Breast Pain

Breast pain or discomfort is very common and to some degree should be considered normal. Severe pain is unusual but falls into two main categories:

Cyclical pain

This means pain that is related to the menstrual cycle. It is most commonly worse in the few days before a period starts and gets better when a period finishes. This type of pain is hormonal and occurs only in pre-menopausal women.

Lateral chest wall pain

This is often perceived to be coming from the breast but is actually coming from the tissues behind the breast, most commonly over the ribs on the lateral chest wall. It tends to be present most days and is not related to the menstrual cycle. This type of pain often seems to be related to a repetitive strain.

Other categories of breast pain exist but are less common and usually have a specific underlying cause. It is rare for this cause to be a breast cancer.

Treatment

Very often no treatment is required. You will be examined and if the breast is normal, you can be reassured. Sometimes pain is so severe or is interfering with your lifestyle such that treatment is required. Treatment varies depending on the type of pain you have.

Cyclical pain

There is unfortunately no magic treatment for this type of pain. Fortunately a large percentage settles over a few months without treatment. Simple measures include taking painkillers and wearing a support bra day and night for the few days before your period. Some people feel that avoiding excesses of tea and coffee or taking certain vitamins or evening primrose oil can help, but there is little evidence for these measures.

For severe cyclical pain the most effective treatment is taking a low dose of Tamoxifen, a drug normally used to treat breast cancer. It has side effects but these can be minimal if taken only for a few days each month. There are other types of drug treatments, all with potential side effects.

Lateral chest wall pain

Sometimes an underling cause can be identified and corrected. Occasionally an anti-inflammatory sports gel applied to the area can help. If the pain is severe then injection with steroid and local anaesthetic is the most effective treatment although this sometimes needs to be repeated every 2 - 3 months.

There are a variety of other treatments that can be tried in resistant cases. Other categories of breast pain can usually be treated by treating the underlying cause.