18 Oct Mastodynia: What to do when you feel breast pain?
Mastodynia, also known as mastalgia, is the sensation of pain in one or both breasts. This is a common symptom, as approximately 70% of women may experience at least one episode of mastodynia during their lifetime. This pain often causes intense anxiety and is one of the main reasons that push women to seek medical advice from a specialized Mammologist-Breast Surgeon.
Mastodynia and menstrual cycle
Cyclical mastodynia affects women of reproductive age, with the most common occurrence between the ages of 25 and 35. The condition is associated with the hormonal changes that take place each month during the phases of the menstrual cycle. Possible contributing factors to the onset of mastodynia include an increase in estrogen levels, hyperprolactinemia, or heightened sensitivity of breast receptors, though none of these theories have been fully substantiated. The pain is described as a tightening sensation, usually bilateral, but of different intensity in each breast, almost always affecting the outer quadrants. The pain begins in the middle of the cycle, becoming noticeable during ovulation, and peaks during the last three to five days before menstrual flow, with the pain resolving once menstruation begins. Physical activity, wearing tight clothing, and palpation during this period often exacerbate the pain. Unfortunately, mastodynia is a pain that often recurs periodically, lasting until menopause. The use of anti-inflammatory or decongestant medications, such as those containing bromelain and boswellia, may reduce breast sensitivity.
Breast pain unrelated to the menstrual cycle
Acyclic mastodynia mainly affects women between the ages of 40 and 50. It can affect only one breast or both, lasts less and tends to go away. The pain is often described as a burning sensation, and in many cases may be related to the presence of cysts, abscesses or hematomas, although in many cases the cause remains unknown.
Non-mastogenic causes of breast pain
Mastodynia, or breast pain, can be caused by factors not directly related to the breast. Such causes include disc problems, cartilage issues of the ribs or sternum, inflammation of the chest muscle, shingles, hiatal hernia, cardiomyopathies, or lung diseases. In these cases, the pain is usually unilateral and often worsens with pressure on the chest wall. However, it is crucial for every woman experiencing persistent chest pain to visit a breast specialist or breast surgeon to definitively rule out the possibility of breast cancer. Although only 7% of women with breast cancer report pain as a symptom, early diagnosis is essential for safety and proper treatment.
Symptoms of mastodynia
The symptoms of mastodynia can vary from patient to patient. The most common include:
- Breast sensitivity
- Breast swelling
- Localized pain in a specific area of the breast.
- Extensive pain over a larger area of the breast.
These symptoms may affect one or both breasts and occur either cyclically or non-cyclically. In some cases, mastodynia can be associated with the presence of mastitis, an inflammation of the mammary gland, which is often accompanied by redness in the breast area.
Diagnosis
In the case of breast pain, the physician must take an accurate medical history accompanied by a clinical breast examination by a specialized mammologist, often completed with further imaging tests such as:
- Breast ultrasound: useful to identify what causes may have produced the symptoms described by patients.
- Mammogram: an X-ray test useful in identifying the type of lesion, if any, in the breast.
Mastodynia and risks
The primary risks associated with mastodynia concern its underlying causes. In most cases, chest pain is a reversible condition. However, if the pain persists in intensity and, more importantly, if it does not follow a cyclical pattern, it is essential to consult a specialized breast surgeon who focuses exclusively on breast conditions. This will allow for a thorough investigation of any potential pathological causes that may be responsible for the symptoms.
Early diagnosis allows the mammologist to guide the patient towards the most effective and least invasive treatment.
Treatment options
The treatment of mastodynia depends on the causes that cause it. For this reason, before starting any therapeutic procedure, the patient undergoes a detailed examination of the breasts. Depending on the results of the examination, the specialist breast surgeon – mammologist can propose:
- Treatment with medication: analgesics to help relieve pain.
- Hormonal therapy: aimed at restoring normal hormonal activity.
- Surgical treatment: in particularly severe cases, such as when the pain is caused by breast cancer.