Breast Issues: Breast pain

When discussions of breast health take place, the number one topic that most women are concerned about is breast cancer. This is understandable as breast cancer is still a major cause of death of women in the United States. However, breast health includes many different issues including breast lumps (that are non-cancerous), breast pain and pregnancy-related breast symptoms.

Breast pain

Breast pain can be described as a tenderness, sharp or stabbing sensation of the breast tissue. Some women also describe the sensation as a feeling of tightness.

Breast pain may be categorized into pain that is associated with pregnancy or breastfeeding and breast pain that is related to other non-pregnancy related causes.

Pain associated with pregnancy or breastfeeding

  • Breast pain experienced in the early stages of pregnancy
  • Mastitis

Breast pain of early pregnancy

Breast pain or tenderness may be experienced during the early stages of pregnancy. In particular, the first trimester. This is normal and generally requires no medical intervention. If significant breast pain continues to persist over the course of your pregnancy into the second or third trimester then a discussion with your midwife or doctor may be required.

Mastitis

Mastitis is an inflammation of breast tissue that is usually caused by an infection. Mastitis most commonly effects women who are breast-feeding. In addition to pain, other symptoms of mastitis include breast swelling, warmth and redness. Women may also experience a high temperature and chills. If any of these symptoms are noticed, immediate advice should be sought from a midwife, a lactation consultant or your doctor. Mastitis can be treated with a simple course of antibiotics. Furthermore, your doctor can provide advice on how to safely and comfortably continue breastfeeding.

Other non-pregnancy causes of breast pain

  • Period-related breast pain
  • Pain due to medication from birth control pills, hormone therapy, postmenopausal hormone therapy

Period-related breast pain

Period-related breast pain occurs just before the beginning of a menstrual cycle. Breast pain is described as tenderness or heaviness of the breasts. It usually appears the week before a period is due to arrive and disappears almost immediately when menstrual bleeding starts. Most women do not experience severe pain.

When to seek medical help

Breast pain is not a symptom that should be ignored. A source of the breast pain should always be found. Make an appointment to see your doctor if any of the following is true:

  • Breast pain is persistent and does not subside
  • The pain experienced is intense in nature
  • The pain is associated with abnormal nipple discharge or changes to the breast tissue (ie. swelling, redness, firmness)

If in doubt it is always best to make an appointment to see your doctor to have a full evaluation carried out.

Breast Issues: Breast lumps

Fortunately, a majority of breast lumps are benign, meaning they are not cancerous. However, it is important to pay attention to when a lump first appears and if it is associated with other symptoms. Listed below are some different causes of lumps that may be felt in the breast tissue.

Fibroadenomas

Fibroadenomas are solid, smooth and firm lumps that appear in the breast tissue. They are painless, feel rubbery and move around smoothly. Fibroadenomas are benign (non-cancerous) and are most commonly found in women in their 20s and 30s.

Breast cyst

A cyst is a fluid-filled sac that develops in the breast tissue. Cysts are most commonly seen in women between the ages of 35 and 50 and in those nearing menopause. Breast cysts are often round, moveable and can feel either soft or hard. As with fibroadenomas, breast cysts are non-cancerous.

Fat necrosis

Fat necrosis is a medical condition usually caused by trauma or damage to the breast tissue. It can also happen after breast surgery or radiation treatment. Fat necrosis is more common in women with very large breasts. As a breast lump, fat necrosis feels like a round, firm lump. The skin around the lump might look thicker, red, or bruised. It is usually not associated with pain.

Lipoma

A lump in the breast that is composed entirely of fatty tissue. Lipomas are common, non-cancerous and are usually found as a new lump in the breast.

Fibrocystic breasts

A condition in which breast tissue feels lumpy in texture and is sometimes accompanied by pain. Fibrocystic breasts is a benign (noncancerous) condition.

Breast cancer

Breast lumps that are associated with breast cancer may be associated with other symptoms such as a change in size, shape or contour of the breast or a change in the feel or appearance of the breast. See below for more detailed symptoms and how to screen for breast cancer.

What to do if you feel a lump in your breast

If you feel a lump in the breast tissue or notice any abnormal changes in your breasts, make an appointment to see your doctor. They will carry out a full medical examination, take a history and order diagnostic tests if needed. All breast lumps should be investigated by a medical professional.

Breast Issues: Breast cancer

Breast cancer is still a very real concern for women. Over the past few decades we have made great strides in the detection, management and treatment of breast cancer. However, women should still remember to keep up to date with their mammograms, manage the risk factors that they can control (ie. exercise, alcohol intake) and know the signs and symptoms of breast cancer.

Signs and symptoms of breast cancer

  • New lump in the breast or underarm (armpit)
  • Thickening or swelling of part of the breast
  • Dimpling of breast skin
  • Redness or flaky skin in the nipple area or the breast
  • Nipple discharge other than breast milk, including blood

If you feel a lump in your breast

If you feel a lump in the breast tissue or notice any abnormal changes in your breasts, make an appointment to see your doctor. They will carry out a full medical examination, take a history and order diagnostic tests if needed.

Breast cancer screening

Breast cancer screening will take a different form for each woman but the following is a general screening guide

  • Breast-self examinations are no longer recommended.
  • Mammograms

Women ages 50 to 74 years old and who are at average risk for breast cancer should have a mammogram every two years.

Women ages 40 to 49 years old should speak to their doctor about when it is appropriate for them to start going for mammograms and how often.

These screening recommendations are based on guidelines from the United States Preventive Services Task Force (USPSTF) an organization made up of doctors and disease experts.

Breast cancer screening is an issue that is unique to each woman and decisions around screening must be made in consultation with your own doctor. Each woman will have her own personal medical history and family history that will determine what her own risk factors are. A discussion with your doctor will include all of these elements and together, you can determine what the best screening regimen is for you.

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