Breast Pain - Dr.Adem Dervişoğlu, MD, Professor

Dr.Adem Dervişoğlu, MD, Professor

Breast Pain

What Causes Breast Pain?

The real cause of pain in the breast is generally unidentified. The hormonal status of the individual is associated with pain. Fibrocystic disease is the most common cause of breast pain. Cysts growing at certain sizes in the breast may cause pain. Breast pain is an important clinical finding in patients with breast abscess or infection with accompanying symptoms of redness, increased temperature, and swelling. Breast trauma and thrombosis of the breast veins are among the rare causes of pain originating from the breast. The major cause of pain in women with large breasts is the weight of the breast.

Muscle pain beneath the breast tissue and arthritis of the ribs may require a visit to a physician with a complaint of pain in the breast. Changes in the psychological state of an individual account for a considerable portion of the causes of breast pain. Emerging breast pain is also a common psychological problem in women with family members or acquaintances diagnosed with breast cancer.

HOW IS THE DIAGNOSIS MADE AND TREATMENT CARRIED OUT?

Fibrocystic breast is not dangerous but a disturbing condition for the individual due to the associated symptoms. Fibrocystic disease of the breast is not associated with the increased risk of developing cancer. Changes in the breast make it difficult to detect and identify cancerous masses during breast examinations. In some cases, some pathological changes in these areas increase the risk of developing breast cancer. A biopsy may be required for the differential diagnosis.

The characteristics of the pain should be questioned. The relationship of the pain with menstrual cycles, the duration of pain, the factors or conditions associated with pain alleviation or recovery, and whether the pain causes difficulties in the daily or business life should be understood. Information should be obtained whether the pain relieves spontaneously or with medication. After a physical examination, breast ultrasound is performed in women under 40 years of age. In women older than 40 years old, both mammography and breast ultrasound are performed after the physical examination.

Patients with breast pain should see a physician if the pain is associated with a mass in the breast, if the pain persists at the same location all the time independent of the menstrual cycles, and if the pain is accompanied by redness, swelling, increases in temperature.

The initial treatment should aim to treat the factors related to breast pain if they are identified. If an infection is detected, abscess or infection should be treated. Other modes of intervention include needle aspiration of growing cysts, surgical removal of masses growing in the breast tissue, treatment of the  inflammation in the breast or around the milk ducts with antibiotics, treatment with anxiolytics for stress-induced pain, and treatment of the underlying factors due to myalgia or rheumatic causes.

It is not always necessary to treat pain if the pain is associated with the menstrual cycles and does not cause any serious complaints. Also, some recommendations and medications can alleviate pain. Caffeine intake can be limited by cutting back on some types of foods; such as coffee, tea, cola drinks, and chocolate. Reduction of the intake of fermented food including beer, cheese, and wine can alleviate the pain, too. Also, wearing the appropriate bra size provides relief. Reducing the fat intake, increasing the intake of fibers and fruits, controlling body weight, walking, and exercising may help reduce the pain. Aspirin, paracetamol or analgesics are effective for pain relief. Vitamin E preparations and evening primrose oil relieve the tension in the breast. In recent years, preparations containing monk’s pepper (agnus castii) are commonly used.

WHAT IS THE RELATIONSHIP BETWEEN BREAST PAIN AND CANCER?

The biggest fear of women with breast pain is the possibility of cancer. There is no direct relationship between breast pain and cancer. Only a minority of patients with breast cancer may have pain accompanied by other complaints.

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