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| Mastalgia (Breast Pain) |
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| What is mastalgia? |
Mastalgia is breast pain. It is generally classified
as either cyclic or noncyclic.
Cyclic pain is associated with menstrual periods.
Noncyclic pain may come from the breast or somewhere else, such as
nearby muscles or joints, and may be felt in the breast. Pain can range
from minor discomfort to severely incapacitating pain in some cases. Such
a pain makes a woman fear that she may have cancer. This thought causes
more worry than the pain itself. |
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| What is cyclical breast pain? What are the causes?
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The most common type of breast pain is associated with the menstrual
cycle and is nearly always hormonal. Some women begin to have pain around
the time of ovulation. This pain continues until the beginning of their
menstrual cycle. The pain can either be barely noticeable or so severe
that the woman cannot wear tight-fitting clothing or tolerate close contact
of any kind. The pain may be felt in only one breast or may be felt as
a radiating sensation in the under-arm region.
Researchers believe that hormones play a crucial role in cyclical mastalgia.
One study has suggested that some women with cyclical mastalgia have a
decreased ratio of progesterone to estrogen in the second half of the
menstrual cycle. Other studies have found that an abnormality in the hormone
prolactin may affect breast pain. Hormones can also affect cyclical breast
pain as a result of stress - breast pain can increase or change its pattern
with the hormonal changes that occur during times of stress.
But this hormonal theory cannot explain why pain is often more severe
in one breast than in the other (hormones would tend to affect both breasts
equally). It is believed that a combination of hormonal activity and something
in the breast that responds to this activity may hold the answer. However,
more research is necessary to draw this conclusion.
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| What is the treatment for cyclical breast pain? |
| Specific treatment for cyclical breast pain will
be determined by a doctor, depending on: |
- the woman's age, overall health, and medical history
- extent of the condition · the individual's tolerance to specific medications,
procedures, or therapies
- expectations for the course of the condition · the woman's opinion
or preference Treatments vary significantly and may include the following:
- caffeine avoidance
- vitamin E
- a low-fat diet
- In some cases, various supplemental hormones and hormone blockers
are also prescribed. These may include:
- birth control pills
- Bromocriptine (which blocks prolactin in the hypothalamus)
- Danazol, a male hormone · thyroid hormones
- Estrogen blockers Supplemental hormones and hormone blockers may
have side effects.
In addition, the risks and benefits of such treatment should be carefully
discussed with the doctor.
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| What is noncyclic breast pain? |
Noncyclic breast pain is fairly uncommon, feels
different than cyclical mastalgia, and does not vary with the menstrual
cycle. Generally, the pain is present all the time and is present in one
specific location.
One cause of noncyclic breast pain is trauma, or a blow to the breast. Other
causes could be arthritic pain in the chest cavity and in the neck, which
radiates down to the breast. |
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| What is the treatment for noncyclic breast pain? |
It is difficult to decide on the appropriate treatment
for noncyclic breast pain because it is hard to pinpoint where the pain
is coming from and also because the pain is not hormonal.
Specific treatment for noncyclic breast pain will be determined by the doctor,
depending on: |
- the woman's age, overall health, and medical history
- extent of the condition
- tolerance to specific medications, procedures, or therapies
- expectations for the course of the condition
- the woman's opinion or preference
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| Generally, doctors will perform a physical examination
and may order a mammogram. In some cases, a biopsy of the area is also necessary.
If it is determined that the pain is caused by a cyst, the cyst will be
aspirated. Depending on where the pain originates, treatment may include
analgesics, anti-inflammatory drugs, and compresses. |
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