Non-operable benign conditions are common, with pain likely resulting from hormonal fluctuations, stress, costochondritis, caffeine, and fatty food intake.
Breast Pain:
Breast pain is a common reason women seek consultation with a breast specialist. Patients are concerned that their pain may be signaling a more serious condition, but only an estimated 4% of patients with breast cancer will experience pain as a symptom.
Breast pain that happens due to a change in hormone levels is cyclic breast pain. Women may experience more pain, or their breasts can feel swollen or more sensitive around their menstrual cycle. Other things that change hormone levels, such as birth control pills or hormone therapy for menopause, can cause similar symptoms.
When pain is not a result of hormone level changes, it is noncyclic breast pain. An injury, infection, certain medications, or large breast size can cause pain. It can be caused by breast cancer. However, that is rare.
Fibrocystic breast changes can cause breast pain due to fluid-filled cysts and areas with fibrosis, which is a thickening of breast tissue that can be felt through the skin. Fibrosis can also happen without the presence of cysts. These types of changes are common and don't require medical treatment. They don't increase the risk of developing cancer. However, fibrocystic changes may make it more difficult to detect breast cancer.
These changes often occur in premenopausal women and are caused by hormonal changes. In addition to the "lumpy, bumpy" feeling of breast tissue in one or both breasts, pain, tenderness, and nipple discharge can also be present due to fluctuating hormone levels.
Other common triggers for breast pain include caffeine or stress. Omitting coffee, tea and soda can help reduce breast pain. Other things also cause breast pain, including chocolate, cheese, bananas, nuts, red wine, "energy" drinks, over-the-counter diet pills, and migraine medications. Changing your diet to exclude these can help reduce breast pain.
Fibrocystic conditions are seen on mammograms and ultrasounds as normal breast tissue.
Costochondritis is a common form of localized breast pain caused by inflammation of the costal cartilage around the ribs behind the breast. It might feel like the pain is from the breast, but it comes from somewhere else.
While it can be caused by an injury, strained or torn muscle, conditions such as rheumatoid or osteoarthritis, or ankylosing spondylitis, joint infections caused by bacteria, viruses, fungi, or both noncancerous and cancerous tumors, sometimes there isn't a clear cause.
It occurs most often in women and people older than age 40. Costochondritis in teenagers and young adults can be caused by a rare musculoskeletal disease called Tietze syndrome.
Breast imaging such as mammograms, ultrasounds, MRIs, chest x-rays, and CT scans will not diagnose costochondritis but can confirm that there are no other abnormalities in the breast or chest.
Breast Cysts:
Some women with fibrocystic breast changes can develop cysts in their breasts. However, there are different types of benign breast cysts. Although doctors and scientists don't know what causes breast cysts, some research has shown that they may result from hormonal changes in the body.
Typically, cysts are small and will go away by themselves. However, if the cyst is enlarging or painful, or there is a question about the type of cyst, fluid may be drained using a needle. Then, a breast surgeon or radiologist would perform ultrasound-guided cyst aspiration. This is often used for large and unsightly or painful cysts.
Breast surgeons rarely recommend surgical removal of a benign cyst. Most women find that benign cysts will resolve after menopause, especially if they are not taking hormone-replacement medications.
Breast cysts do not increase a person's risk of developing future breast cancer.
To help alleviate the pain that breast cysts can cause, breast specialists may recommend modifications to a person's diet as well as wearing a well-fitted bra (sports bra when active), using vitamin E, and treating pain with non-steroidal anti-inflammatory medications (NSAIDs)
Fat Necrosis:
This is a small area of fat located under the skin of the breast. It is usually near a scar that has hardened after losing its blood supply. This can happen after trauma to the breast, including bruising of the breast, or as a result of a breast biopsy or surgery. This is seen on ultrasound imaging as a benign-appearing lump.
