Breast Pain

Breast Pain Women’s Clinic Breast pain can cause a lot of anxiety. Many women worry that they may have breast cancer. You may find it reassuring to know that breast pain alone is usually not a sign of breast cancer. This information helps you understand more about breast pain and what it means to you.

often goes away once the period starts.

Breast pain is very common in women across all ages.

Approximately 2 out of 3 premenopausal women (women who have not been through the menospause) will experience breast pain at some point in their lives. There are two main categories of breast pain, both of which can be treated.

Cyclical breast pain Cyclical breast pain is linked to changing hormone levels during the menstrual cycle, which mainly affects premenopausal women.

These hormonal changes make the breast tissues more sensitive, which in turn can cause pain.

Breast pain that is part of a woman’s normal menstrual cycle is known as ‘cyclical breast pain’.

Women may experience it as discomfort and lumpiness in their breast a week or so before their period. The breast becomes tender and sore to touch. The pain can also vary from mild to severe. It

Some women have lasting pain in the breast that is not related to their menstrual cycle and may be coming from elsewhere in the body. This is known as ‘noncyclical breast pain’.

You may experience heaviness, tenderness, burning, prickling or stabbing pain, or feel tightness in the area. The pain can affect one or both breasts and can spread to the armpit, down the arm and to the shoulder blade. This type of pain usually stops when the ovaries become inactive after menopause. However, women on hormone replacement therapy

(HRT) after their menopause can also experience breast pain. This is because the HRT maintains some hormones at a pre-menopausal level.

before and after menopause. The pain can be in one or both breast and can affect the whole breast or a specific area. The pain may last from a few minute up to a few days.

Common causes of cyclical breast pain Although cyclical breast pain is linked to the menstrual cycle, its exact causes are unknown.

Pain can also be associated with consuming contraceptive pill, certain anti-depressant drugs, herbal remedies like ginseng, or even stress.

Common causes of non-cyclical breast pain It is not entirely known what causes breast pain that is not linked to the menstrual cycle. It may be due to certain non-cancerous (benign) breast conditions, previous breast surgery or underlying medical conditions, previous breast surgery or underlying medical conditions not directly related to the breasts.

Common causes of non-cyclical breast pain There are two types of non-cyclical breast pain: • True non-cyclical breast pain comes from the breast but is not linked to the menstrual cycle. • Extramammary or chest wall pain (known as musculoskeletal pain) is felt in the area of the breast but actually comes from elsewhere, such as the muscles, bones and joints.

Both types can result in continuous pain or pain that comes from time to time and can affect women

Diagnosis Your doctor will examine your breasts and take a detailed history of the type of pain you have and how often it occurs. To check if the pain is linked to your menstrual cycle, your doctor may ask you to keep a record on when the pain occurs.

If your doctor thinks you have non-cyclical breast pain, they may conduct further examination on your breast by asking you to lean forward. This will help the doctor assess whether the pain is within your breasts or in the chest wall.

Treatment If you have cyclical breast pain, your doctor may reassure you that what you are expriencing is a part of your monthly cycle and is normal. However, the treatment options for cyclical and noncyclical pain are not always as easy.

Diet and lifestyle changes For a start, your doctor may suggest simple things you can do to help reduce the pain. These include reducing your intake of caffeine, chocolate and red wine, while increasing the amount of fresh fruits and vegetables you eat, and engaging in regular exercise to help maintain a healthy weight.

You may also be advised to wear a supportive and correctly fitted bra.

Some women have found relaxation therapy, such as listening to soothing music, useful in reducing the symptoms of cyclical breast pain. Other complementary therapies that promote well-being, such as acupuncture and aromatherapy, may also be helpful.

If your pain started when you began taking a contraceptive pill, changing to a lower dosage pill or a different brand may help. If

the pain continues, you may want to try non-hormonal methods of contraception such as condoms or a diaphragm.

There is evidence that having low levels of an essential fatty acid “gamolenic acid (GLA)� can contribute to cyclical breast pain.

However, recent research has shown that taking additional GLA does not reduce pain levels.

Despite this, your doctor may suggest that you take evening primrose or starflower oil (which containts GLA), as some women have found it helps them feel better.

Evening primrose oil does not usually cause any side effects, but you may experience nausea, stomach upset or headaches. It is not advisable to consume evening primrose oil if you are pregnant or trying to get pregnant. People with epilepsy are advised not to take evening primrose or starflower oil.

Treatment for pain from elsewhere Pain from elsewhere usually comes from the chest wall (musculoskeletal) area. It can be associated with underlying problem such as inflammation

(swelling) of the chest wall.

This is called costochondritis.

Costochondrities affect parts of the ribs (called costal cartilages) while lateral chest wall pain involves the sides of the chest wall.

Your doctor may be able to tell whether the costal cartilages may cause pain when pressure is put on them. Sometimes the pain caused by the inflammation can feel similar to heart pain. You may feel tightness in the chest and a severe, sharp pain. The pain may also spread down the arm and can feel worse when you move.

You might find it helpful to rest and avoid sudden jerky movements that increase pain. Pain relief such as Paracetamol or Ibuprofen (either as a cream, gel or tablet) may be helpful. Your doctor may also suggest local anaesthetic or steroid injections for the painful area.

Occasionally, pain from other conditions such as, angina (tightness across the chest) or

gallstones, can be felt in the breast. This is known as referred pain. If this happens, your doctor will advise you on the most appropriate treatment.

Breast pain can be very distressing, and many women are anxious that they may have breast cancer.

In most cases, breast pain will be the result of normal changes that occur in the breast. Women affected by breast pain may feel a range of emotions - fear, frustration and helplessness, are common reactions. Understanding more about your breasts may not bring relief but it may help you get back some control over your life.

Having breast pain does not increase your risk of breast cancer.

However, it is still important to be breast aware by routinely examining your breasts. Consult your doctor if you notice any abnormal changes in your breast.

Yishun Health is a network of medical institutions and health facilities in the north of Singapore, under the National Healthcare Group.

Admiralty Medical Centre • (65) 6807 8000 • www.admiraltymedicalcentre.com.sg Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg The information is correct at the time of printing and subject to revision without further notice.

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