What is breast pain?

Breast pains are severe, sharp, stabbing, shooting or throbbing pains of the breast either felt on the outside of the breast (superficial) or deeper within the breast tissue. Pain may be a result of breast inflammation and can be accompanied by breast swelling, warmth/heat and/or redness of the skin.

Breast pain (medical term ~ mastalgia) is an indication of pathology of the breast itself or underlying organs within the thoracic cavity (thorax or chest). Less commonly, breast pain may indicate pathology at other areas with referred pain to the breast.

Breast Pain or Sore, Tender Breasts

It is important to differentiate between sore or tender breasts and pain. Tender breasts are a common occurrence in normal physiological phases in a woman’s life, like prior to menstruation and pregnancy. Breast pain is usually an indication of pathology that needs to be investigated.

Questions to ask yourself when differentiating breast pain from soreness or tenderness.

  • Is the pain aggravated with touch or pressure to the point that it is excruciating and unbearable? Pain is usually excruciating and unbearable even with light pressure.
  • Is the pain affecting your mood, ability to concentrate and focus on work? Pain impairs mental functioning and impacts on your emotional state.
  • Is the pain affecting your sleep patterns or normal body movements? Pain disturbs your normal sleep pattern, either falling asleep or maintaining sleep and impairs normal body movements which may aggravate the sensation of pain.
  • Do you need to use pain killers constantly to ease the level of discomfort and function properly? Persistent pain usually requires anti-inflammatory drugs or analgesics to reduce the sensation and allow for normal sleep and mental or physical functioning.

Breast pain or other breast symptoms are indicative of  underlying pathology that needs to be identified, investigated and treated.

Localized Causes of Breast Pain

Unilateral (one side) or bilateral (both sides) breast pain, either intermittent or persistent, due to causes directly related to pathology within the breast.

  • Mastitis (breast infection)
  • Breast Abscess
  • Breast Cancer
  • Fat necrosis
  • Trauma or Injury
  • Breast augmentation or surgery (post-operatively)
  • Fibrocystic breast disease
  • Mastodynia
  • Excessive intake of certain hormone altering/regulating drugs like oral contraceptives, hormone replacement therapy and fertility drugs.

Non-Localized Causes of Breast Pain

Unilateral or bilateral breast pain, either intermittent or persistent,  due to causes or pathology of other areas of the body (lungs, heart, muscles or bones of the chest, spinal column, jaw or dental causes). Breast pain in these cases may be a result of referred pain or perceived as pain of the breast itself.

  • Lung infections
  • Inflammatory lung disease
  • Lung cancer
  • Angina
  • Myocardial infarction (heart attack)
  • Psychosomatic or ‘chest pains’ due to anxiety.
  • Cirrhosis of the liver
  • Abdominal pathology causing abdominal pain
  • Heartburn / Gastroesophageal reflux disease (GERD)
  • Cervical spondylosis
  • Rib or sternal injury or fracture
  • Muscle pain – pectoral muscles and intercostal muscles
  • Shingles

Diagnosis of Breast Pain

If you are experiencing persistent breast pain, which is severe and aggravating with time, it is advisable to seek immediate medical attention. A comprehensive case history followed by physical examination would be the first approach to diagnosing the cause of breast pain. It is important to inform your doctor of any aggravating or ameliorating factors – contributing factors that may increase, reduce or relieve pain temporarily. Based on your doctor’s assessment of your case history and physical examination, further diagnostic investigation (tests and procedures) may be required to confirm a diagnosis.

Diagnostic Procedures for Breast Pain

  • Mammography to identify masses within the breast or a chest x-ray to identify lung pathology and fractured ribs.
  • Culture and cytology of any nipple discharge or from the breast lesions to identify microorganisms causing infection.
  • Fine needle aspiration for the removal and investigation of fluid within a cyst.
  • Magnetic Resonance Imaging (MRI)

Treatment of breast pain will be directed at the causative factor(s) once diagnosed.

References

  1. Breast Pain. Merck
  2. Causes of Breast Pain. Wrongdiagnosis

Article reviewed by Dr. Greg. Last updated on December 17, 2011