June 28th, 2012 by Hasham
Breast Lumps and Pain Overview
Breast changes are common. From the time a girl begins to develop breasts and begins menstruating and throughout life, women may experience various kinds of breast pain and other breast changes. Some of these changes normally occur during the menstrual cycle, during pregnancy, and with aging. Breast lumps, tenderness, and other changes may occur. Most breast lumps and other changes are not cancer.
Your breast is composed of several glands and ducts that lead to the nipple and the surrounding colored area called the areola. The milk-carrying ducts extend from the nipple into the underlying breast tissue like the spokes of a wheel. Under the areola are lactiferous ducts. These fill with milk during lactation after a woman has a baby. When a girl reaches puberty, changing levels of hormones cause the ducts to grow and cause fat deposits in the breast tissue to increase. The glands that produce milk (mammary glands) that are connected to the surface of the breast by the lactiferous ducts may extend to the armpit area (axilla).
There are no muscles in the breasts, but muscles lie under each breast and cover the ribs. These normal structures inside the breasts can sometimes make them feel lumpy. Such lumpiness may be especially noticeable in women who are thin or who have small breasts.
Lumps within breast tissue are usually found unexpectedly or during a routine monthly breast self-exam. Most lumps are not cancer but represent changes within the breast tissue. As your breasts develop, changes occur. These changes are influenced by normal hormonal variations.
Breast pain is a common breast problem mostly in younger women who are still having their periods, and happens less often in older women. Although pain is a concern, breast pain is rarely the only symptom of breast cancer. Most breast cancers involve a mass or lump.
Cyclic mastalgia: About two-thirds of women with breast pain have a problem called cyclic mastalgia. This pain typically is worse before your menstrual cycle and usually is relieved at the time your period begins. The pain may also happen in varying degrees throughout the cycle. Because of its relationship to the menstrual cycle, it is believed to be caused by hormonal changes. This type of breast pain usually happens in younger women, although the condition has been reported in postmenopausal women who take hormone replacement therapy.
Noncyclic mastalgia: Breast pain that is not associated with the menstrual cycle is called noncyclic mastalgia. It occurs less often than the cyclic form. It typically occurs in women older than 40 years and is not related to the menstrual cycle. It is sometimes linked to a fibrous mass (called a fibroadenoma) or a cyst.
Breast pain or tenderness may also occur in a teenage boy. The condition, called gynecomastia, is enlargement of the male breast which may occur as a normal part of development, often during puberty.
Breast infection: The breast is made up of hundreds of tiny milk-producing sacs called alveoli. They are arranged in grapelike clusters throughout the breast. Once breastfeeding begins, milk is produced in the alveoli and secreted into tube-shaped milk ducts that empty through the nipple. Mastitis is an infection of the tissue of the breast that occurs most frequently during the time of breastfeeding. This infection causes pain, swelling, redness, and increased temperature of the breast. It can occur when bacteria, often from the baby’s mouth, enter a milk duct through a crack in the nipple. This causes an infection and painful inflammation of the breast.
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Breast pain is any discomfort or pain in the breast.
There are many possible causes for breast pain. For example, hormone level changes from menstruation or pregnancy often cause breast tenderness. Some amount of swelling and tenderness just before your period is normal.
Although many women who have pain in one or both breasts may fear breast cancer, breast pain is NOT a common symptom of cancer.
Menopause (unless a woman is taking hormone replacement therapy)
Menstruation and premenstrual syndrome (PMS)
Pregnancy — breast tenderness tends to be more common during the first trimester and in women who become pregnant at a young age
Puberty in both girls and boys
Soon after childbirth, your breasts may become swollen with milk. This can be very painful. If you also have an area of redness, call your health care provider. Breastfeeding itself may also cause breast pain.
Fibrocystic breast changes are also a common cause of breast pain. Fibrocystic breast tissue contains lumps that tend to be more tender just before your menstrual period.
Certain medications may also cause breast pain, including digitalis preparations, methyldopa (Aldomet), spironolactone (Aldactone), certain diuretics, Anadrol, and chlorpromazine.
Shingles can lead to pain in the breast if the painful blistering rash appears on the skin over one of your breasts.
If you have painful breasts, the following may help:
Take medication such as acetaminophen or ibuprofen
Use heat or ice on the breast
Wear a well-fitting bra that supports your breasts
Although some women believe that reducing the amount of fat, caffeine, or chocolate in their diet helps with their symptoms, there is no good evidence that this helps. Vitamine E, thiamine, magnesium, and evening primrose oil are not harmful, but in most studies they have not shown any benefit. Before taking any medication or supplement, be sure to talk with your health care provider.
Certain birth control pills may help relieve breast pain. Ask your health care provider if this therapy is right for you.
When to Contact a Medical Professional
Call your health care provider if you have:
Bloody or clear discharge from your nipple
Given birth within the last week and your breasts are swollen or hard
Noticed a new lump with the pain that does not go away after your menstrual period
Persistent, unexplained breast pain
Signs of a breast infection, including local redness, pus, or fever
What to Expect at Your Office Visit
Your health care provider will perform a breast examination and ask questions about your breast pain. You may have amammogram or ultrasound.
Your health care provider may schedule a follow-up visit if your symptoms have not gone away in a given period of time. Your health care provider may recommend that you see a specialist if the symptoms do not go away.
What Causes Breast Pain?
There are two main types of breast pain:
Cyclical breast pain is related to how the breast tissue responds to monthly changes in a woman’s estrogen and progesterone hormone levels. If breast pain is accompanied by lumpiness, cysts (accumulated packets of fluid), or areas of thickness, the condition is usually called fibrocystic change. During each menstrual cycle, breast tissue sometimes swells because hormonal stimulation causes the breast’s milk glands and ducts to enlarge, and in turn, the breasts retain water. The breasts may feel swollen, painful, tender, or lumpy a few days before menstruation. Breast pain and swelling usually ends when menstruation is over. The average age of women who have cyclical breast pain is 34 years old. Cyclical breast pain may last for several years but usually stops after menopause unless a woman uses
Breast pain: what does it mean?
Breast pain is one of the most common breast problems. Pain can range from mild to severe, and sometimes requires treatment. It may affect one or both breasts, or can radiate into the armpit. In general, breast pain is not a sign of cancer.
Types of breast pain
There are 3 types of breast pain: pain related to the menstrual cycle, pain not affected by the menstrual cycle, and pain originating in the chest that feels as though it is in the breast.
Breast pain related to the menstrual cycle: This pattern of pain seems to be related to changes in hormone levels. Women usually feel increased breast pain before their menstrual period and a reduction in pain afterwards. Pain can be present with or without accompanying lumpiness of the breast due to a fibrocystic condition. Because stress can also affect hormone levels, this may influence breast pain.
Breast pain not affected by the menstrual cycle: This type of breast pain can show up in either premenopausal or postmenopausal women. It may be felt in one specific area of the breast and is sometimes called “target zone” breast pain. It may occur in one or both breasts. In some women it lasts for as long as one or 2 years, then disappears.
Sometimes this pain is caused by trauma to the breast, or it will center on the site of a previous breast biopsy. In most cases, doctors don’t know the cause of this continuous type of pain. Although breast cancer is very rare in women with this form of pain, it still must be ruled out with tests.
Breast pain originating in the chest: This category is not really a form of breast pain, but is actually a type of chest pain that feels as though it is coming from the breast. This type of arthritic pain originates in the middle of the chest and is called costochondritis. It occurs where the ribs and breastbone connect. Poor posture and the aging process can contribute to increased stress on these joints, resulting in pain. This pain does not change with the menstrual cycle.