Breast pain is extremely common; however it is also the source of much concern among women. The medical term for breast pain is mastalgia or mastodynia. The pain is often cyclic, which means that it occurs in relation to (often just before) the menstrual period, and is related to changes in the level of estrogen and progesterone. The pains are at times severe, and most commonly occur in the upper outer breast and may also extend to the nipple or underarm. Usually the pains resolve after the menstrual period begins.
Non-cyclic mastalgia refers to pains which are not related to the menstrual period. Often, only one breast will have pain, and it may be localized to a single pinpoint area. The pains may be fairly constant and “aching” in nature, or may be sharp, burning, or stabbing in character. Evaluation to rule out a specific mass or cyst is indicated, but most times, the pains are not related to any specific lesion (including cancer), and often resolve over time. Pulled chest wall muscles, pinched nerves, or costochrondritis (inflammation of the cartilage of the ribcage) may also cause pain which appears to originate in the breasts.
Careful history and examination can usually rule out a significant cause of the pain. Often, a mammogram or ultrasound will be done to ensure that there is no mass or other specific lesion causing the pain. If no specific abnormality is found, simple maneuvers such as reducing intake of caffeine, salt, and tobacco, wearing a supportive bra, and using over-the-counter medications such as ibuprofen during the premenstrual period will help to control symptoms. Vitamin E, B-complex vitamins, and Evening Primrose Oil have also shown benefit in some patients in treating persistent pain, but none has been proven effective in placebo-controlled clinical trials. For more severe cases, hormonal agents may also be indicated. Persistent pains or pains associated with any mass or lump require evaluation by a physician.