Breast pain

Breast pain is a common symptom experienced by up to two thirds of all women. It is most commonly minor or moderate and is accepted as part of the normal changes of the menstrual cycle. A small proportion of women however have more significant symptoms. Studies have shown that those presenting with mastalgia are psychologically no different from women attending outpatients for other conditions.

Two thirds of women with mastalgia have cyclical pain linked to hormonal fluctuations during the menstrual cycle, with symptoms intensifying during the luteal phase and subsiding with menstruation. Factors such as hormonal medications, caffeine, and dietary fat intake may exacerbate symptoms, though their influence remains inconclusive(1).

The remaining third have pain which is non-cyclical and is often caused by factors such as large breasts, cysts, pregnancy, trauma, prior breast surgery, or inflammatory conditions like mastitis and abscesses (1).

A prospective study of study of 10 830 symptomatic women presenting to a breast cancer diagnostic clinic demonstrated that, in the absence of other breast symptoms, there is no association between breast pain and breast cancer (2).

References

1. Sivarajah R, Welkie J, Mack J, Casas RS, Paulishak M, Chetlen AL. A Review of Breast Pain: Causes, Imaging Recommendations, and Treatment. J Breast Imaging. 2020 Mar 25;2(2):101-111.
2. Dave RV et al. No association between breast pain and breast cancer: a prospective cohort study of 10 830 symptomatic women presenting to a breast cancer diagnostic clinic. Br J Gen Pract. 2022 Mar 31;72(717):e234-e243.