Breast pain

Pain in the mammary glands is a kind of signal of the body about the presence of problems that may be associated with diseases of the gland itself or a systemic pathological process. Due to the peculiarities of the structure and physiology of the mammary glands, they are very sensitive to neuroendocrine influences throughout life. The slightest hormonal disruptions can cause unpleasant sensations in them.

Almost every woman faces chest pain at some stage of her life. And everyone reacts to this in different ways – some ignore it, hoping that it will pass, others are afraid, immediately thinking of the worst and suspecting cancer. In fact, there are many reasons for this condition. In this article, we will try to understand the most important of them.

§ Content

  • Reasons
  • Benign breast dysplasia
  • Mastitis
  • Benign tumors
  • Breast cancer
  • Ectasia of the ducts of the gland
  • Principles of diagnostics
  • Which doctor should I contact
  • Conclusion
  • View popular articles

ReasonsSometimes breast pain occurs in women during lactation and is a symptom of stagnation of milk in the ducts, or lactostasis

Breast pain in women can occur at any age. It often bothers young girls and women after childbirth (during lactation). And it can even occur in the menopausal period. Most often, it has a close connection with the cycle and appears a few days before the expected menstruation, but it can occur independently of it.

Cyclical pain is often associated with hormonal disorders. They are usually bilateral, combined with a slight swelling of the glands and are felt by patients as heaviness or bursting in the upper or outer quadrants. Sometimes their severity increases, and the pain becomes quite intense, making it difficult to move your hands and disrupting the normal life of a woman. With the onset of menstruation, the pain passes, and then after a certain time it appears again.

Non-cyclic pain sensations in most cases are associated with structural changes in the gland tissue or underlying organs that have a common innervation with it. They are often unilateral and have a sharp burning or cutting character. Typical localization is the middle part of the organ or the area around the nipple. They can be based on a bruise, mastopathy, cyst, or tumor.

There is a special pathology of the mammary glands, which is characterized by their cyclic swelling with pain and an increase in size due to venous congestion and edema. It was called mastodynia or mastalgia.

The following factors contribute to the development of breast pathology and the development of pain syndrome::

  • burdened heredity;
  • neuroendocrine disorders;
  • early menarche;
  • age over 35 years;
  • late first pregnancy;
  • lack of breastfeeding;
  • milk stagnation in a nursing woman;
  • long-term stress;
  • fatness;
  • violation of the menstrual cycle;
  • gynecological diseases;
  • late menopause;
  • breast injuries.

It should be noted that pain in the gland is not always caused by its diseases. A woman may regard it as mastalgia or heart muscle pain. At the same time, she really feels that her chest hurts, but the cause of this pain lies much deeper. Therefore, you should not postpone the visit to the doctor, because to find out the nature of the pathological process, you need the help of a specialist and an examination.

Below we will focus on the main causes of pain in the mammary glands.

Benign breast dysplasia

Breast cancer, or mastopathy, or fibrocystic disease, is one of the most common diseases in women. About 50-70% of patients with breast pain suffer from various forms of breast pain.

The disease occurs in predisposed individuals against the background of hormonal imbalance, which leads to a violation of the concentration of sex hormones, in particular, an increase in the level of estrogens and increased proliferation processes in the tissues of the gland. This condition is considered precancerous (malignant tumors occur against its background 3-5 times more often), so it requires close attention.

Mastopathy pain is usually bilateral. It occurs constantly or periodically, increases in the premenstrual period and persists throughout the second half of the cycle. Its nature can be different: prickly, throbbing, burning.

In young women, a slight soreness and engorgement of the mammary glands occurs a week before menstruation, at the age of 30-40 years, pain increases and appears earlier-2-3 weeks before menstruation. Sometimes patients lose sleep, develop depressive disorders and cancer phobia. After 40-50 years, the pain becomes less intense and appears periodically, while there are many cystic formations in the gland.

In 20% of women with mastopathy, abnormal discharge from the nipples is observed.

Mastitis

This is an inflammatory process in the breast tissue. Women are more likely to get sick while breastfeeding, but the disease can develop in non-breastfeeding women and even in infants.

In 95% of cases, mastitis occurs during lactation and is associated with stagnation of milk and damage to the nipples – cracks, maceration, through which the infection penetrates deep into the ducts. These changes are already the cause of pain, even without the inflammatory process. With lactostasis, a woman first feels only local soreness in the chest, but if the process is not resolved, then the general condition is also disturbed – fever and chills appear. In most patients, its duration does not exceed 3-4 days, after which the outflow of milk normalizes, or mastitis develops. Contribute to its occurrence:

  • incorrect feeding technique;
  • rare application to the breast;
  • reduced immunological reactivity;
  • non-compliance with personal hygiene rules.

The clinical picture of mastitis can have significant differences depending on the form of the disease:

  • With serous inflammation, women are concerned about pain and heaviness in the chest, a slight redness in the pathological zone, a decrease in the amount of milk, fever.
  • With purulent mastitis, a softening center and a cavity with purulent contents form in the chest, edema and hyperemia of the gland increase, and intoxication increases.
  • The most severe forms of the disease are phlegmonous and gangrenous. The gland increases sharply in volume, is painful, hyperemic. Areas of purulent melting of tissues, skin necrosis are determined. General condition is serious.

Acute non-lactation mastitis is much less common than lactation mastitis. The infection enters the breast tissue through the milk ducts or damaged skin. Separately, we can distinguish mastitis of pregnant women associated with the restructuring of the glandular tissue before childbirth, and mastitis of infants against the background of physiological edema of the glandular tissue.

Benign tumorsA large cyst squeezes breast tissue, causing pain

Among benign breast tumors, pain syndrome is more often caused by:

  • Intraductal papilloma. This is a tumor that occurs in the duct of the gland. It is characterized by the presence of pain in the premenstrual period and discharge from the nipple of a bloody nature.
  • A cyst. It is considered a manifestation of fibrocystic mastopathy. It has the appearance of a cavitary neoplasm in the gland, which grows, reaching a large size, squeezes the gland tissues, causing pain.

Breast cancer

Malignant tumors of the mammary glands do not always occur with pain, so when pain appears, you should not immediately think about it and worry, but you should not forget about such a terrible disease. For a long time, a cancerous tumor exists in the breast, without causing any symptoms. As it grows and squeezes the surrounding tissues, it appears:

  • bitterness;
  • deformity of the gland;
  • nipple retraction;
  • nipple discharge;
  • general symptoms (malaise, low-grade fever, poor appetite).

Ectasia of the ducts of the gland

It is an expansion of the ducts of the breast, associated with various physiological and pathological causes. Moderate ectasia may develop in pregnant women in preparation for lactation or during lactation. Dyshormonal disorders, high levels of prolactin, accumulation of abnormal secretions in the ducts or growth of a tumor inside them can lead to pathological ectasia. The clinical picture of ectasia is dominated by local symptoms:

  • discomfort, itching, or pain in the areola area;
  • compaction of surrounding tissues.

Principles of diagnostics

Women suffering from breast pain should definitely undergo a full examination. To do this, you need to consult a gynecologist or mammologist.

To find out the cause of the pain syndrome and determine further tactics of patient management, the doctor begins the examination with a question. It is specified in this case:

  • how long ago were the complaints received;
  • what is the nature of the pain and where is it localized;
  • is it one-way or two-way;
  • where is the area of maximum soreness;
  • when unpleasant feelings arise, are they related to a cycle or something else;
  • what else is bothering you;
  • what else does the patient have;
  • there are cases of breast cancer in the family.

At the next stage, the mammary glands and regional lymph nodes are examined and palpated. It is important to clarify the phases of the menstrual cycle before doing this. After all, it is considered impractical to conduct a study in the second phase of the cycle due to the high probability of diagnostic errors. During this period, the mammary glands are very rough, which makes it difficult to palpate them. Examining such a gland, the doctor may miss a tumor-like formation or, conversely, assume the presence of a disease that does not actually exist. It is optimal to perform palpation in the first phase of the cycle-on the 2-3 th day after the end of menstruation.

To examine the mammary glands, a woman should remove her clothes from the upper half of her torso and turn to face the light source. Starting the examination, the doctor evaluates the appearance of the glands, paying attention to the symmetry, condition of the nipples, contours, skin color, the presence of deformity, venous network. Then the patient is asked to raise her hands, after which the glands are examined again. After that, palpation of the mammary glands is performed in two positions-first standing, then lying on your back.

Depending on the detected pathological changes, the woman is assigned an additional examination, which may include::

  • general blood test;
  • blood test for the level of sex hormones and prolactin;
  • Breast ultrasound;
  • mammography;
  • ductography (if necessary, visualize the ducts);
  • computer or magnetic resonance imaging (if cancer is suspected);
  • biopsy of a suspicious lesion followed by histological and cytological examination.


Which doctor should I contact

If you experience pain in the mammary glands, you should consult a gynecologist. After a preliminary examination, the doctor may refer the patient to a mammologist or oncologist.

ConclusionMammography will help in the diagnosis of breast diseases associated with pain in its tissues

Pain syndrome never occurs in completely healthy individuals. Therefore, all patients suffering from it should undergo an appropriate examination. Early diagnosis of breast diseases is very important, it allows you to prescribe treatment in a timely manner and prevent complications. Self-medication, on the contrary, contributes to the late detection of pathological processes and aggravation of their course.

Neurologist M. M. Shperling talks about the causes of breast pain:

Oncologist-mammologist talks about chest pain:

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