Mastalgia
Basics
Description
- 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
Epidemiology
Incidence
- 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
Genetics
Familial tendency
Risk Factors
- Diet high in saturated fats
- Cigarette smoking
- Recent weight gain
- Pregnancy
- Large, pendulous breasts (caused by stretching of Cooper ligaments)
- Exogenous hormones
General Prevention
- Avoid exposure to risk factors.
- Properly fitted bra support
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Citation
Domino, Frank J., et al., editors. "Mastalgia." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688714/1.2/Mastalgia.
Mastalgia. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688714/1.2/Mastalgia. Accessed October 13, 2024.
Mastalgia. (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688714/1.2/Mastalgia
Mastalgia [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 October 13]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688714/1.2/Mastalgia.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Mastalgia
ID - 1688714
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688714/1.2/Mastalgia
PB - Wolters Kluwer
ET - 33
DB - Medicine Central
DP - Unbound Medicine
ER -