Breast Pain: Causes, Symptoms, and When to Seek Help

Breast pain

Hello, Dr.
Lin.
Recently, while massaging my breasts, I felt a small lump that hurts when pressed firmly, and it seems that some surrounding areas are also painful, which was not the case before.
Could you please help me understand the possible reasons for this and the symptoms associated with it? Additionally, which department should I visit for an examination, general surgery or obstetrics and gynecology? Thank you very much for your assistance.

Ting Ting, 30~39 year old female. Ask Date: 2003/08/07

Dr. Lin Kecheng reply Surgery

A 33-year-old woman has palpable lumps in her breast that are tender to the touch.
If these occur during the menstrual cycle, there is a higher likelihood that they are benign fibroadenomas.
It is recommended to visit a general surgeon (or preferably a breast surgeon) for further physical examination and ultrasound evaluation.
Please do not panic until detailed examination results are available.
Wishing you good health.
Lin Kecheng 0810

Reply Date: 2003/08/07

More Info

Breast pain, also known as mastalgia, is a common concern among women and can arise from various causes. Understanding the underlying reasons for breast pain is essential for determining the appropriate course of action and when to seek medical help.

Causes of Breast Pain
1. Hormonal Changes: One of the most common causes of breast pain is hormonal fluctuations, particularly related to the menstrual cycle. Many women experience breast tenderness or pain in the days leading up to their period due to changes in estrogen and progesterone levels. This type of pain is often cyclical and can be expected to resolve after menstruation.

2. Fibrocystic Breast Changes: This condition involves the development of lumpy, painful areas in the breast tissue, often exacerbated by hormonal changes. Women with fibrocystic breasts may notice that their symptoms worsen before their menstrual cycle.

3. Breast Cysts or Fibroadenomas: These are benign lumps that can develop in the breast tissue. Cysts are fluid-filled sacs, while fibroadenomas are solid lumps. Both can cause localized pain, especially if they are pressed or manipulated.

4. Infections or Inflammation: Conditions such as mastitis (an infection of the breast tissue) can lead to pain, swelling, and redness. This is more common in breastfeeding women but can occur in others as well.

5. Injury or Trauma: Any recent injury to the breast, even minor, can lead to pain. If you have recently engaged in activities that could have caused trauma to the breast, this could be a contributing factor.

6. Other Medical Conditions: Sometimes, breast pain can be related to other health issues, such as costochondritis (inflammation of the cartilage connecting the ribs to the breastbone), or even gastrointestinal issues that can cause referred pain in the chest area.

Symptoms to Watch For
- Localized Pain: If you feel a specific area of pain, especially if it is associated with a lump or mass, this warrants further investigation.

- Changes in Breast Appearance: Any changes in the size, shape, or texture of the breast should be evaluated.

- Nipple Discharge: Any unusual discharge from the nipple, especially if it is bloody or occurs without squeezing, should be assessed by a healthcare provider.

- Persistent Pain: If the pain lasts for several weeks or worsens over time, it is essential to seek medical advice.

When to Seek Help
Given your description of feeling a small lump and experiencing pain upon pressure, it is advisable to consult a healthcare professional. You can start by visiting either a general surgeon or a gynecologist. Both specialists can perform a thorough examination and may recommend imaging studies, such as a breast ultrasound or mammogram, to assess the lump and surrounding tissue.

Recommended Actions
1. Avoid Manipulation: Until you have been evaluated, try to avoid pressing on the painful area to prevent further irritation.

2. Supportive Garments: Wearing a well-fitted bra can provide support and may help alleviate some discomfort.

3. Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain temporarily.

4. Follow-Up: Keep track of your symptoms, including any changes in the lump or pain intensity, and report these to your doctor during your visit.

In summary, breast pain can arise from various causes, and while many are benign, it is crucial to seek medical evaluation, especially when new symptoms develop. Early assessment can provide peace of mind and ensure that any necessary treatment is initiated promptly.

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