Is there anything that could help my breast pain?

Transferencia Directa en Espanol (PDF)

70% of women experience breast pain throughout their lives.

BREAST PAIN IS NOT USUALLY ASSOCIATED WITH CANCER.

ONLY 15% OF WOMEN WITH BREAST PAIN REQUIRE TREATMENT.

2 MAJOR CATEGORIES:

• CYCLICAL
• NON-CYCLICAL

CYCLICAL:

This is the normal pain women experience, usually prior to the onset of menstruation, due to hormonal stimulation.

• Occurs usually before the menstrual period and then subsides
• Not usually seen in post menopausal women unless they are on hormonal replacement therapy
• Can be associated with lump/mass/swelling/cyst
• Charting the pain (i.e keeping a daily diary of pain level) can help confirm cyclical nature
• Limit foods which may contribute to PMS (premenstrual symptoms) which produce arachidonic acid; e.g. certain cheeses and nuts, mushrooms, meats, wine and bananas.

TREATMENT:  Usually knowing the pain is physiologic (normal) and not of significance is all that is needed.  See also treatment below for non-cyclical pain.

NON-CYCLICAL:

This is not related to the menstrual cycle.

• Less common than cyclical breast pain
• Usually felt in one specific area of the breast(s)
• Can be secondary to trauma or biopsy
• Seen in infection/abscess
• In pre and post menopausal
• In pregnancy and when breast feeding/lactating
• May be secondary to water retention
• Usually subsides after one to two years
• Most common in women 40-50 years old
• Pain in the pectoral (chest) muscles from (e.g. exercise) or from costochondritis (inflammation/arthritis at the junction of the ribs and sternum) can mimic non-cyclical breast pain
• May be caused by oral contraceptives and hormones
• May be caused by weight gain
• May be caused by an ill-fitting bra
• Most cancers do not cause pain, although cancer needs to be excluded, particularly if there is a mass or lump felt in the breast

Mammography and ultrasound are the two tests used initially to evaluate women with pain.  Occasionally, an MRI (Magnetic Resonance Imaging) will be done.

TREATMENT:

• Wear a good fitting supportive bra
• Take non-prescription pain medications
• Avoid caffeine  (in coffee, tea, soft drinks and chocolate)
• Limit foods which may contribute to PMS (premenstrual symptoms), which produce arachidonic acid (a fatty acid that contributes to the pain pathway of the body) found in some  cheeses and nuts, red meats, egg yolks, some vegetables
• Losing weight may help breast pain by stabilizing hormone levels
• If felt to be related to water retention take diuretics and avoid salt
• Take Vitamin E ( 400 to 800 IUs per day),  B1 or B6
• Oral evening primrose oil may help
• For severe pain:  prescription drugs—Danazol ( Danocrine—a testosterone derivative) or Bromocriptine. Your doctor will be able to discuss the  side effects
• Taking fluid off (aspiration) with a needle if felt pain to be related to cysts
• Surgery not usually recommended

CONTACT YOUR PHYSICIAN WITH ANY CONTINUING BREAST SYMPTOMS.