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Many women experience mastalgia — non-cancerous breast pain. Pain and tenderness may be a routine part of the monthly menstrual cycle. But if the pain seems unbearable, or occurs during mid-cycle, it may be time to take action.

A Proper Diagnosis   

Most breast pain is caused by not life-threatening problems. Only a small percentage of diagnosed breast cancers present pain as a symptom. A physical exam of the breast is usually the first step in a diagnosis. If the exam is normal, your doctor will decide if mammography or ultrasound studies are needed.

Cyclic and noncyclic pain can be caused by a wide array of factors and sometimes can be reduced by changing your diet, clothes or medication.

Cyclic Pain    

Cyclic pain is usually caused by hormonal changes as part of your menstrual cycle and the increase in milk-producing cells and breast fluid.

The resulting pain can be described as dull and aching. It's usually greatest in the upper and outer portion of the breast, closest to the armpit where most of the milk duct tissue is. The pain is often felt more acutely in one breast, although both are usually involved.

Monitoring the Pain

Keeping a record of your pain and its intensity will help you determine whether the pain occurs before your upcoming menstrual cycle. 

Finding Dietary Causes

Relief may start with simple dietary modifications:

  • A low-fat, high-carbohydrate diet may decrease breast tenderness and swelling before your period.
  • Adding a soy protein drink to your diet might help cyclic breast pain.

A properly-fitted support bra, hot and cold applications during intense pain and a breast massage may also relieve your pain.

If you have no success with these remedies, medication may be advised. 

Noncyclic Pain    

As with cyclic pain, you should keep a daily record of your discomfort to help determine the cause. Noncyclic pain is usually localized in a specific area and isn't related to the hormonal fluctuations of your menstrual cycle. Benign changes in the breast include:

  • Cysts
  • Fibroadenomas
  • Duct ectasia (widening)
  • Mastitis (inflammation)
  • Injury 
  • Breast abscesses

If these problems are not the source of your pain, you might have a musculoskeletal condition causing your pain, such as costochondritis, an inflammation of the cartilage connecting the ribs to the sternum. Fibrocystic disease, a common and benign condition, is also possible. Noncyclic breast tenderness and pain can also be caused by medications prescribed for hormonal conditions, high blood pressure and heart and gastrointestinal problems. Some women even find their pain is made worse by herbal products, particularly products that are marketed as reducing premenstrual symptoms.


Make an appointment with your OB or primary care provider — call 434.243.3675.

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