Breast Pain (Mastalgia)

Breast pain is a frequent complaint women report to their physicians. It is rarely a sign of cancer. In fact, it is usually a sign of properly functioning breast tissue. Breast pain can be divided into three categories:

  • Cyclic
  • Noncyclic
  • Chest wall pain

Cyclic Pain

Cyclic pain is the most common type of breast pain. It usually occurs in women in their 30s or of child-bearing age. Both breasts may be affected. More often than not, one side is worse than the other. The most common area of tenderness is the upper outer quadrant of the breast near the armpit. The pain usually begins the week before your period starts and goes away after your period stops. Symptoms may worsen around the time of menopause. They usually resolve completely after menopause.

Hormonal changes (fluctuating estrogen, progesterone, or adrenaline levels) during the menstrual cycle affect breast growth with each monthly cycle. This causes breast engorgement (swelling) and pain.

Cyclic pain may be exacerbated or worsened by substances found in common foods or drinks. For example, caffeine can further sensitize breast tissue leading to increased breast pain. Avoiding or decreasing your intake of tea, coffee, chocolate, colas and dietary fat may reduce breast pain during your period. Exercise and other stress relieving activities as well as the use of anti-inflammatories have proven to reduce breast pain.

Noncyclic Pain

Noncyclic pain is the second most common form of mastalgia. It occurs in approximately 25% of patients. It is most common in women in their 40’s and is almost always in one breast. The pain is usually sharp and shooting, but is of a shorter duration than cyclic pain. The pain does not fluctuate with the menstrual cycle, but comes and goes randomly.

Noncyclic pain is probably related to the natural aging changes that occur in the breast as a woman moves beyond the child-bearing years. Hormone fluctuations become less cyclic or regular causing similar changes in the breast. It may be associated with normal underlying fibrocystic breast tissue, breast cysts, fibroadenomas (benign breast mass-see below), or a breast infection. Non-cancerous cysts can often be aspirated or drained with a small needle. Generally this pain will resolve on its own. Abscesses or infections can be managed with antibiotics or drainage as necessary (see above). As with cyclic breast pain, avoiding substances like caffeine that may sensitize breast tissue to hormonal fluctuations and using anti-inflammatories may lessen the breast pain experienced.

Chest Wall Pain

Musculoskeletal disorders of the chest wall may cause referred pain (pain that is felt in a location other than where it originates). Sometimes, the referred location may be perceived in the breast. Some of these disorders include costochondritis, arthritis, boney disease of the rib, and pinched nerve from a bulging or ruptured vertebral disc.

Treatment of Breast Pain

This is usually non-surgical in nature. Treatment options may include:

  • Various medications
  • Additional Imaging Studies may be utilized to identify other causes of pain.

Our goal is to coordinate your care allowing you to get back to life. Please call us today at 303‑449‑3642 to schedule an appointment or ask a question. The entire Boulder Breast Center team is here to help.