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Mastalgia by Krisha McCoy, MS

Definition

Mastalgia is breast pain. There are two types of mastalgia: cyclic and noncyclic. Cyclical breast pain is most often associated with menstrual periods. Noncyclical breast pain is not related to the menstrual cycle.

Causes

Mastalgia can be caused by:

Hormonal changes associated with the menstrual cycle
Pregnancy
Trauma to the breast
Arthritis in the chest cavity and neck
Mastitis (breast infection)
Thrombophlebitis
Stretching of breast ligaments
Pressure from a bra
Hidradenitis supportiva
Medicines (eg, hormone medicines, antidepressants, heart medicines)

Risk Factors

Risk factors include:

Having a history of breast surgery
Having a history of arthritis
Having an irritation of cervical (neck) nerve roots
Having large breasts

Cervical Nerve Roots

Symptoms

Symptoms of mastalgia may include pain in the breast area. Pain may be mild or severe. It may occur in both breasts or just one. It may be painful only in one spot or all over the breast.

When Should I Call My Doctor?

Call your doctor right away if you have any signs of infection, such as redness, tenderness, fever, or chills.

Call your doctor if you notice any other changes in your breasts, such as:

Change in the size or shape of your breast
Discharge from your nipple
New lumps or masses felt in the breast
Other changes to the skin on your breasts, such as crusting, dimpling, or puckering

Call your doctor if your breast pain persists, interferes with your daily routine, or is in one specific area of your breast.

If you think you have an emergency, call for medical help right away.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. The diagnosis is most often done with history of pain and physical exam.

Your doctor may order further testing to look for any suspicious changes. These tests may include:

Treatment

Talk with your doctor about the best treatment plan for you. If an underlying cause is found, treatment will be based on that (eg, antibiotics for an infection). General treatment options include:

Medications

Topical nonsteroidal anti-inflammatory drugs (NSAIDS) may reduce the pain associated with mastalgia. Danazol and other prescription medicines may be prescribed to help reduce cyclical mastalgia.

If you are taking hormones (eg, estrogen, progesterone), your doctor may make changes to your medicines to reduce pain.

Other Treatments

Your doctor may suggest some changes depending on the cause of your breast pain. These might include:

Wearing a properly fitting bra that has good support
Avoiding caffeine
Eating a low-fat diet
Using a hot or cold compress

Prevention

The best way to prevent mastalgia is to avoid trauma to the breast. Wearing a sports bra when exercising can also prevent breast pain and tenderness.

RESOURCES:

American Congress of Obstetricians and Gynecologists http://www.acog.org/For_Patients
Office on Women's Health http://www.womenshealth.gov/

CANADIAN RESOURCES:

Canadian Women's Health Network http://www.cwhn.ca
The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org/

References:

Mastalgia. DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated August 1, 2012. Accessed October 9, 2012.
Mastalgia (breast pain). The Ohio State University Medical Center website. Available at: http://medicalcenter.osu.edu/patientcare/healthcare_services/breast_health/common_breast_conditions/mastalgia/Pages/index.aspx . Accessed October 9, 2012.

Last reviewed October 2012 by Andrea Chisholm, MD

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