What are the common causes of breast pain?

At least two in three women gets breast pain, ranging from mild discomfort on few days a month to a source of constant distress. Doing some detective work on what it's linked to can help your GP to help you manage the misery.

Cyclical breast pain

The most common kind of breast pain is 'cyclical' - starting in the second half of your cycle and stopping with your period. This begins most commonly in your 30s or 40s, and goes after the menopause (unless you're taking HRT).

Cyclical breast pain is thought to happen because your breast tissue is particularly sensitive to the normal hormone changes that happen during your menstrual cycle. That's why some women find their symptoms get worse if they get pregnant or take the oral contraceptive pill. The good news is that this is one thing you won't have to worry about after you go through the menopause!

Non-cyclical breast pain

The other kind of breast pain is 'non-cyclical' - it doesn't come and go predictably at the same time every month. It's more common in the over-40s, and can happen after the menopause. It can affect both breasts or just one (or part of one). The key is to work out if the pain is coming from the breasts themselves or from the muscles and bones of the chest wall under the breasts. Your GP can help you tease this out.

Mastitis and shingles

Shingles can cause pain over the skin of the breasts before a rash occurs. An infection in the breast called mastitis also causes pain, usually on one side. Pregnancy can cause swelling and pain in the breasts. Pain is rarely a sign of cancer or a non-cancerous cyst, especially if there's no lump to feel. However, pain in one breast should always be checked out if it persists.

Treatments

Whatever kind of breast pain you have, getting a properly fitted, supportive bra and buying new bras regularly (if they've gone grey they've probably also lost their support!) can make a big difference. Underwired bras can worsen pain, but a sports bra for exercise is a must. Anti-inflammatories (like ibuprofen) in tablet or rub-on form may also be worth trying.

For cyclical breast pain, changing or stopping your contraceptive pill may help - but obviously don't do that without using another reliable form of contraception. In very severe cases, female hormone-blocking medicines can be tried, but they commonly cause side effects of their own. Some women swear by evening primrose oil for breast pain - but there's no good evidence it works, so you can't get it on prescription.

Most of us have learnt from experience that as you get older, everything drops a bit. Your skin is largely made up of a protein called collagen, which provides support as well as flexibility. As you get older, all your skin gets less firm - and the skin over your breasts is no exception. But you should love yourself just the way you are.

Breast pain and cancer

It's hardly surprising that almost every woman who asks me about breast pain is worried about cancer. Interestingly, most women diagnosed with breast cancer haven't had any pain from it.

However, it's hugely important to be breast aware so you can get changes in your breasts checked out early. Use the flat of your fingers to check for lumps or changes in breast tissue. Get into the habit of looking and feeling your breasts when you're in the bathroom or bedroom. Look for changes in the contours of your breasts - especially areas where the skin is puckered, as if something is tethering it from inside. Be alert for discharge (particularly if it's bloodstained) from your nipples, or changes in their shape such as a newly turned-in nipple. Persistent dry skin or scabbing on the nipple, as well as a dimpled 'orange peel' appearance of breast skin should also be looked at by your doctor.

Do remember that even if you do find a lump, there are lots of other things it might be apart from cancer. Clearly you should always get a doctor to check it out quickly, but don't panic too much. The patients I see end up getting good news more often than bad.

With thanks to 'My Weekly' magazine where this article was originally published.

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.



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