Manage Your Breast Pain

Breast pain (mastalgia) can occur in anyone with breast tissue -- including men! Women may start experiencing breast pain at puberty, menstruation, pregnancy, and even during menopause. Whether you have pain in both breasts or in one breast, there's no need to panic -- breast cancer seldom causes breast pain. Hormonal changes, weight gain, or benign anatomical changes within the breast may cause pain. Learn what type of pain you have and then use the right treatment to get relief.

Focus on the Details of Your Breast Pain

Before you can get relief for your breast pain, take some time to figure out what may be causing it -- then match the treatment to the cause. Breast pain can be sorted into two major types: cyclical and non-cyclical. Cyclical breast pain fluctuates with your hormones, and is the most common type of breast pain. Non-cyclical breast pain is related to internal anatomical changes, such as injury, surgery, infections or growth of large cysts. Last of all, there is pain that occurs just below your breast in bones, muscles, or nerves. Pain beneath your breast can be just as worrisome as pain within your breast, so please know that all these pains can be properly diagnosed and treated.
       Breast pain can be anything from a vague feeling of tenderness, to a dull ache, to a constant, throbbing pain.  Episodes of breast pain may come on a regular schedule, may happen only once, or may endure for long periods of time.  Most cases of breast cancer are not associated with breast pain.  You may have heard breast pain referred to as mastodynia, mastalgia, mammalgia, or mastitis.  Here are the two main types of breast pain.
Cyclical Breast Pain

Cyclical breast pain happens during a woman's menstrual cycle.  A range of sensations in both breasts can accompany the hormonal ebb and flow that a premenopausal woman normally experiences.  Those of us who have had premenstrual syndrome -- PMS -- know the feeling of achy, swelling breasts that starts before your period and goes on until your menses have stopped. Cyclical breast pain can be due to fibrocystic breast changes, but may also be due to mammary duct ectasia -- two benign breast conditions.

Noncyclical Breast Pain
Noncyclical breast pain is also known as trigger zone pain.  With noncyclical breast pain, you will feel pain in one specific area, and it will be unrelated to your menstrual cycle.  This noncyclical breast pain may occur in only one breast, but may affect both breasts.  This kind of pain also varies in intensity and may be caused not by hormones, but by illness or injury; internal changes brought on by pregnancy, weight gain, or breast surgery; or certain medications.  Hormonal medications, such as HRT or birth control pills, will cause changes in your breast sensitivity.  Wearing an ill-fitting bra can cause breast pain, but it won't cause breast cancer.  In only 5 out of 100 cases of cancer, pain is linked to a breast tumor.

Pain Near Your Breast
Your breasts rest on your chest wall muscles and ribs.  Breasts are threaded through with nerves, blood vessels and connective tissues.  If you feel noncyclical pain in the middle of your chest, it may be due to arthritis -- try some ibuprofen for the pain.  Sometimes you may pull a muscle in your chest and pain will appear beneath one breast.  Again, this isn't breast pain, and should fade as the muscle recovers.  Nerves can get pinched, veins can become inflamed, but anti-inflammatory medications can help resolve this pain.

How To Handle Breast Pain
If you are premenopausal, you can understand the nature of your breast pain by keeping a chart of your cycle and tracking your pain.  Review the chart to see if you have cyclical or noncyclical breast pain.  See your doctor if your pain persists in order to have a clinical breast exam and get proper medications or treatments if those are needed.  And if your body and breasts have changed, perhaps it is time for a bra fitting session and some pretty, supportive, new bras.

Get Relief For Cyclical Breast Pain

Women who are still having a menstrual cycle are likely to have cyclical breast pain –- in fact, about 70% of American women report having periodic breast pain. If you have this type of hormonal breast pain, there are many ways to get relief. Track your menstrual cycle and compare it to your breast pain levels. Bring this record to your breast pain appointment.

If swelling is causing pain, try a support or sports bra. Lose weight if you can, to take the load off your back and breasts. Eat a healthy diet and take your vitamins. Alternate hot and cold packs when pain peaks and won’t fade away. Take ibuprofen or aspirin, but swallow those with a non-caffeinated drink. Ask your doctor if you can take evening primrose oil or black cohosh. Lower your stress levels.
      In younger women, breast pain is often linked with one's menstrual cycle. This kind of pain is called cyclical breast pain. The hormones that rise and fall during menstruation can cause breast tenderness, swelling, aches, and even tingling in your breast.

If your breasts are fibrocystic (noncancerous changes that give your breasts a lumpy or rope-like texture), you'll also notice lumps and bumps more easily during your menstrual period.

Why Do I Experience Breast Pain During Menstruation?

Your monthly menstrual cycle is determined by fluctuations in levels of estrogen and progesterone. These important hormones prepare your breasts and reproductive system for potential pregnancy. Sensations of breast tenderness may come from lobes and ducts enlarging around the time of ovulation.
Breast pain may be worse just before menstruation, and then gradually taper off during and after your period. For some women, breast pain persists constantly but varies in intensity as her cycle progresses. Cyclical breast pain is not a symptom of breast cancer.

Breast cysts, fibrocystic changes, and breast fibroadenomas may also cause fluctuating pain, even though all of these are benign breast conditions.

Getting Treatment For Menstrual Breast Pain

If you're worried about monthly breast pain and you're not sure whether or not it's related to your menstrual period, try keeping a breast pain chart.  This chart will make things easier in the event you need to consult a doctor about your breast pain.

Your doctor may conduct a clinical breast exam, a mammogram, and/or an ultrasound study.

Your doctor may suggest using ibuprofen, vitamin E, evening primrose oil (gamolenic acid), acupuncture, meditation, or stress reduction techniques. If your breast pain persists, there are also prescription medications that may help.

Self-Help For Breast Pain During Menstruation

Here are some tips you can try to help prevent and relieve breast pain during your menstrual period:

Support Bra: Wear a properly fitting support bra, as reducing the bounce and sway of breast tissue during your menstrual period sometimes prevents or reduces breast pain.
Hot or cold packs may help, but don't apply these directly to your breast skin. Use a towel or soft cloth between you and the pack, and apply a hot or cold pack for only 20 minutes at a time.
Pain Relievers: For more relief, try taking ibuprofen or aspirin, both of which contain no caffeine or hormones.
Hydrate: Drink more water and avoid caffeinated beverages. While you're at it, cut back on salt, too, which can contribute to water retention.
Slim Down: Drop some pounds if you need to.
Eat Right: Use a high-fiber, low-fat diet that depends on whole grains and vegetables. Start thinking of meat as a condiment and use it sparingly. This is good for heart health, weight loss, and bone health, as well as breast and bowel health.
Take Vitamins: Taking a daily supplement of calcium (1,000mg to 1,500mg) and vitamin E (800 IUs) may help.
Try Herbs: Consider taking evening primrose oil or black cohosh to reduce breast pain and menopausal symptoms. Be aware that that is no strong scientific evidence for these herbal remedies, and that you should tell your doctor that you are using them. These herbs do not appear to be harmful, but may interact with other drugs and can cause some side effects.
Destress Yourself: Lower your stress levels by doing gentle exercise, taking a tub soak, or using some simple breathing exercises. Aromatherapy may also help bring down stress, which may lower your breast pain.

Home Treatments for Non-cyclical Breast Pain

Pain that is not related to your hormonal cycle may occur in only one breast. It may be sharp or dull, but it will be in one specific area, sometimes called a trigger zone. Non-cyclical breast pain may be caused by an injury, surgery, or the growth of benign breast lumps. It may also be due to clogged milk ducts or infected tissues, and sometimes it is caused by tension and stress.

For bruises or surgical scars, try hot or cold packs, acetaminophen, ibuprofen, or aspirin. If cysts or fibroadenomas seem to be the problem, ask your doctor whether you could take some evening primrose oil or vitamin E. Call your doctor if your nipples are infected or leaking and ask about antibiotics or other prescription medications. Got stress? Try a hot soak in the tub with lavender oil.

Professional Help For Pain Beneath Breasts

Just beneath your breasts are your chest wall muscles, rib cage, spine, heart and lungs. Aches and pains can come from inflammation of chest wall cartilage, arthritis in the breastbone, and bronchitis. Muscles in your back and chest may be strained and pull against bones, sometimes causing soreness or sharp pains. When these pains happen close to your breasts, it can be very hard to pinpoint their location. Try taking acetaminophen, ibuprofen, or aspirin for the pain, and if it does not respond, then call your doctor for a breast pain appointment. You may need antibiotics or further testing to diagnose and treat the cause of your pain.

Treating Breast Cancer Pain

When breast cancer does cause pain, it is rare. Most breast tumors themselves don’t create pain, but some of the treatments -– surgery, drugs, and radiation –- may cause pain. Be sure to let your doctor and nurses know when you have treatment-related pain, as this can be relieved so that you can continue to receive your cancer treatments.

In metastatic breast cancer, pain may be caused by cancer cells in bones, nerves, or organs. This can be relieved by targeted radiation. Your oncologist can prescribe a variety of drugs to help with metastatic cancer pain. Holistic therapies, such as acupuncture, aromatherapy, meditation, and guided imagery, may help alleviate pain also, without creating unwanted side effects.

Bottom Line:

No matter what kind of pain you’re having, discuss it with your health care team and get help. You don't always have to suffer!

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