Hormonal fluctuations cause most cases of mastalgia during puberty, during or before menstruation, during the first three months of pregnancy, during breastfeeding, after childbirth when the breasts often swell as they fill with milk even in women not breastfeeding, and during perimenopause. Mastalgia during these times is normal and does not indicate a serious problem.
Many women experiencing mastalgia fear that they may have breast cancer, however, breast pain or tenderness is not a symptom of breast cancer caused by breast cancer is extremely rare. Inflammatory breast cancer can cause breast pain or tenderness, however,IBC occurs in only 1 to 5 percent of all breast cancers. Other causes of mastalgia include:
- Benign fibrocystic breast disease
- Breast infection
- Injury to breast tissue
- Alcoholism when liver disease occurs
Medications such as digitalis preparations including aldomet, and aldactone, as well as diuretics such as anadrol and chlorpromazine can also cause breast pain.
Diagnostic tests that your doctor may order to determine the cause of your breast pain can include breast biopsy, lab culture of any nipple discharge to test for infection, mammography, fine needle aspiration to remove fluid that can collect in non-cancerous breast cysts, and a microscopic evaluation of nipple discharge called cytology.
Treatments for mastalgia depend on the cause. For example, mastalgia caused by hormonal fluctuations often diminishes with the use of oral contraceptives; breast pain caused by infection requires antibiotics. Reducing sodium intake is helpful when fluid retention causes breast pain. NSAIDs such as ibuprofen often provide effective relief from breast pain.
See your doctor if you experience any type of nipple discharge such as blood or pus. Women who have recently given birth should contact their doctor if their breasts become swollen or hard. Signs of breast infection include redness, pus, and / or fever and require medical care. Other signs that you should see a doctor about breast pain include the onset of a new and painful breast lump that does not resolve after menstruation, as well as constant unexplained breast pain.
Wearing a well-fitted bra that provides good support often helps prevent the onset of breast pain, particularly in women who have large breasts.
Source: Breast Pain; MedlinePlus Medical Encyclopedia; http://www.nlm.nih.gov/medlineplus/ency/article/003152.htm; accessed 08/24/08.
Inflammatory Breast Cancer; National Cancer Institute; http://www.cancer.gov/cancertopics/factsheet/Sites-Types/IBC; accessed 08/26/08.
Breast Pain; MedlinePlus Medical Encyclopedia; http://www.nlm.nih.gov/medlineplus/ency/article/003152.htm; accessed 08/24/08.