Breast Pain and Fibroadenomas: What You Need to Know

Breast tenderness & fibrocystic adenoma

Hello Doctor, I am 20 years old and around 2021, I discovered a hard lump in my right breast.
I went to the hospital for an examination and was diagnosed with a fibroadenoma (which is movable and not painful), measuring approximately 2.2 cm.
The doctor performed an ultrasound but did not conduct a biopsy, and it was later confirmed to be a benign fibroadenoma.
I was advised to have check-ups approximately every six months.
During my most recent check-up, there was no change in size.
However, since my last menstrual period, both breasts have been consistently painful (they hurt when lightly pressed).
Initially, I thought it was due to breast engorgement associated with my menstrual cycle, as I typically experience breast pain during menstruation.
However, my period has now ended for almost two to three weeks, and the tenderness in both breasts persists.
I would like to ask if it is possible that this could be breast cancer or if there are other reasons causing the breast tenderness? (Aside from the tenderness, I do not have any other symptoms of breast cancer.) Thank you, Doctor.

Nìmíng, 20~29 year old female. Ask Date: 2023/03/26

Dr. Chen Jiaming reply Surgery

Given your age, the likelihood of developing breast cancer is very low.
As for breast tenderness, at 20 years old, it can be influenced by factors such as development, diet, and other variables that may contribute to the sensation of tenderness.

Reply Date: 2023/03/26

More Info

Breast pain, also known as mastalgia, is a common concern among women and can arise from various causes, including hormonal fluctuations, benign breast conditions, and, in rare cases, malignancies. In your situation, you have a history of a fibroadenoma, which is a benign tumor of the breast. Fibroadenomas are typically painless, mobile lumps that can vary in size and are most common in younger women.
The pain you are experiencing in both breasts, especially after your menstrual cycle, could be attributed to several factors. First, hormonal changes during the menstrual cycle can lead to breast tenderness and discomfort. This is often referred to as cyclical mastalgia, which is linked to the hormonal fluctuations that occur during the menstrual cycle. Many women experience breast pain in the days leading up to their period, and it can persist for a short time after menstruation ends.

Since you mentioned that the pain has persisted for about two to three weeks after your last menstrual period, it is important to consider other potential causes. Non-cyclical breast pain can occur due to various reasons, including:
1. Fibrocystic Changes: This condition involves the development of fibrous tissue and cysts in the breast, which can lead to pain and tenderness. It is often exacerbated by caffeine intake, high-fat diets, or hormonal medications.

2. Injury or Trauma: Any recent trauma to the breast area, even if minor, can result in localized pain.

3. Infection or Inflammation: Conditions such as mastitis or abscesses can cause pain and tenderness in the breast. While you have not reported any redness or swelling, it is still a possibility worth considering.

4. Musculoskeletal Issues: Sometimes, pain in the breast area can be referred pain from the chest wall, ribs, or muscles. Conditions such as costochondritis or muscle strain can mimic breast pain.

5. Psychological Factors: Stress and anxiety can also manifest as physical symptoms, including breast pain.

Regarding your concern about breast cancer, it is important to note that breast cancer typically does not present with pain as an initial symptom. Most breast cancers are painless lumps, and pain is not a common early sign. However, if you notice any changes in the breast, such as new lumps, changes in size or shape, skin changes, or discharge from the nipple, it is crucial to seek medical evaluation.

Given your history of a fibroadenoma and the recent onset of breast pain, it would be advisable to follow up with your healthcare provider. They may recommend further evaluation, such as a breast ultrasound or a clinical examination, to rule out any other underlying issues. Regular monitoring of your fibroadenoma is also essential, as changes in size or characteristics may warrant additional investigation.

In summary, while breast pain can be concerning, it is often related to benign conditions, especially in younger women. Hormonal fluctuations are a common cause, and your symptoms may be linked to these changes. However, it is always best to consult with a healthcare professional to ensure that any potential issues are addressed and to provide peace of mind. Regular check-ups and open communication with your doctor about any changes in your breast health are key to maintaining your overall well-being.

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