Breast pain is the symptom of discomfort in either one or both breasts. Pain in both breasts is often described as breast tenderness, is usually associated with the menstrual period and is not serious. Pain that involves only one part of a breast is more concerning, particularly if a hard mass or nipple discharge is also present.
Causes may be related to the menstrual cycle, birth control pills, hormone therapy, or psychiatric medication. Pain may also occur in those with large breasts, during menopause, and in early pregnancy. In about 2% of cases breast pain is related to breast cancer. Diagnosis involves examination, with medical imaging if only a specific part of the breast hurts.
In more than 75% of people the pain resolves without any specific treatment. Otherwise treatments may include paracetamol or NSAIDs. A well fitting bra may also help. In those with severe pain tamoxifen or danazol may be used. About 70% of women have breast pain at some point in time. Breast pain is one of the most common breast symptoms, along with breast masses and nipple discharge.
Breast pain linked to the menstrual cycle is called cyclic breast pain or cyclic mastalgia. Some degree of cyclical breast tenderness is normal in the menstrual cycle, and is usually associated with menstruation and/or premenstrual syndrome (PMS). Cyclic breast pain is often associated with fibrocystic breast changes or duct ectasia and thought to be caused by changes of prolactin response to thyrotropin.
Breast pain that is not linked to a menstrual cycle is called noncyclic breast pain. Noncyclical breast pain has various causes and is harder to diagnose and frequently the root cause is outside the breast. Some degree of non-cyclical breast tenderness can normally be present due to hormonal changes in puberty (both in girls and boys), in menopause and during pregnancy. After pregnancy, breast pain can be caused by breastfeeding.
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Mastitis is inflammation of the breast or udder, usually associated with breastfeeding. Symptoms typically include local pain and redness. There is often an associated fever and general soreness. Onset is typically fairly rapid and usually occurs within the first few months of delivery. Complications can include abscess formation. Risk factors include poor latch, cracked nipples, use of a breast pump, and weaning. The bacteria most commonly involved are Staphylococcus and Streptococci. Diagnosis is typically based on symptoms.
Fibrocystic breast changes is a condition of the breasts where there may be pain, breast cysts, and breast masses. The breasts may be described as "lumpy" or "doughy". Symptoms may worsen during certain parts of the menstrual cycle due to hormonal stimulation. These are normal breast changes, not associated with cancer. Risk factors include an early age at first menstrual period and either having children at a late age or not at all. It is not a disease but represents normal breast changes.
Hormone replacement therapy (HRT), also known as menopausal hormone therapy or postmenopausal hormone therapy, is a form of hormone therapy used to treat symptoms associated with female menopause. These symptoms can include hot flashes, vaginal atrophy, accelerated skin aging, vaginal dryness, decreased muscle mass, sexual dysfunction, and bone loss or osteoporosis. They are in large part related to the diminished levels of sex hormones that occur during menopause. Estrogens and progestogens are the main hormone drugs used in HRT.
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