What is breast pain?
Breast pain, also known as mastalgia, is one of the most common complaints in the breast clinic. It can be described as a discomfort, fullness, tenderness, throbbing, sharp, stabbing, burning pain or tightness in the breast tissue.The pain may be constant or it may occur only occasionally.
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Breast pain can range from mild to severe. It can be divided into cyclical and non-cyclical pain, depending on whether the breast pain is occurring in the premenstrual period or not.
Cyclical Breast Pain
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Clearly related to the menstrual cycle and changing hormone levels
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Described as dull, heavy or aching
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Often accompanied by breast swelling, fullness or lumpiness
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Usually affects both breasts, particularly the upper, outer portions, and can radiate to the underarm
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Intensifies during the two weeks leading up to the start of the menstrual period, then eases up afterward
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More likely to affect people in their 20s and 30s, as well as people in their 40s who are transitioning to menopause
Non-cyclical Breast Pain
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Unrelated to the menstrual cycle
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Described as tight, burning, stabbing or aching sensation
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Constant or intermittent
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Usually affects one breast, in a localized area, but may spread more diffusely across the breast
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In women, most likely to occur after menopause
Where is breast pain felt?
It usually affects both breasts. However, some patients experience pain only on one side.
Who does breast pain affect?
Breast pain can affect both men and women but is more commonly experienced in women. In fact, many (up to 70%) of women may experience mastalgia during their lifetime, especially during the reproductive period.
Breast pain in men is most commonly caused by a condition called "gynecomastia". This refers to an increase in the amount of breast gland tissue that's caused by an imbalance of the hormones estrogen and testosterone. Gynecomastia can affect one or both breasts, sometimes unevenly.
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Why does breast pain occur?
There are many causes of breast pain and most are benign (non-cancerous).
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The most common cause of breast pain is cyclical pain. Cyclical pain is often due to changing hormone levels. The levels of female hormones in our body changes regularly according to the menstrual cycle. The changing hormone levels not only affect the endometrial (womb) lining resulting in shedding (menses). They also affect our skin, intestine, mood/mental wellness and breasts.
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In the breasts, the changing hormones can cause changes in the milk ducts or milk glands. These changes in the ducts and glands can cause breast cysts, which can be painful and are a common cause of cyclic breast pain.
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Non-cyclical breast pain may be caused by:
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Use of a poor-fitting bra
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Medications such as some infertility treatments, oral birth control pills, hormone replacement therapy, certain antidepressants and high blood pressure medicines
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Trauma
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Muscle ache/pain - this is because our breasts sit on a large muscle called the pectorals
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Costochondritis
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Cardiac/heart events
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Referred pain from the neck or back
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Shingles
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How is breast pain assessed & treated?
Evaluation of breast pain will involve taking a proper history about the duration and characteristics of the pain etc.
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Clinical examination will include examination of the breasts and the surrounding areas to determine the cause of the breast pain and whether the pain could be related to another condition.
Additional tests may be performed to aid in diagnosis and these include:
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Mammogram
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Breast Ultrasound
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Chest X-ray
Treatment depends on the cause of breast pain.
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Cyclical breast pain is usually treated with painkillers which can be taken orally or applied on the area causing pain. A trial of evening primrose oil and lifestyle changes may also be needed to help manage the pain.
When should we see a doctor?
Unexplained breast pain that doesn't go away after one or two menstrual cycles, or that persists after menopause, or breast pain that doesn't seem to be related to hormone changes needs to be evaluated.
Notify your doctor as soon as you can should you feel the symptoms prolonging for more than 2 weeks, interrupting your daily activities, or if you find that the discomfort seems to be getting worse. Our experienced doctor will help guide you through diagnosing and treating your condition and get you back to your daily life with a peace of mind.
Dr Jesse Hu: Breast Specialist in Singapore
Dr Jesse Hu is a breast specialist and experienced breast surgeon in Singapore. With a commitment to excellence and a focus on patient well-being, Dr Jesse Hu brings her expertise to the field of breast health. Whether you're seeking preventive consultations or surgical solutions, trust in Dr Jesse Hu's expertise for compassionate care that prioritises your needs.
