The breast pain is an extremely common symptom. About 60% of women have some degree of breast tenderness, but few consider this important symptom enough to seek medical help. In fact, only 1 in 10 women who reported pain in one or both breasts describes the pain as moderate to strong intensity.
In the vast majority of cases, breast pain is not a sign of serious illness of the breasts. This does not mean, however, that women with persistent breast pain should not seek their gynecologists to try to clarify the source of your pain.
Two thirds of breast pain are considered cyclical and one-third is considered non-cyclical. Cyclic pain is that which is associated with hormonal variations of the menstrual cycle arising usually one week before menstruation. The non-cyclic pain is that which does not follow a more or less predictable pattern, may be continuous, intermittent or spot only, such as after breast or chest trauma.
1. Main causes of cyclical breast pain
Mild pain or diffuse small discomforts in both breasts are normal during the menstrual cycle and occur in almost all women of childbearing age. This type of breast pain usually occur in the second half of the menstrual cycle worsens days before menstruation and disappears as soon as the woman menstruate.
When this cyclic pain related to the menstrual cycle is moderate to strong, we say that the patient has cyclic mastalgia . The features are the same of any cyclical pain, but the trouble is so important that it can disrupt sexual, social and physical activities in the days before menstruation.
Another common cause of cyclical breast pain is called fibrocystic breast disease . Despite illness in the name, this change of the breast is not an actual disease. It is only benign cystic that can arise in the breast throughout life due to hormonal stimuli. In some cases, these cysts can be painful.
2. Main causes of non-cyclical breast pain
Unlike cyclic pain, non-cyclical mammary pain does not maintain connection with the menstrual cycle and typically affects only one breast. Among the common causes of non-cyclical pain, include:
Very large breasts - the weight can cause stretching of the Cooper's ligament, which is the structure that supports the breasts.
Mastitis - Breast inflammation are very common during breastfeeding, but can also occur in women who are not breastfeeding.
Trauma in the breast - after injury or trauma, the breast can present non-cyclical pain for some time.
Ectasia ductal - this change occurs in dilatation and obstruction of the mammary ducts that carry milk. The ductal ectasia can cause inflammation, leading to a very similar view with mastitis.
Pregnancy - breast development during pregnancy can lead to a situation of non-cyclic pain.
Breast cancer - a type of malignant breast tumor, known as breast Paget's disease is an uncommon form of breast cancer that can cause inflammation, ulceration and pain in the breast.
Prior breast surgery - after healing of breast tissue due to surgery or biopsy, the breast may have intervened frames of non-cyclic pain.
Medications - some drugs can cause non-cyclical breast pain, for example antidepressants (fluoxetine or sertraline), birth control pills, metronidazole, clomiphene, spironolactone and others.
3. Main causes of extra-mammary pain
Some women with mastalgia can be actually outside the breast problems, such as muscle pain in the chest region, the ribs lesions, herpes zoster, fibromyalgia, back problems, etc.
Most women seeking your gynecologist for pain account the breasts, does the fear of breast cancer. Fortunately, this fear is unfounded in most cases.
The truth is that breast pain is a symptom more related to benign breast disease than cancer. Less than 3% of women with breast pain as the only symptom end up discovering that the source of the pain was a malignant breast tumor.
In the case of cyclic pain, or when the cause of breast pain is obvious, as recent trauma or an ongoing mastitis, no need to perform imaging tests, such as mammography or ultrasound of the breast, to rule out more serious conditions.
Unless the pain is of unknown origin and during the breast examination is possible to identify a lone suspect nodule, there is no reason to think of breast cancer for patients with breast pain complaints.
The first step in treating mastalgia is to calm the patient and explain that this symptom is not a normal sign of breast cancer.
In many cases, the breast pain disappears with time, without any procedure being required. In others, simple changes in diet and lifestyle can help. Cut fat, stop smoking and reduce caffeine consumption appear to be effective in some cases. Women with large breasts should change the size and type of bra in order to keep them with better support. Women who practice jogging or other physical activities that cause intense movement of the breasts should wear "sports bras" in order to keep them more "stuck".
When the pain is related to the medication, or exchange if the medicine or the dose should be reduced.
If the pain is very uncomfortable, anti-inflammatory or simple analgesics can be used for a few days. In cases of severe pain, drugs such as tamoxifen and danazol may be prescribed, despite frequent side effects.
