberg VS, Copeland EM, Bland KI. Etiology and management of benign breast disease. In: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, eds. The Breast: Comprehensive Management of Benign and Malignant Diseases. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 5.

Last reviewed on: 10/10/2022

Reviewed by: Jonas DeMuro, MD, Diplomate of the American Board of Surgery with added Qualifications in Surgical Critical Care, Assistant Professor of Surgery, Renaissance School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Breast Pain: 10 Reasons Your Breasts May Hurt

Breast Pain: 10 Reasons Your Breasts May Hurt | Johns Hopkins Medicine

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Most women experience some form of breast pain at one time or another. Breast pain is typically easy to treat, but on rarer occasions it can be a sign of something more serious.

Medical director of the Suburban Hospital Breast Center Pamela Wright, M.D., discusses the most common causes of breast pain (mastalgia), their treatments and when to see a doctor:

1. Hormones are making your breasts sore.

   Hormonal fluctuations are the number one reason women have breast pain. Breasts become sore three to five days prior to the beginning of a menstrual period and stop hurting after it starts. This is due to a rise in estrogen and progesterone right before your period. These hormones cause your breasts to swell and can lead to tenderness.

   “It’s normal to have breast tenderness that comes and goes around the time of your period,” says Wright. “It’s nothing to worry about.”

   If you become pregnant, your breasts may remain sore during the first trimester as hormone production ramps up. Breast tenderness is one of the earliest signs of pregnancy for many women.

   Steps you can take to minimize sore breasts include:

   • Eliminate caffeine
   • Eat a low-fat diet
   • Reduce salt intake
   • Avoid smoking
   • Take an over-the-counter pain reliever
   • Ask your doctor if switching birth control pills or hormone replacement therapy medications may help

2. You have a breast injury.

   Like any part of your body, breasts can be injured. This can happen because of an accident, while playing sports or from breast surgery. You may feel a sharp, shooting pain at the time of injury. Tenderness can linger for a few days up to several weeks after trauma to the breast. See your doctor if the pain doesn’t improve or you notice any of these signs:

   • Severe swelling
   • A lump in the breast
   • Redness and warmth, which could indicate an infection
   • A bruise on your breast that doesn’t go away

3. Your breasts hurt due to an unsupportive bra.

   Without proper support, the ligaments that connect breasts to the chest wall can become overstretched and painful by the end of the day. The result is achy, sore breasts. This may be especially noticeable during exercise. Make sure your bra is the correct size and provides good support.

4. Breast pain is really coming from your chest wall.

   What feels like breast pain may actually be coming from your chest wall. This is the area of muscle, tissue and bone that surrounds and protects your heart and lungs. Common causes of chest wall pain include:

   • A pulled muscle
   • Inflammation around the ribs
   • Trauma to the chest wall (getting hit in the chest)
   • Bone fracture

5. Breastfeeding is causing breast tenderness.

   Breastfeeding can sometimes be the source of breast pain. Some of the things you can experience while nursing include:

   • Painful nipples from an improper latch (the way a baby latches on to suck)
   • Tingling sensation during letdown (when the milk starts to flow to the baby)
   • Nipple soreness due to being bitten or having dry, cracked skin or an infection

   If you have pain while breastfeeding, it’s best to talk to your doctor or a lactation consultant. They can help you troubleshoot the problem while maintaining your milk supply. 

6. You have a breast infection.

   Breastfeeding women are most likely to get breast infections (mastitis), but they occasionally occur in other women, too. If you have a breast infection, you may have a fever and symptoms in one breast, including:

   • Pain
   • Redness
   • Swelling

   If you think you may have a breast infection, it’s important to see a doctor. Treatment typically includes antibiotics and pain relievers.

7. Breast pain could be a medication side effect.

   Some medications may cause breast pain as a side effect. Talk to your doctor about the medications you’re on and if this could be the case for you. Some drugs with this known side effect include:

   • Oxymethone, used to treat some forms of anemia
   • Chlorpromazine, used to treat various mental health conditions
   • Water pills (diuretics), drugs that increase urination and are used to treat kidney and heart disease and high blood pressure
   • Hormone therapies (birth control pills, hormone replacement or infertility treatments)
   • Digitalis, prescribed for heart failure
   • Methyldopa, used to treat high blood pressure

8. You have a painful breast cyst.

   If a tender lump suddenly appears in your breast, you may have a cyst, says Wright. “These fluid-filled lumps aren’t dangerous and often don’t need to be treated as they may resolve on their own. But it’s important to get any lump in your breast evaluated by a doctor.”

   To diagnose a cyst, your doctor may recommend a mammogram, ultrasound or aspiration (drawing fluid from the lump). Draining fluid from the cyst is also a form of treatment. If the cyst isn’t bothersome, you may not need any treatment at all.

   Learn more about breast cysts and other noncancerous breast lumps.

9. You’re experiencing painful complications from breast implants. 

   Some women have complications with breast implants, whether made of silicone or saline. One of the most common causes of pain after breast augmentation surgery is capsular contracture, when scar tissue forms too tightly around implants. Breast pain can also be an indication that one of your implants has ruptured. Talk to your doctor about any pain you’re having to determine if it could be related to the breast implants.

10. Breast pain can sometimes be a sign of breast cancer.

    It’s unusual for breast cancer to cause pain, says Wright, but not impossible. Inflammatory breast cancer often causes pain but it’s rare, accounting for 1% to 5% of breast cancer cases in the United States. Symptoms of this aggressive disease often come on suddenly and progress rapidly. Inflammatory breast cancer may cause the breast to become:

    • Red or discolored
    • Swollen or heavy
    • Painful

    Skin on the breast may also thicken or dimple. If you’re concerned about inflammatory breast cancer, see your doctor immediately. 

Although most cases of breast pain are minor problems, it’s important to talk to your doctor about your concerns. “If you have persistent breast pain, you should be evaluated,” says Wright. “And anyone who has a lump — painful or not — should see their doctor for an exam to make sure there isn’t a problem.”

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Pain in the mammary glands – causes and types, diagnosis and examination of the mammary glands in the clinic

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Pain syndrome in the mammary glands, which is also called mastalgia, occurs during the life of 75% of all female representatives. Statistics show that every tenth woman experiences at least a slight chest pain around 5 days of the month.

Due to this prevalence, many women do not pay due attention to it and do not turn to specialists for diagnostic measures.

Pain in the chest can disturb both very young girls (in the premenopausal period) and in women after 45 years (in the postmenopausal period). In some cases, it is observed throughout life during periods of menstruation.

Pain symptom is divided into two types: cyclic and non-cyclic.

In some cases, chest pain may not be related to any of the types. This happens with another source of disease, such as muscle pain.

Causes of pain in the mammary glands can be:

• hormonal disorders
  They are the main cause of cyclic pain. As a rule, pain stops during pregnancy, before the onset of the menstrual cycle, or after menopause. This is a consequence of the fact that at these moments hormonal changes in the body stop.
• anatomical changes in the breast
  This is non-cyclical pain that can be caused by a cyst, blunt trauma, or surgery. The pain here is only on one side, mainly in the nipple area. Character – sharp, cutting. Most often permanent. In this case, you need to immediately contact a specialist.
• violation of the balance of fatty acids in the tissues of the mammary glands
  The pain is due to the increased sensitivity of gland cells to hormones.
• taking certain medications
  As a rule, these include hormonal substances, drugs to restore reproductive function, antidepressants.
• infectious diseases (in particular mastitis)
  Local symptoms are clearly expressed: significant pain, swelling and redness. There are fever, headaches, lack of appetite, feeling of weakness.
• Benign and malignant neoplasms (mastopathy, breast cancer) Pain sensations may be completely absent here, which makes timely diagnosis difficult. A slight tumor-like formation appears, a change in color or structure (wrinkling of the skin), discharge from the nipple is possible. The risk group includes nulliparous women after 30 years of age, who initially gave birth late, the hereditary factor and overweight are also important.
• Osteochondrosis of the thoracic spine

Infectious diseases of the mammary glands are no less dangerous to health. Untimely treatment of mastitis causes an abscess (accumulation of pus), which requires surgery to remove. After the operation, the wound heals for a long time, the risk of re-inflammation and suppuration is not excluded.

To rule out the possibility of complications, you need to make an appointment at our clinic. On the basis of tests and diagnostics, specialists will conduct a course of treatment and talk about prevention methods.

Diagnostic measures for pain in the mammary glands consultation of a mammologist (the doctor collects an anamnesis, conducts a detailed survey of the patient)

• manual breast examination
• mammography
• Breast ultrasound
• Breast MRI with contrast

These procedures will allow you to more accurately determine the condition of the mammary glands, the presence of benign and malignant tumors, their size and exact location. Make an appointment with a gynecologist, and qualified specialists will make a diagnosis in a short time, prescribe treatment, and advise on existing issues.

Remember that an annual visit to a mammologist can give you a guarantee of a high quality of life and confidence in a secure future.

Here are some preventative tips that will help you reduce your risk of breast pain:

• boost immunity regularly
• take care of your body from stressful situations
• have a regular sexual partner, categorically avoid abortion and breastfeed
• choose a comfortable and high-quality bra

Prices for the treatment of breast pain

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Mokronosov Alexey Sergeevich

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“Many-sided pain” in the mammary gland

A woman in our country is a special woman! She thinks and worries about everyone except herself – for her husband with his complaints and problems, for the children with their vaccinations, examinations and schools . .. At the very last moment, she suddenly remembers herself. Does he remember why? Something hurt! The most common complaint of women of any age and the most motivating reason for visiting a doctor is pain in the mammary gland. This is what I would like to talk to you, dear women.

Pain in the mammary gland can be characterized and divided into different manifestations: cyclic – non-cyclic; one-time – constant; sharp, dagger, dull, aching, arching, girdle, local (local), bilateral, unilateral, etc.

The most common of these is cyclic soreness. A few days before the expected menstruation, the mammary glands become engorged, become sensitive, painful when pressed. These symptoms can appear both in 14 and in 2-3 days and disappear immediately after menstruation. This is due to ovulation and the preparation of the body for the natural process – pregnancy. In the second phase of the menstrual cycle, the female body is rebuilt. The hormonal background and the rheological properties of the blood change. For example, have you ever wondered why it is recommended to visit a mammologist for an examination from the 6th to the 12th day of the cycle? Of course, these are average days for most women, and they can vary significantly depending on your personal menstrual calendar: if the discharge stops already on day 2-3, and the cycle duration is, say, 35 days, then such a patient can be extended consultative days from 4 to 17th day of the cycle. The principle should be clear: the discharge practically stops, and ovulation does not occur. On these (recommended) days, the doctor will more objectively assess the situation: the chest is in a calm state; if puffiness is observed, it is in no way connected with physiological processes. In the case when the patient comes to any day convenient for her (not according to the cycle), this threatens with overdiagnosis, sometimes even errors in diagnosis. Let me give you an example again. Patient N., 45 years old, underwent mammography two years ago. Now there are complaints of soreness of the mammary glands. The patient came for examination on the 25th day of the cycle. A mammogram was performed, which did not reveal exact data for a nodular formation, but the glandular tissue, compared to a two-year-old mammogram, became much larger. This indicates a hormonal surge, since the amount of glandular tissue should decrease over the years, and not increase. In this case, you and I knew in advance that the patient did not come according to the cycle, therefore, having repeated the study on the right days, we saw that the state of the mammary glands on the radiographs was without significant dynamics.

The same error often occurs with diagnostic punctures. First, you need to know that in the second phase of the menstrual cycle, the risk of hematomas at the biopsy site is much more serious. Therefore, surgeons try to carry out any operations for women of reproductive age during the week following menstruation, when bleeding is significantly reduced. Secondly, swelling is directly related to the swelling of each cell of the gland. The cytologist at the time of the procedure – taking a puncture – does not take into account the day of the cycle: he sees a cell that is slightly larger than the norm and – the diagnosis automatically becomes more complicated. The boundaries are very close: norm – hyperplasia – atypia – cancer. From this follows the conclusion – neither you nor the doctor need overdiagnosis.

Pain in the breast on both sides is associated with an imbalance of hormones that are not completely removed from the body by our liver, which remain on the cells of the glandular tissue of the mammary gland and attract fluid. Such a clinical picture with exacerbations in the autumn-spring period is characteristic of fibrocystic mastopathy. Sometimes there are shifts in a specific direction associated with the asymmetry of the mammary glands themselves or with a different amount of glandular tissue in the breast.

Local pain (local) inside the gland, aggravated by movement, patients often characterize as sharp, dagger, or, conversely, dull and aching. It occurs with cystic inclusions in the mammary gland. When filled, the liquid formation pushes the tissues apart, which leads to unpleasant sensations in a particular area of ​​the gland, and the severity of complaints depends on the degree of cavity filling. Cysts are the most benign of all problems, but they are the ones that bring the most discomfort to a woman’s life.
In adolescents, cysts are often asymptomatic and do not cause any complaints. Diagnosed by ultrasound, sometimes they can be suspected when examining the gland – the appearance of a bluish color on the skin of the areola of the nipple. When screening schoolgirls, it was cysts in the mammary gland that were the most common pathology, although the girls did not complain of pain. In adolescence, untreated cysts are often complicated by inflammatory processes.

Inflammation of the mammary gland – mastitis – is manifested by pain, accompanied by reddening of the skin over the area and an increase in temperature, both local and general. The clinical picture, as a rule, develops quickly – within 1-2 days. There is a misconception that mastitis occurs only in lactating women. This is a really common complication in this group: it occurs, as a rule, in the first 2-3 weeks after childbirth, and in most cases after the first childbirth; has two causes – lactostasis and infection (as a result of infection through cracks and / or other damage to the nipples).

In our practice, we often encounter inflammation of the mammary glands in adolescents or women outside the lactation period. Change of season or a sharp temperature drop, drafts are the most common causes of mastitis. We observe a surge of such appeals in the May period. But this year, at the beginning of autumn (after unbearable heat), the number of patients with this pathology has increased dramatically. For the timely appointment of treatment, it is important to consult a doctor at the first symptoms, then, most likely, local antibacterial treatment will be sufficient.