Breast Pain: Diagnosis and Causes
Diagnosis of breast pain
If a woman is pre-menopausal, the doctor will try to determine whether the breast pain might be cyclical. The patient will probably be asked:
- How much caffeine she consumes
- Where within the breasts the pain is
- Whether both breasts are painful
- Whether she is a smoker
- Whether she is on any medication or the combined contraceptive pill
- Whether she might be pregnant
- Whether there are any other symptoms, such as nipple discharge or a lump.
The physician will listen to the patient’s lungs and heart, and also check her chest and abdomen to rule out other possible conditions and illnesses.
The doctor may also conduct a clinical breast exam to determine whether there are any lumps, changes in nipple appearance, or nipple discharge. The lymph nodes in the lower neck and armpit will also be checked to determine whether they are swollen or tender to the touch.
A mammogram may be used to provide an X-ray exam of the breast.
If a breast lump or unusual thickening of an area of tissue is detected, or a specific area of breast tissue is particularly painful, the doctor may order further tests:
- Mammogram – this is an X-ray exam of the breast. Also known as mammography
- Ultrasound scan – sound waves produce images of the breasts. Even if the mammography does not detect anything, an ultrasound scan is usually done as well
- Breast biopsy – if anything suspicious is detected, the doctor will surgically remove a small sample of breast tissue and send it to the laboratory for analysis.
The patient may be asked to complete a breast pain chart, which can be used to confirm the diagnosis and help the doctor decide on the best therapy.
What causes breast pain?
It is not always possible in every case to determine exactly why breast pain occurs. The following factors are associated with possible breast pain:
- Acid reflux
- Alcoholism with liver damage
- Angina
- Anxiety, stress and depression
- Benign breast tumors
- Bornholm disease
- Breast cancer
- Breast cysts
- Breast trauma – e.g. previous breast surgery
- Breastfeeding related – possible infection
- Cervical and thoracic spondylosis/radiculopathy
- Chest wall pain
- Coronary artery disease
- Costochondritis
- Cyclical breast pain
- Diet – especially caffeine
- Fibromyalgia
- Herpes zoster
- Mastitis
- Medications – including digitalis, chlorpromazine, oxymetholone, some diuretics, spironolactone, and methyldopa
- Peptic ulcer
- Pericarditis
- Pleurisy
- Pregnancy
- Psychological
- Puberty
- Pulmonary embolism
- Rib fracture
- Shingles
- Shoulder pain
- Sickle cell anaemia
- Trauma to the chest wall.
