Breast Pain
Breast pain (mastalgia) — a common complaint among women — can include breast tenderness, sharp burning pain or tightness in your breast tissue. The pain may be constant or it may occur only occasionally.
Breast pain can range from mild to severe. It can affect you just a few days a month, for instance just before your period, or can last for seven days or more each month. Breast pain may affect you just before your period or it may continue throughout the menstrual cycle. Postmenopausal women sometimes have breast pain, but breast pain is more common in younger, premenopausal women and perimenopausal women.
Most times, breast pain signals a noncancerous (benign) breast condition and rarely indicates breast cancer. Still, unexplained breast pain that doesn't go away after one or two menstrual cycles or that persists after menopause and occurs in one specific area of your breast needs to be evaluated by your doctor.
Tests and diagnosis
Tests to evaluate your condition may include:
- Clinical breast exam. Your doctor checks for changes in your breasts, looking at and feeling your breasts and the lymph nodes in your lower neck and underarm. Your doctor will likely listen to your heart and lungs and check your chest and abdomen to determine whether the pain could be related to another condition. If your medical history and the breast and physical exam reveal nothing unusual, you may not need additional tests.
- Mammogram. If your doctor feels a breast lump or unusual thickening, or detects a focused area of pain in your breast tissue, you'll need an X-ray exam of your breast that evaluates the area of concern found during the breast exam (diagnostic mammogram).
- Ultrasound. An ultrasound exam uses sound waves to produce images of your breasts, and it's often done along with a mammogram. You might need an ultrasound to evaluate a focused area of pain even if the mammogram appears normal.
- Breast biopsy. Suspicious breast lumps, areas of thickening or unusual areas seen during imaging exams may require a biopsy before your doctor can make a diagnosis. During a biopsy, your doctor obtains a small sample of breast tissue from the area in question and sends it for lab analysis.
Treatments and drugs
For many women, breast pain resolves on its own over time. You may not need any treatment.
If you do require treatment, your doctor might recommend that you:
- Eliminate an underlying cause or aggravating factor. This may involve a simple adjustment, such as wearing a bra with extra support.
- Use a topical nonsteroidal anti-inflammatory (NSAID) medication. You apply the medication directly to the area where you feel pain.
- Adjust birth control pills. If you take birth control pills, skipping the pill-free week or switching birth control methods may help breast pain symptoms. But don't try this without your doctor's advice.
- Reduce the dose of menopausal hormone therapy. You might consider lowering the dose of menopausal hormone therapy or stopping it entirely.
- Take a prescription medication. Danazol is the only prescription medication approved by the Food and Drug Administration for treating breast pain and tenderness. However, Danazol carries the risk of potentially severe side effects, such as acne, weight gain and voice changes, which limit its use. Tamoxifen, a prescription medication for breast cancer treatment and prevention, may be recommended for some women, but this drug also carries the potential for side effects that may be more bothersome than the breast pain itself.
Breast Cancer
Breast cancer is cancer that forms in the cells of the breasts. After skin cancer, breast cancer is the most common cancer diagnosed in women in the United States. Breast cancer can occur in both men and women, but it's far more common in women.
Substantial support for breast cancer awareness and research funding has helped improve the screening and diagnosis and advances in the treatment of breast cancer. Breast cancer survival rates have increased, and the number of deaths steadily has been declining, which is largely due to a number of factors such as earlier detection, a new personalized approach to treatment and a better understanding of the disease.
Tests and diagnosis
Tests and procedures used to diagnose breast cancer include:
- Breast exam. Your doctor will check both of your breasts and lymph nodes in the armpit, feeling for any lumps or other abnormalities.
- Mammogram. A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality.
- Breast ultrasound. Ultrasound uses sound waves to produce images of structures deep within the body. Ultrasound may help distinguish between a solid mass and a fluid-filled cyst. An ultrasound is often obtained as part of the examination of a new lump.
- Removing a sample of breast cells for testing (biopsy). Biopsy samples are sent to a laboratory for analysis where experts determine whether the cells are cancerous. A biopsy sample is also analyzed to determine the type of cells involved in the breast cancer, the aggressiveness (grade) of the cancer, and whether the cancer cells have hormone receptors or other receptors that may influence your treatment options.
- Breast magnetic resonance imaging (MRI). An MRI machine uses a magnet and radio waves to create pictures of the interior of your breast. Before a breast MRI, you receive an injection of dye.
Other tests and procedures may be used depending on your situation.
Staging breast cancer
Once your doctor has diagnosed your breast cancer, he or she works to establish the extent (stage) of your cancer. Your cancer's stage helps determine your prognosis and the best treatment options. Complete information about your cancer's stage may not be available until after you undergo breast cancer surgery.
Tests and procedures used to stage breast cancer may include:
- Blood tests, such as a complete blood count
- Mammogram of the other breast to look for signs of cancer
- Breast MRI
- Bone scan
- Computerized tomography (CT) scan
- Positron emission tomography (PET) scan
Not all women will need all of these tests and procedures. Your doctor selects the appropriate tests based on your specific circumstances and taking into account new symptoms you may be experiencing.
Breast cancer stages range from 0 to IV with 0 indicating cancer that is noninvasive or contained within the milk ducts. Stage IV breast cancer, also called metastatic breast cancer, indicates cancer that has spread to other areas of the body.
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