Breast Pain: Causes, Symptoms, and Solutions

Breast pain issues?

Hello, Doctor.
About a month ago, I started experiencing pain in the left outer breast and along the lower edge of the breast, with occasional sharp pain in the sternum.
I have visited a neurologist and a thoracic surgeon for examinations, diagnoses, and blood tests, but no significant issues were found.
After applying heat, the pain has diminished, and sometimes I do not feel any pain at all.
However, recently, I have noticed that about 2-3 days a week (I observed this tends to occur around Sunday to Monday), the outer side of my left breast starts to hurt again.
Sometimes, I also experience sharp pain in the breast.
Activities like going down stairs or riding a bike, which cause vibrations, can lead to swelling and pain.
Additionally, if I sleep on my side and apply pressure, it definitely causes pain.
The right breast occasionally has sharp pain, but it is not as frequent or pronounced as on the left side.
Upon observation, there are no indentations, discharge, redness, or swelling in the breast.
I am unsure if there are any lumps upon self-examination, or if it is just breast tissue.
I have not yet gone to a breast surgeon for further examination.
I would like to ask the doctor what possible issues could be causing these symptoms and if you have any recommendations.
Thank you for your help.

Niming, 30~39 year old female. Ask Date: 2023/08/29

Dr. Yuan Tianmin reply Breast and Thyroid

Breast pain at this age is generally related to menstrual cycles.

Reply Date: 2023/08/29

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 crucial for effective management and alleviation of symptoms. In your case, the pain you are experiencing in the left breast, particularly around the lower edge and the sternum, could be attributed to several factors.

Common Causes of Breast Pain
1. Hormonal Fluctuations: One of the most prevalent causes of breast pain is hormonal changes, particularly those associated with the menstrual cycle. Many women experience cyclical breast pain, which typically occurs in the days leading up to menstruation. This is due to the hormonal changes that stimulate breast tissue, leading to swelling and tenderness.

2. Fibrocystic Changes: This condition involves the development of fibrous tissue and cysts in the breast, which can lead to pain and discomfort. Women with fibrocystic breasts often report pain that fluctuates with their menstrual cycle.

3. Musculoskeletal Issues: Sometimes, breast pain can be referred pain from the chest wall or musculoskeletal structures. Activities that involve heavy lifting or repetitive motion can strain the muscles and lead to discomfort that may be perceived as breast pain.

4. Injury or Trauma: Any recent injury or trauma to the breast area can cause localized pain. Even minor injuries that may not seem significant can lead to discomfort.

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

6. Other Medical Conditions: In rare cases, breast pain can be associated with more serious conditions, such as breast cancer or other tumors. However, these are less common, especially in the absence of other symptoms like lumps, discharge, or skin changes.

Symptoms to Monitor
In your case, the intermittent nature of the pain, its localization to the left breast, and the absence of lumps or other alarming symptoms are reassuring. However, it is essential to monitor for any changes, such as:
- Development of new lumps or masses
- Changes in breast shape or size
- Nipple discharge (especially if it is bloody or clear)
- Persistent pain that does not improve with time
- Any skin changes, such as redness or dimpling

Recommendations for Management
1. Heat Therapy: As you mentioned, applying heat has helped alleviate your pain. Warm compresses or heating pads can relax the muscles and improve blood flow, providing relief.

2. Supportive Bras: Wearing a well-fitted, supportive bra can help reduce discomfort, especially during physical activities. A sports bra may provide additional support during exercise.

3. Pain Relief Medications: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain when necessary.

4. Lifestyle Modifications: Reducing caffeine and high-fat foods may help some women with breast pain. Regular exercise and maintaining a healthy weight can also contribute to overall breast health.

5. Follow-Up with Specialists: Since you have already consulted with neurologists and thoracic surgeons, it may be beneficial to see a breast specialist or a gynecologist who can perform a thorough evaluation, including imaging studies like a mammogram or ultrasound if necessary.

6. Keep a Pain Diary: Documenting when the pain occurs, its intensity, and any associated activities can help identify patterns and triggers, which can be useful for your healthcare provider.

Conclusion
Breast pain can be multifactorial, and while it is often benign, it is essential to remain vigilant and proactive about your health. Given your symptoms and the absence of alarming signs, it is likely that your pain is related to hormonal changes or musculoskeletal issues. However, continuing to monitor your symptoms and seeking further evaluation from a breast specialist will ensure that any underlying issues are addressed promptly. Always prioritize open communication with your healthcare providers to ensure comprehensive care.

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