Breast Pain and Causes

Breast pain (mastalgia) occurs in two separate categories – cyclic and noncyclic. The causes of mastalgia depend on the type of mastalgia it is.

Cyclic Mastalgia

Cyclic mastalgia is the most common type of mastalgia. It occurs periodically on a regular pattern most associated with your menstrual cycle or other hormonal changes. It can also be associated with oral contraceptive pills. Cyclic mastalgia rarely occurs in postmenopausal females.

The hormonal change associated with your menstrual cycle is the rise of estrogen and progesterone levels just before your period. 

The pain from cyclic mastalgia is usually heavy, dull, or aching. It is often accompanied by breast swelling or lumpiness. Most often it affects both breasts and radiates to the armpit. The duration is directly related to the start and end of the menstrual period.

Noncyclic Mastalgia

Noncyclic mastalgia is breast pain that doesn’t vary with hormonal changes. Hence postmenopausal females rarely experience noncyclic mastalgia. Sometimes noncyclic mastalgia is a sharp, stabbing, or burning pain and often occurs only in one breast. It most commonly occurs between the ages of 35 and 50.

The causes of noncyclic mastalgia include:

There is a clear indication that daily iodine supplements for breast pain are effective for reducing pain from cyclic mastalgia. However, it is not so clear that iodine deficiency has a causal relationship to noncyclic mastalgia.

What are the conditions leading to Mastalgia?

The following conditions all can cause breast pain but some are not iodine-deficiency related.

• Fibrosis – Changes in breast tissues effected by hormonal changes (e.g.menstrual period). Fibrosis forms abnormal firm tissues and tenderness, nipple discharge, thickening skin, and lumps. This is often confused with breast cancer but it is not.

• Cysts – Breast cysts are often painful and fluid-filled. They can come and go usually with hormonal changes. Sometimes your doctor will aspirate the cyst but often they will be absorbed and go away.

• Duct Ectasia – This condition usually occurs in women in their 40s and 50s. Its symptoms are breast redness, a dark discharge from your nipple, and pain around your nipple. Sometimes benign lumps will form. Your doctor will want to biopsy to confirm there is no unlikely cancer.

• Fat necrosis. – This usually is associated with breast trauma. A fluid-filled cyst will form and sometimes with painless lumps. Your doctor will biopsy to confirm there is no unlikely cancer.

• Mastitis – This condition is an infection that typically affects breastfeeding mothers. This should be treated by your doctor immediately to prevent infection of the baby.

• Benign breast tumors – Non-cancerous but abnormal breast cells can form solid lumps similar to cancerous lumps.

• Intraductal papillomas – These are tumors found around the nipple. They form within the milk duct tissues. Large tumors can be very painful and require surgery to remove them.

• Sclerosing adenosis – This is a cluster of small nodules or cysts that can combine to form a larger painful but benign lump. The pain can worsen during your menstrual cycle.

Breast Anatomy

Your breast is a complex combination of lobes, lobules, ducts, and connective tissue. The lobules are glands that produce milk. The ducts are tubes that carry milk from the lobules to your nipple.  

The connective tissue consisting of fibrous and fatty tissue fills the spaces between lobules and ducts and contains everything in a nice shape. The size of your breasts is a factor in the amount of fat tissue in your breast.  

Your breasts have no muscle tissue. Muscles lie beneath the breast separating it from your rib cage.

Your breast tissues are nourished by blood arteries and capillaries that carry oxygenated blood to the tissues. 

Your lymphatic system is essential for fighting infections. It is made up of a complex network of nodes and ducts that trap harmful substances and expel them from your body. The lymphatic system forms in tributaries throughout your entire body. 

Unfortunately, they also serve as avenues for cancer cells to metastasize and transport to various organs if not eradicated.

The tissue of your breast is sensitive to hormonal changes that routinely occur before and during menstruation. Those hormonal changes often lead to breast pain of various types.

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