Breast Pain

Breast pain is very common.

Clinical examination, mammography and ultrasound are necessary to exclude any serious problems.

Any lump or other focal abnormality requires appropriate triple assessment.

The description of the pain often gives a clue to the cause.

Hormonal Pain

Many women experience cyclical tenderness, heaviness and lumpiness in their breasts at some time. This  often affects the upper, outer part of both  breasts.

It is thought to be due to hormonal fluctuations affecting the breast tissue.

Tenderness is often mild and improves spontaneously within a few months.

Reassurance that there is no serious problem such as cancer is frequently all that is necessary.

Using a supportive sports bra and avoiding unnecessary jolting activities such as running for a while can help.

A small number of women will experience very severe pain that does not respond to these measures. There are a number of more potent hormonal medications that have been reported to be effective such as Danazol and Tamoxifen. They are associated with some quite significant side effects and should only be used as a last resort. In my experience this is very seldom necessary.

Musculoskeletal Pain

Breast pain may be due to a problem with the ribs and muscles lying underneath the breast.

Examination of the chest wall will show a tender spot. One common site is the junction between the ribs and breastbone (sternum) about 2cm from the midline.

Musculoskeletal pain often disappears spontaneously over a matter of months without any specific treatment.

Reassurance that there is no serious problem is often all that is necessary.

A supportive bra and simple pain tablets work well for moderate discomfort.

Injection of local anaesthetic around the tender area can provide dramatic and rapid relief in the occasional severe case.

Breast pain may be due to other problems, such as nerve root compression, arthritis affecting the shoulder, pleurisy or shingles.