Let’s Talk About Breast Pain

Breast pain, also known as mastodynia, is the topic that breast surgeons love to hate and is literally a sore spot for patients. Breast pain is one of the most common complaints I see in my office. The question most patients have when they experience breast pain is “does this mean I have breast cancer?” Take a deep, cleansing breath because I can say, with certainty, that breast pain is nota sign of breast cancer. However, itcanbe a huge annoyance and many patients seek medical attention to ensure that their breast health is on the up and up. 

When you visit your primary care physician or breast surgeon for breast pain, be prepared to potentially answer any or all of the following questions: 

 1.    Is the pain associated with your menstrual cycle? (This is the most common scenario and completely normal.)

2.    Do you consume caffeine (i.e. coffee, tea, chocolate, sodas)?

3.    Have you had any recent trauma to the breast?

4.    Have you felt any breast masses or lumps in addition to the breast pain?

5.    Have you noticed any skin changes or nipple changes (inversion and/or discharge)?

6.    Is the breast pain diffuse or can you pinpoint a particular area of concern?

7.    How long has the pain been present?

8.    Any recent changes in your diet or prescribed medications?

9.    Could you potentially be pregnant? 

10.Are you breastfeeding?

11.Have you had any breast imaging before? If so, was it normal or abnormal?

Most women have considerably dense breast tissue or may have even been diagnosed with fibrocystic breasts. The glandular tissue of the breast is very responsive to the female hormones, estrogen and progesterone, and may even form cysts, in addition to causing considerable pain. When women age and begin to go through menopause, there is a drastic decline in those female hormones and the glandular tissue of the breast involutes. At this point, breast pain usually improves considerably and is no longer a cause for concern. 

There is always a catch and as a breast surgeon, it is my job is to rule out the worst possible diagnosis that could be contributing to your breast pain, which is a potential underlying malignancy or other mass that requires surgical intervention. However, the truth of the matter is that the most common cause of breast pain is cyclical changes in the female hormones, estrogen and progesterone. 

 If you are having breast pain, please inform your physician as soon as possible. You will need an examination and breast imaging. This is standard procedure and will help delineate potential underlying causes of breast pain. If the findings are unremarkable, then there can and should be a discussion regarding how to best manage your breast pain.  Breast pain is managed with conservative measures initially. This may include one or any combination of the following: warm compresses, non-steroidal anti-inflammatory drugs (NSAIDs), such as Tylenol or ibuprofen; minimal or no caffeine intake; vitamin E supplementation; and evening primrose oil, amongst other things. If these don’t work, there are other medications that can potentially be prescribed. But remember: beginning these interventions independently is NOT a substitution for a conversation and thorough evaluation with a physician you trust. 

 If you have any additional questions regarding this information, please contact us. 

With love,

Disclaimer: This article is not a substitution for seeking medical attention.