Mastodynia also known as Mastalgia or breast pain is a common complaint in females. The pain arises from the breast, but sometimes when it is referred from the chest wall it gets commonly mistaken as pain in the breast. The pain which is specific to the breast is called true mastalgia and is divided into; Cyclical and Non-Cyclical Breast Pain
- Duration of Pain
- Cyclical Breast Pain
- Non-Cyclical Breast Pain
- Other pains mistaken as Mastodynia
- Diagnosis
- When to consult a doctor?
- Breast Awareness
Duration of Pain
Mastodynia or Mastalgia usually begins a few days before the onset of the menstrual period but some times the pain can begin a week before menstruation, last 2,3 days being the most painful. It usually eases upon the beginning of menstruation.
Cyclical breast pain
Cyclical Pain often affects the upper outer side of the breast. Pain occurs 3 to 7 days before menstruation. After that, it improves at the onset of menstruation. It is due to an exaggerated response to the hormonal changes. Moreover, these changes that take place are associated with swelling and increased lumpiness of the breast. In comparison to this, it could still remain in women using hormone replacement therapy. This occurs in two-third of the patients.
Symptoms:
- Pain is dull and heavy
- Tingling and burning sensation in the breast
- Tenderness upon touch
- Swelling of the breast
- Lumpiness and discomfort
- Soreness with irritation
- Increased pain during sexual activity
Causes:
Reproductive hormones are the major cause of cyclical pain in the breast. The disturbance in the hormone levels occurs at different times in life. These include:
- Puberty
- Premenstrual syndrome
- Pregnancy
- Breastfeeding
- Menopause
- Stress
- Hormone replacement therapy
- The pain often has psychogenic relevance too.
- It could also be due to the side effects of drugs or medicines; Antidepressants, Haloperidol, Digoxin, etc.
Treatment:
- Reassurance is often the only form of management after cancer has been excluded.
- Evening primrose oil is the mainstay of the treatment. In conclusion, the fatty acid component plays its role. Further, the treatment is continued for four months before the benefit can be assessed.
- Breast support is given with the use of a firm bra during the day time while a soft bra can be used at night time.
- Medicine like Danazol is given in case of severe pain only.
Non-cyclical breast pain
It is the type of breast pain that could come and go. It is important in this case to exclude the chest wall pain. Moreover, it can occur both before and after the menopause. However, it is common in postmenopausal women. These women are not on estrogen therapy. This pain can affect both breasts. It can occur on one side as well or in a specific area too and occurs in one-third of the patients.
Symptoms:
- Pain is burning and stabbing in nature
- Radiation of pain to the neck and shoulders
- The tightness of breast
- Tenderness of the affected area
Causes:
- Trauma to the breast
- Any blow or history of fall
- Lack of estrogen hormone
Treatment:
- Non-steroidal pain relievers are used more often to treat this pain.
- Injection of a local anesthetic can be given in the affected area.
- Gel medication can be applied directly to the affected site.
Other pains mistaken as Mastodynia
Often the patient comes with complaint of Breast pain while the pain actually is not due to any problem in the breast but else where and is a reffered pain. This can be due to following possible causes:
- Nerve Pain due to any sort of irritation or compression
- Joint pain in the Ribs or spine
- Pneumonia
- Gall stones
Diagnosis
Most women present with concerns regarding the pain as a sign of tumor or breast cancer. However, their concerns are right but pain alone is seldom a cause of breast cancer. A detailed breast examination followed by an ultrasound or mammography depending upon the examination results will help reach a proper conclusion.
When to consult a doctor?
Breast pain (Mastodynia) is seldom a sign of tumor or breast cancer. However some other signs may indicate an underlying cause and need immediate attention. You should consult the doctor if you feel any sort of Lumps, shape or size changes, changes or discharge from nipples or any othe pecularity you notice and think is worth an examination.
Breast Awareness
Breast awarness is being fimiliar with how your breast look and feel like so that any changes in shape, size or other features is detected as early as possible . Upon consultation with the doctor they can be differentiated from the recent changes that might indicate an underlying problem.
FAQ
Cyclical or non cyclical breast pain is dull and heavy, tingling or pinching in character. The breast is also tender to touch.
Most common cause is sensitivity of breast tissue towards changes in hormones that take place in the body around the cycle.
Yes, at some point in life, all women come across mastalgia but cyclical breast pain is not faced by everyone.
