Jayantika Shandilya, 24, a working woman from Jaipur, Rajasthan, had never experienced breast pain till she was 17.
“For my studies, I moved to a hostel. One of the changes I noticed gradually was breast pain. The pain was always ahead of my periods,” she says. She soon realised that the pain was due to hormonal changes that happened due to changes in her diet and daily schedule; from a very relaxed atmosphere at home, she had moved on to a hostel life.
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Dr Vaishnavi S, consultant medical oncologist Apollo hospital, Bengaluru, tells Happiest Heath that breast pain is common among women between 15-40 years. “Though most cases are mild and benign, it [the pain] may cause significant anxiety among young women,” she points out.
Pain, tenderness, throbbing, burning or stabbing sensations and tightness in the breast are the typical signs of breast pain. “This pain can be continuous or may occur occasionally,” says Dr Nirmala M, consultant obstetrician, gynaecologist and fertility specialist, Motherhood Hospitals, Bengaluru.
What triggers breast pain?
“Breast pain can be caused by trauma, prior breast surgery or other factors. It’s not easy to find out the reason behind breast pain but certain lifestyle factors like caffeine consumption, fatty acid imbalance and certain medications can cause breast pain,” says Dr Nirmala.
She adds that hormonal imbalance can also bring about changes in milk ducts and glands which can cause breast cysts, which in some cases, could be painful.
According to Dr Vaishnavi, some things can aggravate breast pain like the usage of oral contraceptive pills (OCPs), anxiety, smoking, alcohol consumption and hormonal therapies.
Wearing extremely tight brassiere can potentially contribute to breast pain.
Dr Nirmala adds that breast pain can also be seen in men due to a condition called gynecomastia, where there is an increase in the breast gland tissue. “It is often caused by an imbalance of the hormones estrogen and testosterone. This condition can affect one or both breasts, evenly and unevenly,” says Dr Nirmala.
Pain is not always related to cancer
While breast pain is commonly seen, it rarely indicates breast cancer, says Dr Nirmala. In case of severe breast pain, an ultrasound scanning and tests such as mammography of the breast are done.
The development of tumours in the breast can be with or without pain, due to which most breast cancer cases are detected when the cancer is advanced to the third stage, say doctors.
Dr Seema Singh, consultant, surgical oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, says that in the early stage of breast cancer, a person may feel a lump nodule and experience discomfort, but may not always develop pain. “The nodule must be examined to know the cause, the probability and to determine the chances of cancer. It may be another condition and not always cancerous. Based on the clinical analysis, if required, tests like a biopsy are advised,” says Dr Singh.
Types of breast pain
Doctors classify breast pain into three types:
Cyclical pain occurs due to changes in hormonal levels during the menstrual cycle. “It is a dull aching pain during the luteal phase (before periods) of the menstrual cycle and reduces after the onset of menses. The pain goes away after the period ends. Cyclic breast pain goes away after a woman reaches menopause,” says Dr Vaishnavi.
That’s the pain that Shandilya experiences, which typically begins four to five days ahead of her period. “Soreness in the breast is a reminder of the pain that follows and it hints that the period is nearing. For me, the pain generally lasts for nearly ten days,” Shandilya says.
Shandilya says she has come to accept breast pain as part of her life. “I have now gotten used to it. I have realised that’s how my body reacts,” she says.
Dr Vaishnavi points out that cyclical mastalgia should be treated with reassurance as in most cases, it resolves without treatment.
Non-cyclical pain is not associated with the menstrual cycle. It may be due to inflammatory, vascular, skeletal or muscular causes. “It may be sharp, more localised than cyclical mastalgia,” says Dr Vaishnavi. Possible causes for non-cyclical mastalgia are breast abscess (painful pus caused by infection), ductal ectasia or enlargement, underlying cancer or fibroadenoma (non-cancerous breast lump).
Dr Singh recalls the case of a college-going girl from Delhi who came to her with breast pain and a lump. “The girl had developed fibroadenoma (non-cancerous lump). Based on the severity, we surgically removed the lump,” she says.
The girl was fine after the lump removal and the family was informed that there could be a probability of lump recurrence; she had to be on follow-up consultations once in six months.
Non-cyclical breast pain can occur in women after they attain menopause.
Extramammary pain may be unrelated to breast tissues. When pain occurs in the cardiac, lung and skeletal muscles, it could radiate to the breast and this could be interpreted as breast pain.
Avoid self-medication and seek help
As the treatment varies with the cause, knowing the cause is a must, say doctors. Pinpointing the area of origin of the pain is essential for diagnosis, apart from considering the menstrual cycle and the age of the person.
“Women should consult a doctor when the pain is bothersome and seek proper advice. Self-medication must stop,” says Dr Singh.
“Treatment can include limiting certain medications like birth control pills, steroids or anti-inflammatory medication. We also prescribe medicines to ease the pain,” Dr Nirmala says.
Takeaways: lifestyle change can help
Dr Nirmala suggests the following lifestyle changes to tackle breast pain:
- Low-fat, high-fibre diet
- Less consumption of caffeine
- Supplement food with vitamin B6 and vitamin E
- Avoid high salt diet
- Wear comfortable clothing including the right kind of bra
- Practise relaxation techniques as high levels of anxiety and stress can also lead to breast pain