Mastalgia: Definition, Causes, Treatment, and Cyclicity

The Incidence and Management of Cyclic and Non-Cyclic Mastalgia

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women with mastalgia, the medical term for breast pain
Fibromyalgia Symptoms Can Include Breast Pain. http://fibromyalgianewstoday.com/

Mastalgia is a medical term used to describe breast pain. Breast pain can be cyclical, and related to the menstrual cycle, or non-cyclical. Breast pain may also arise from structures outside of the breast. Breast pain is very common, and is most often not associated with breast cancer. That said, it can interfere with quality of life and an accurate diagnosis should be made. When diagnosed, a number of treatment options are available.

Types

Mastalgia if often broken down into 3 separate categories:

Cyclic Mastalgia

Cyclic mastalgia is breast pain that varies with the menstrual cycle, often worst shortly before the cycle begins, decreasing on the day menses starts, and then going away over the next few days. This type of mastalgia is often described as a heavy, achy feeling without localization, and occurring in both breasts.  It often occurs in younger women and disappears upon menopause.

Noncyclic Mastalgia

Noncyclic mastalgia of breast pain does not vary with the menstrual cycle.  It may be described as sharp or burning and is often localized to one breast and one particular area of that breast.  It is most common in women between the ages of 30 and 50 and is sometimes attributed to a breast fibroadenoma or a breast cyst.

Extramammary Mastalgia 

The term "extramammary" describes the that is felt in the breast but is referred from another location - for example, the lungs, the heart, or the esophagus. A syndrome of inflammation of the joints connecting the ribs called Tietze's disease may give rise to this type of pain. Any time a woman has unexplained pain in the region of her breasts, it's important to consider the possibility of heart disease. We've learned that the symptoms of heart disease in women are different from those found in men, and are often vague and atypical. Extramammary mastalgia may also be related to conditions in other structures of the chest and upper abdomen, such as the lungs, esophagus, or gallbladder and stomach.

Prevalence

Mastalgia is very common, estimated to affect half of women at some point in their lifetime. It can occur in any woman (or man) but is somewhat more common in women who are older, those who are larger breasted, and those who participate in less physical activity.

Studies have found that Between 30 percent and 40 percent of women have found that the symptoms have been severe enough to interfere with sex or their sleep. Up to 10 percent of women claim they have lived with mastalgia for at least half of their lifetime. For severe mastalgia, the symptoms often recur after treatment, disappearing on their own in a matter of time.

Diagnosis

The diagnosis of mastalgia is most often made based on symptoms and exam, though imaging studies may be done to evaluate abnormalities noted on exam. The chance of mastalgia being a symptom of breast cancer is quite low, but it is important to screen women who are at risk.

Management

Sometimes, reassurance that you are normal is all you will need. Many things have been tried to decrease the pain, sometimes with good results. These may include:

  • Wearing a well-fitting bra.
  • Practicing stress relief (stress can make this symptom worse).
  • Exercise (exercise decreases estrogen but from studies it's difficult to tell if it really decreases mastalgia).
  • Vitamin E and vitamin B6 have been tried with mixed results.
  • Tylenol or Advil for discomfort.
  • Reducing caffeine in the diet and eating a low-fat diet (again, studies are mixed on how well this works, but it may help for some women).
  • Keeping a journal can be helpful, especially if you are trying to see a pattern in your symptoms.

Treatments

Roughly 15 percent of women seek treatment at some time for mastalgia, though this includes over-the-counter medications such as Tylenol. Medications that have been found to help some women include Tamoxifen, Danazol, and Bromocriptine, though all of these medications can have side effects of their own.  Studies appeared to show the greatest benefit with Tamoxifen, but Danazol is the only medication FDA approved for mastalgia at this time.

Pronunciation: mas-TAL-juh

Also Known As: mammalgia, mastodynia, breast pain, breast tenderness

Common Misspellings: mustalgia, mastaljia, mastalgea

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