Breast pain is experienced by 50-70% of women and is the most common discomfort women seek medical attention for in relation to the breast. Breast pain mostly occurs on the outside or upper part of the breast, sometimes spreading to the armpits and upper arms; there is a variety of pain types and pain levels, with about 15-20% requiring treatment; consultation with a specialist is the safest way to go.
According to whether the pain is associated with the menstrual cycle, breast pain can be divided into: menstrual cyclic pain and non-menstrual cyclic pain.
Signs and symptoms
Menstrual cycle pain in the breast.
l Common in premenopausal women, often involving both breasts
l Periodic breast pain that accompanies menstruation, mostly occurs 2-3 days before menstruation, and gradually relieves to disappear after menstruation; some women’s breast pain can accompany the whole menstrual cycle, and the symptoms are obvious
l The pain usually appears on the outer part of the breast or the upper part of the breast, sometimes spreading to the armpit and upper arm.
l The breast may be swollen, painful to the touch, burning sensation, skin irritation, roughness of the breast tissue, and may be accompanied by the appearance of lumps
Non-menstrual pain in the breast.
l It can occur both before and after menopause, and is most common in women aged 40-50 years
l No significant association with the menstrual cycle
l Pain can occur anywhere in the breast, mostly in one quadrant of the breast; it can also spread to the thorax
l Stabbing pain is a common type of pain
Factors that may cause breast pain
l Pregnancy
Stress, anxiety and depression
Breast cysts
Benign tumors of the breast
Breast cancer
Trauma to the breast
l Mastitis
Hormone therapy: including birth control pills, hormone replacement therapy, and hormone therapy during fertility assistance
l Non-breast diseases: acid reflux in the esophagus, chest wall pain, coronary artery disease, costochondritis, herpes zoster, etc.
Painful menstrual cycle of the breast is not a risk factor for breast cancer, but please seek medical attention if
Lumps or localized glandular thickening in the breast
Lumps or bulges in the armpits
Change in the shape or size of one or both breasts
sunken skin of the breast
nipple discharge
l Nipple eczema
l Skewed nipples
Clinical diagnosis of breast pain
l History collection: location of pain, whether it affects both breasts, whether smoking, caffeine intake, whether taking birth control pills, whether pregnant, whether there is nipple discharge or lump, etc.
l Physical examination: auscultation of the heart and lungs, palpation of the thorax and abdomen to exclude other diseases
Ultrasound, mammogram and, if necessary, puncture or partial biopsy may be performed when there are breast lumps or abnormal thickening of some breast tissues.
Treatment of breast pain
Non-pharmacological treatment
l Relaxation: reducing work and life stress, relieving anxiety and depression can significantly reduce stress breast pain.
Wearing a well-fitting bra
Reducing caffeine intake
l Avoid smoking
n Medication
l Over-the-counter medications: over-the-counter pain relievers, vitamins, evening primrose oil, etc.
l Prescription medications: Danazol, Cryptotene, Tamoxifen, etc.
l Chinese herbal treatment: including drugs to de-stress the liver and Qi and to activate blood circulation and remove blood stasis