Breast pain (mastalgia)

Mastalgia, commonly known as breast pain, is a common condition experienced by many women at some point in their lives. The pain can vary in intensity, duration, and frequency, and may affect one or both breasts. While mastalgia can be concerning, it is important to know that breast pain is rarely a sign of breast cancer, especially when not accompanied by other symptoms. However, any new or persistent pain should be evaluated by a healthcare professional to rule out other conditions.

Types of mastalgia

Mastalgia is generally categorised into two types: cyclical and non-cyclical.

Cyclical mastalgia: This type of breast pain is linked to the menstrual cycle and is usually hormone-related. It commonly occurs in the days leading up to a period and often resolves once menstruation begins. Cyclical mastalgia typically affects both breasts and is more common in younger women. The pain may feel heavy, tender, or dull, and can fluctuate with the menstrual cycle.
Non-cyclical mastalgia: This type of breast pain is not related to the menstrual cycle and can occur at any time. It may affect one breast or a specific area of the breast, and the pain may be sharp, burning, or constant. Non-cyclical mastalgia is more common in older women, and its causes can include benign breast conditions, such as cysts or trauma, as well as muscle or joint pain in the chest wall (known as musculoskeletal pain).

Causes of mastalgia

The causes of mastalgia can vary depending on the type:

Cyclical mastalgia is primarily caused by hormonal fluctuations. Changes in hormone levels during the menstrual cycle can lead to breast tissue swelling and tenderness.

Non-cyclical mastalgia may be caused by several factors, including:
- Breast cysts or fibroadenomas: Benign lumps or growths in the breast tissue that may cause discomfort or pain.
- Infection or inflammation: Mastitis, an infection of the breast tissue, can cause pain, swelling, and redness, particularly in breastfeeding women.
- Chest wall pain: Conditions affecting the muscles or joints near the breast, such as costochondritis (inflammation of the rib cartilage), can mimic breast pain.
- Medications: Certain medications, including hormonal treatments, antidepressants, and cardiovascular drugs, may contribute to breast pain.

Symptoms of mastalgia

Mastalgia can present in different ways, depending on the cause and type of pain. Common symptoms include:

A dull ache or heaviness in one or both breasts
Tenderness or soreness, especially before a menstrual period
Sharp, burning, or stabbing pain in the breast
Pain that radiates to the armpit or arm
Sensitivity to touch in the breast area

In most cases, breast pain is not a sign of a serious condition, but if you notice other symptoms such as a lump, nipple discharge, or skin changes, it’s important to seek medical advice.

Diagnosis

If you are experiencing persistent or severe breast pain, your GP may refer you to a breast clinic for further evaluation. Diagnostic tests may include:

Clinical breast examination: A doctor will examine your breasts to check for lumps, tenderness, or any other abnormalities.
Mammogram or ultrasound: These imaging tests can help identify any underlying causes of the pain, such as cysts or lumps.
MRI: In some cases, an MRI may be used to provide more detailed images of the breast.
Biopsy: If a lump is found, a small sample of tissue may be taken for analysis to rule out cancer or other conditions.

Treatment options

The treatment for mastalgia depends on the underlying cause and the severity of the pain. Common treatment options include:

Lifestyle changes: Wearing a supportive bra, especially during exercise, can help reduce discomfort. Limiting caffeine and reducing dietary fat may also ease symptoms for some women.
Pain relief: Over-the-counter pain medications such as paracetamol or ibuprofen can help manage mild to moderate breast pain. In some cases, prescription medications may be necessary.
Hormonal treatments: For women with cyclical mastalgia, hormonal treatments such as oral contraceptives or hormone replacement therapy (HRT) may be recommended to regulate hormone levels and reduce pain.
Treatment for underlying conditions: If the pain is caused by an underlying condition, such as a cyst or infection, treating that condition can help alleviate the pain. This may involve draining a cyst or prescribing antibiotics for an infection.
Topical treatments: Some women find relief from breast pain by applying topical pain relievers, such as diclofenac gel, to the affected area.

Possible risks of treatment and recovery

Mastalgia itself is rarely harmful, but it can impact daily activities and cause distress. If surgery or other invasive treatments are required for an underlying condition, risks include infection, bleeding, and scarring. However, recovery is typically straightforward, and most cases of breast pain resolve with appropriate treatment and care.

Why choose Birmingham Breast Clinic?

At Birmingham Breast Clinic, we specialise in diagnosing and treating breast conditions, including mastalgia. Our experienced team offers a comprehensive and personalised approach to your care, ensuring accurate diagnosis and effective treatment tailored to your needs. With access to the latest diagnostic technologies and a dedicated team of breast care specialists, we provide prompt, compassionate care to help you manage your symptoms and improve your quality of life.

Contact us

If you are experiencing breast pain or have concerns about mastalgia, contact Birmingham Breast Clinic to schedule a consultation.