Mastalgia is a common condition characterized by breast pain, ranging from mild discomfort to severe sensations. While it often causes concern, breast pain is frequently a benign issue. Understanding the nature of this pain can help alleviate anxiety.
Understanding Mastalgia
Mastalgia refers to pain felt in the breast tissue. This sensation can manifest as tenderness, aching, throbbing, or a sharp, burning feeling. The pain may occur in one breast or both, sometimes extending into the underarm area. It affects up to 70% of women at some point in their lives. Despite its common occurrence, mastalgia is rarely a sign of breast cancer, and is rarely the primary symptom.
Types of Mastalgia
Breast pain is categorized into cyclical, non-cyclical, and extramammary types based on its pattern and origin. Cyclical mastalgia is the most common form, directly linked to the menstrual cycle and hormonal fluctuations. This pain typically begins a few days before menstruation and subsides once the period starts, often described as a dull, heavy ache affecting both breasts, though one may feel more discomfort.
Non-cyclical mastalgia does not follow a menstrual pattern and can be constant or intermittent. This type of pain often feels sharp or burning and is usually localized to a specific area in one breast. It is more common in individuals after menopause and can sometimes be referred to as “trigger zone” pain. A third category, extramammary pain, originates outside the breast but is felt within the breast area. This can stem from musculoskeletal issues like chest wall pain, nerve pain, or conditions affecting organs such as the gallbladder.
Common Causes of Mastalgia
Hormonal changes are a primary cause of cyclical mastalgia. Fluctuations in hormones like estrogen and progesterone throughout the menstrual cycle can influence breast tissue, leading to pain and tenderness. An imbalance, such as a decreased progesterone-to-estrogen ratio, or abnormalities in prolactin levels, may contribute to this pain. Stress can also affect hormone levels, potentially increasing or altering the pattern of cyclical breast pain.
Non-cyclical mastalgia can arise from several factors unrelated to hormonal cycles. Physical trauma or injury to the breast can cause localized pain. Conditions such as breast cysts or fibrocystic changes can also lead to pain. Certain medications, including some antidepressants, hormonal therapies, or antipsychotic drugs, have been linked to non-cyclical breast pain. Prior breast surgery can result in persistent pain, and lifestyle factors like consuming caffeine or wearing ill-fitting bras may contribute to discomfort.
When to Seek Medical Advice
While mastalgia is often benign, certain symptoms warrant a medical evaluation. Consult a healthcare professional if the breast pain is persistent and does not resolve, or if it worsens over time. Pain localized to a specific area of one breast, especially if it does not fluctuate with the menstrual cycle, also warrants evaluation. Also seek advice if the pain is accompanied by new lumps or thickening in the breast, changes in the skin (e.g., redness, dimpling), nipple discharge, or fever. A medical assessment can help determine the underlying cause and guide appropriate management.