Understanding and Treating Breast Pain

Another name for breast pain is called mastalgia. Breast pain that comes and goes with monthly periods is called cyclic. If the breast pain doesn’t follow any pattern that this condition is called noncyclic.

• Cyclic pain is the most common of breast pain. It may be caused by the normal monthly changes in hormones. This pain usually occurs in both breasts. It is usually described as a heaviness or discomfort that travels to the armpit and arm. The pain is generally the most severe before a menstrual period and is often relieved when a period ends. Cyclic breast pain occurs more often in younger women. Most cyclic pain goes away without treatment and usually disappears at menopause.
• Noncyclic pain is mostly seen in women between the ages of 40 to 50 years of age. It may occur in only one breast. It is often described as a sharp, burning pain that occurs in one area of a breast. Usually, noncyclic pain may be caused by a fibroadenoma or a cyst. If the cause of noncyclic pain can be recognized, treating the cause may help the pain go away.

Breast pain can get worse with changes in your hormone levels or in medicines you are taking. Stress can also affect breast pain. You are more likely to have breast pain before menopause than after menopause.

Treatments

• Acetaminophen, such as Tylenol or Panadol.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil or Motrin), naproxen (Aleve or Naprosyn), ketoprofen, or aspirin (Anacin, Bayer). Be sure to follow all labels and instructions. If you are pregnant or trying to become pregnant, talk to your doctor before using any medicine. Do not take aspirin if you are younger than 20.
• Taking magnesium. Magnesium supplements are taken in the second half of the menstrual cycle (usually the 2 weeks before the next period) relieve cyclic breast pain as well as other premenstrual symptoms.
• You may be able to prevent breast pain, tenderness, or discomfort by wearing a sports bra during exercise. It is important that the sports bra fit properly. It should keep the breasts almost motionless and allow them to move together with the chest, not separately. It is important to replace your sports bra as the material stretches and become less supportive. A young woman with developing breasts may need to buy a new bra every 6 months.

Diet

Reducing dietary fat to 15% or less of your dietary intake is likely to reduce breast pain over time. A small study has shown that making this long-term dietary change significantly reduces breast pain.   Diagnosis   A woman with a persistent breast pain (pain not associated with menstrual cycles) or pain associated with a breast lump should see a medical professional for an evaluation. Medical evaluation for breast pain is reliant upon the cause but may include a mammogram. A mammogram an X-ray used to detect abnormalities in the breast that may be too small to see or feel. A needle biopsy may have to be performed. This is a procedure done by inserting a small needle into the lump to recover a cell sample to be reviewed by a pathologist for an accurate diagnosis.

Medical Examinations and other procedures   Clinical Breast Exam – A manual breast exam performed in a clinic by your doctor or nurse practitioner.   Diagnostic Mammogram – A mammogram is an X-ray of the breast. A diagnostic mammogram is used to evaluate a woman with a breast problem or symptom or an abnormal finding on a screening mammogram. It usually includes additional views of one or both breasts.

Ultrasound

Ultrasound is also used to diagnose suspected breast cancer and other breast abnormalities. This test uses high-frequency sound waves to form an image of breast tissues that is displayed on a video screen and photographed for analysis. Because of the different ways various tissue components interact with sound waves, ultrasound can often reveal whether a lump is solid or a fluid-filled, which is not a cancerous cyst.

Fine Needle Biopsy

If breast cancer is suspected, a biopsy is usually done. A fine-needle biopsy involves the extraction of fluid or cells from a lump that can be felt or seen with ultrasound or on a mammogram. A local anesthetic numbs the area before the needle is inserted. If you have a cyst, fluid will come out and the lump will disappear. If the needle extracts cells, the sample is inspected by a pathologist to determine if it is benign or malignant.

Core Biopsy

A core biopsy is virtually the same test as the fine needle biopsy, but a larger needle is used to removes a small cylinder of breast tissue.   Stereotactic Needle Biopsy – This type of biopsy is done when the lump is so small that the doctor cannot insert the biopsy needle accurately. An imaging technique and a computer are used to guide the needle. In this procedure, you lie face down on a special table with an opening that lets the breast hanging down. A mammogram shows the location of the lump and a computer guides the needle.

Surgical Biopsy

In this type of biopsy, all or part of a breast lump is removed surgically for microscopic examination to determine whether cancer is present.

Home Treatment

Breast Self-Exam

It is normal to have some lumpiness or thickening in your breasts. By examining your breasts once each month, you will learn what is normal for you and notice when any changes do occur. Some women find that doing a daily or weekly self-exam works better for them. They become familiar with their breasts at all phases of their menstrual cycle. The more you examine your breasts, the better you will know what is normal for you. Your “job” isn’t just to find lumps, but to notice if there are any changes.

In the shower

With your fingers flat, gently move the pads of your fingertips over every part of each breast. Use your right hand to examine the left breast and your left hand to examine the right breast. Check for any thickening, hard lump or knot.

In front of a mirror

Holding your arms at your sides, look at your breasts. Raise your arms overhead and look for any changes in the shape of the breast or any swelling, dimpling, or changes in the nipples.

Lying down

To examine your right breast, put a pillow under your right shoulder. Place your right hand behind your head. Then, using the fingers of your left hand held flat, press your right breast gently in small circular motions around an imaginary clock face. Begin at the outermost top of your right breast for 12 o’clock, then move to 10 o’clock, and so on, until you get back to 12 o’clock. Each breast will have a normal ridge of firm tissue.

Then move in 1 inch toward the nipple. Keep circling to examine every part of your breast, including the nipple. Repeat the procedure on the left breast with a pillow under the left shoulder and your left hand behind your head. Finally, squeeze the nipple of each breast gently between the thumb and index finger. Any clear or bloody discharge should be reported to your physician immediately.