Breast Pain (Mastalgia)
Breast pain (or mastalgia) is a very common symptom which is most commonly cyclical (related to the menstrual period). This is usually related to hormonal fluctuations, is symmetric (involves both sides) and most commonly affects the upper outer part of the breast.
It is not uncommon, however, for this to be experienced more in one breast than the other.
Non-cyclical mastalgia is breast pain that is unrelated to the menstrual cycle. It usually involves one breast and should be investigated further. There are many causes for this pain including hormonal fluctuations, infections, chest wall pain and rarely cancer.
While breast pain is very common, only 5% of breast pain is due to breast cancer.
There is no increased breast cancer risk with cyclical mastalgia.
When both imaging studies and breast examination are normal, it is unusual to detect an underlying breast cancer in women presenting with breast pain.
It is important to present to your doctor with any new symptom in the breast.
Once it is established that the pain has no sinister cause, there are some general measures that may help with breast pain:
- Regular exercise helps reduce breast pain.
- Reduce caffeine.
- Stop smoking (easier said than done. Please see your GP for advice on how to go about this).
- Wear a supportive brassiere (sports bras are usually best).
- Use iodized salt or iodine supplements – after consultation with your local doctor.
Over-The-Counter supplements that may help with breast pain:
- Vitamin B6 – 100mg – once a day
- Evening Primrose Oil – 1000 units – 1-3 tablets / day
These two can be used as single agents or in combination and should be tried for at least 3 months
A breast pain diary may be helpful to show any relationship to the menstrual period or otherwise and document the severity of the pain.
If these simple measures fail, it is important to see your doctor again to consider further investigations and consider prescription medications.