An Overview of Mastalgia

Mastalgia is the medical term used to describe breast pain. Such pain is fairly common, with up to 70% of women seeing a healthcare provider about it at some point in their lives, and it is not usually associated with breast cancer. It can be concerning but is often not a sign of a larger problem like cancer.

Despite that, breast pain can be uncomfortable and interfere with a person's life, and treatments are available. An accurate diagnosis is important so the appropriate treatment can be recommended.

This article gives an overview of mastalgia, including its symptoms, types, causes diagnosis, and treatment.

Symptoms

Depending on the cause, mastalgia can include:

• Breast tenderness
• Sharp, burning pain
• Tightness in the breast tissue

The pain may be constant or it may occur only occasionally. It can range from mild to severe.

Causes

Mastalgia can be broken down into two separate categories: cyclic and noncyclic. The causes vary, depending on the kind of mastalgia it is.

Cyclic Mastalgia

Cyclic mastalgia is breast pain that's related to the hormonal variations associated with the menstrual cycle, which affect how your breasts feel over the course of a month.

The pain is often described as a dull, heavy ache, not focused on any specific spot. It affects both breasts and the armpit areas.

Cyclic mastalgia is typically at its worst shortly before the cycle begins, decreasing on the first day of your period and then going away over the next few days. If hormones are the cause, the symptoms should decrease at certain times during your monthly cycle.

Since this type of pain is linked to menstruation, premenopausal females are most likely to experience it. Cyclical breast pain can also be associated with oral contraceptive pills and HRT.

Noncyclic Mastalgia

Noncyclic mastalgia is breast pain that doesn't vary with the menstrual cycle or with hormonal changes. In postmenopausal females, most breast pain is noncyclic, but you can have it before menopause as well.

The pain may be described as sharp or burning and is often felt only in one breast and one particular area of that breast. It's also known as "trigger zone" breast pain because you can point to where it hurts. It's most common between the ages of 30 and 50.

Noncyclical breast pain is often related to:

• An injury
• Surgery
• Infections
• Breast fibroadenoma, or a breast cyst
• Inflammatory breast cancer

Large breasts (either from obesity or genetics) may also be a source of noncyclic mastalgia. They can be especially painful if a supportive bra is not worn. This is due to the stretching of Cooper's ligaments, which are bands of connective tissue that support and shape breast tissue.

Diagnosis

The diagnosis of mastalgia is most often made based on symptoms and a physical breast exam, though imaging studies may be done to further evaluate abnormalities noted during a physical exam.

The chance of mastalgia being a symptom of breast cancer is quite low, but it's important to screen women who are at risk.

Treatment

The best treatment for your breast pain depends on what is causing it.

For both cyclic and noncyclic pain, reassurance and ruling out breast cancer is often a relief. If treatment is needed, there are effective treatment options.

Home Remedies

Many home remedies have been tried to decrease cyclic and noncyclic pain, sometimes with good results.

They include:

• Wearing a well-fitting bra: This can help contain painful breasts and keep them from being pulled uncomfortably.
• Practicing stress relief: Increased stress can affect hormone levels and lead to more discomfort.
• Exercising: Physical activity decreases estrogen, but it's difficult to tell from studies if it really decreases mastalgia.
• Reducing caffeine and eating a low-fat diet: Studies are mixed on how well this works, but it may help some women.

Keeping a journal can also be helpful, especially if you're trying to see a pattern in your symptoms, which is the best way to determine the kind of breast pain you have.

Medications

Easing pain with Tylenol (acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) is another option.

If these first-line interventions don't help, your healthcare provider may suggest prescription medications like Nolvadex (tamoxifen) and Danocrine (danazol). All of these drugs have side effects of their own.

Studies appeared to show the greatest benefit with tamoxifen, but Danocrine is the only medication approved by the Food and Drug Administration (FDA) for treating mastalgia at this time.

Summary

While breast pain is common and often harmless, it can still be bothersome and impact your quality of life. Knowing whether your mastalgia is cyclic or non-cyclic can help determine treatment and management. There are treatments available, and you don't have to live in pain.

A Word From Verywell

Breast pain can be alarming, especially if you usually don't experience it. Try not to panic, and remember that breast pain is common. It's still important to see your healthcare provider for an exam to rule out anything more serious, and to determine what may be causing your pain and how to best treat it.