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- Painful breast tissue, often bilateral, which can be cyclic or noncyclic
- 2/3 of breast pain is cyclic and usually associated with hormonal changes related to menses, external hormones, pregnancy, or menopause.
- 1/3 is noncyclic and often is related to a breast or chest wall lesion.
- Synonym(s): mastodynia; breast pain
- Predominant sex: most common in women but occurs occasionally in men
- Predominant age: generally seen from adolescence to menopause
- Frequency of breast cancer with those reporting breast pain ranges from 1.2% to 6.7%.
- Up to 70% of women report some degree of breast pain at some point in their lives.
- Most describe mild pain, but 11% describe pain as moderate to severe.
- Higher incidence in the older population, larger breasted individuals, and those who are less fit and active (1)
Etiology and Pathophysiology
- Causative pathophysiology remains unclear but is thought to be related to hormonal or nutritional factors.
- When fibrocystic disease is the source, growth and distension of the cyst with hormonal fluctuation can cause pain.
- Hormonal factors (e.g., hormone-replacement therapy, oral contraceptives, pregnancy, menses, puberty, and menopause) may influence the diverse conditions that cause mastalgia or may themselves cause breast tenderness and pain.
- Benign breast disorders (e.g., fibrocystic changes)
- Trauma (including sexual abuse/assault)
- Diet and lifestyle (e.g., poor-fitting exercise breast support)
- Lactation problems (e.g., engorgement, mastitis, breast abscess)
- Breast masses, including breast cancer
- Hidradenitis suppurativa
- Costochondritis (Tietze syndrome)
- Postthoracotomy syndrome
- Spinal and paraspinal disorders
- Potential side effects of medications
- Postradiation effects
- Referred pain (e.g., pulmonary, cardiac, or gallbladder disease)
- Ductal ectasia
- Avoid exposure to risk factors.
- Properly fitted bra support