Breast Pain: Causes and Hormonal Influences - Surgery

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Pain in a specific area of the breast?


Hello, Doctor.
I previously consulted you regarding my condition (link: #195154).
Thank you for your response, which has reassured me.
Recently, I have experienced some issues and questions regarding a specific area in my left breast that is very painful when pressed (other areas are not affected).
When I palpate a larger area, it feels like a hard lump, and upon closer examination, I can feel a distinct mass (its edges are not very discernible), but it is movable when pressed.
Currently, I am on the 11th day after the end of my menstrual period (ovulation phase).
Since I have a tendency to develop cysts, is it possible for cysts to form or for their size to fluctuate during the non-menstrual phase? Could this situation be hormone-related? Is it also possible during the ovulation phase? P.S.
I had a sexual encounter a few days ago.
Thank you for your response.

Niming, 20~29 year old female. Ask Date: 2023/04/21

Dr. Chen Jiaming reply Surgery


Regarding the left breast, your description of the condition still resembles the symptoms of fibrocystic changes.
As for the menstrual cycle, it follows a typical pattern where swelling and tenderness begin before menstruation and improve after it ends.
However, the rate at which the cysts resolve may not be entirely consistent, and they usually do not disappear completely.
Medications and diet can also influence their presentation.
Additionally, external pressure or touch may lead to localized discomfort.

Reply Date: 2023/04/21

More Info


Breast pain, or mastalgia, is a common concern among women and can arise from a variety of causes, often linked to hormonal changes throughout the menstrual cycle. Understanding the underlying mechanisms and potential influences can help in managing and alleviating discomfort.


Causes of Breast Pain
1. Hormonal Fluctuations: The most prevalent cause of breast pain is hormonal changes associated with the menstrual cycle. Estrogen and progesterone levels fluctuate significantly, particularly in the days leading up to menstruation and during ovulation. These hormonal shifts can lead to breast tissue swelling and tenderness, often described as cyclical breast pain.

2. Fibrocystic Changes: Many women experience fibrocystic breast changes, which can cause lumpiness and tenderness in the breasts. These changes are often benign and can be exacerbated by caffeine intake or high-fat diets. The presence of cysts, which are fluid-filled sacs, can also contribute to discomfort, especially if they become enlarged or inflamed.

3. Breast Trauma or Injury: Any physical trauma to the breast can result in localized pain. This could be from a direct impact or even from wearing a poorly fitting bra that does not provide adequate support.

4. Infections or Inflammation: Conditions such as mastitis, which is an infection of the breast tissue, can cause pain, swelling, and redness. While more common in breastfeeding women, it can occur in others as well.

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


Your Specific Situation
In your case, you mentioned experiencing significant pain in a specific area of the left breast, which feels like a movable lump. Given that you are currently in the luteal phase of your menstrual cycle (post-ovulation), it is plausible that hormonal influences are at play. The timing of your symptoms suggests that they may be related to the hormonal fluctuations typical of this phase, which can lead to increased sensitivity and swelling in breast tissue.

Additionally, the presence of a movable lump could indicate a benign cyst or a fibroadenoma, both of which are common and typically non-cancerous. However, the fact that you have a history of developing cysts (or "water bubbles," as you described) could mean that you are more prone to these changes, especially during hormonal fluctuations.


Recommendations
1. Monitoring Symptoms: Keep track of your symptoms, noting any changes in size, shape, or pain levels of the lump. If the pain persists or worsens, or if you notice any new changes, it is advisable to consult a healthcare provider for further evaluation.

2. Breast Imaging: Since you have previously undergone breast ultrasound, it may be beneficial to have follow-up imaging if there are significant changes in your symptoms or if the lump becomes more prominent.

3. Lifestyle Modifications: Consider reducing caffeine and high-fat food intake, as these can exacerbate fibrocystic changes. Wearing a supportive bra can also help alleviate discomfort.

4. Consultation with a Specialist: If you have concerns about the lump or if the pain is severe, visiting a healthcare provider or a breast specialist is recommended. They can perform a thorough examination and may suggest additional imaging or tests to rule out any serious conditions.

In conclusion, while breast pain can be alarming, it is often linked to hormonal changes and benign conditions. Understanding these factors can help you manage your symptoms effectively. Always prioritize regular check-ups and communicate any changes in your breast health to your healthcare provider.

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