On the Coast – Families Issue 100 I June/July 2019 | Page 6
What does my breast pain mean?
with Dr Mary Ling, Central Coast Breast and General Surgeon
B
reast pain, or ‘mastalgia', affects
7 out of 10 women. There are 3
types of breast pain.
WHAT HELPS?
Dietary changes
1
Cyclical breast pain
Breast pain related to the
monthly menstrual cycle is referred
to as 'cyclical’. Cyclical breast pain
is most common in younger
women. It is due to monthly
fluctuations in the hormones
oestrogen and progesterone.
Oestrogen increases before
a period, causing milk ducts
and glands to swell and trap
fluid in the breasts. The pain
generally peaks in the 3 to
7 days before each period
and improves when the period begins.
The pain is often felt in the upper outer
breasts. Cyclical breast pain may also
worsen during perimenopause (when
hormones surge erratically) and continue
into menopause (especially in women
taking hormone replacement therapy).
2
Non-cyclical breast pain
Breast pain that does not vary with the
menstrual cycle is referred to as ‘non-
cyclical’. Non-cyclical breast pain is more
common in women in their 40s or older.
The pain can be constant or intermittent
and is usually restricted to a small area of
one breast (typically in the inner part of the
breast or under the nipple). Non-cyclical
breast pain can be due to benign breast
There is no strong evidence to
support specific dietary changes.
However limiting salt, caffeine
and eating low fat may be
helpful.
Evening primrose oil
Evening primrose oil 1000
mg three times a day may
be effective for some
women. Do not use if you have
a bleeding disorder, epilepsy,
schizophrenia or trying to fall
pregnant.
Pain medication
conditions (e.g. cysts, fibroadenomas),
medications (e.g. antidepressants,
antipsychotics, diuretics, digoxin) or
trauma. Often no specific cause is found.
3
Extramammary breast pain
Breast pain can also arise from
conditions outside the breast, including:
Pectoralis muscle strain from activities
such as raking, shovelling & lifting
Costochondritis: inflammation of the
cartilage that joins the ribs to the
breastbone
Referred pain from heart disease,
gastro-oesophageal reflux disease or
gallstones.
Paracetamol or an anti-inflammatory
medication may lessen the severity.
Oral contraceptive pill
Low dose oral contraceptive pill may
improve cyclical breast pain, though
some women find it worsens their
symptoms. Discuss with your GP.
Surgery
Painful breast cysts can be aspirated
and fibroadenomas excised.
WIN THE BRA WARS!
Is it cancer?
Breast pain alone is rarely a
symptom of breast cancer.
It is estimated that 3 out
of 100 women presenting
with pain as their main
problem is diagnosed with
breast cancer. However any
new or persistent breast symptoms always require investigation.
*This advice is general only. All surgical procedures have risks. Speak to your doctor about breast pain.
Dr Mary Ling is a Breast and General Surgeon who consults
at Gosford, Woy Woy and Kanwal.
& 02 4321 0302
6
www.drmaryling.com.au
ON TH E C OA S T – FA MILIES
@drmaryling
Breast pain can be reduced by
wearing a well-fitting supportive bra.
Have a bra specially fitted by trained
staff. Quick check points:
The panel connecting the 2 cups
lies flat against the breastbone
with no gaps or spaces
The band is parallel to the ground
– not riding up your back
Your breasts are fully contained in
the cups – not spilling out, which is
a sign of poor fit.