Mastodynia

Mastodynia, mastalgia or mammalgia are names for a medical symptom that means - pain in the breast (from the Greek masto-, breast and algos, pain).

Mastalgia is breast pain and is generally classified as either cyclical (associated with menstrual periods) or noncyclical. Noncyclical pain may come from the breast or may come from somewhere else, such as nearby muscles or joints, and may be felt in the breast. Pain can range from minor discomfort to severely incapacitating pain in some cases. Many women with mastalgia worry more about the fear of cancer than about the pain itself.^[1]

Types

It can be subdivided into 2 main clinical patterns:

• cyclical when the pain is worse prior to each menstrual cycle
  • This may occur with a woman's natural menstrual cycles and is not due to any hormone or breast disease.
  • It may be caused by use of hormonal contraception

• non-cyclical breast pain is fairly uncommon, feels different than cyclical mastalgia, and does not vary with the menstrual cycle. Generally, the pain is present all the time and is in only one specific location. One cause of noncyclical breast pain is trauma, or a blow to the breast. Other causes can include arthritic pain in the chest cavity and in the neck, which radiates down to the breast. Another cause is a side effect of cabergoline/dostinex - it can cause quite sharp pain throughout the whole breast, general breast discomfort, and is not localised.^[1]

Associations

Breast cancer is, in 19 out of 20 cases, not normally painful in the early stages^{[citation needed]}. New onset of a painless lump should therefore be promptly assessed.

Causes

• methylxanthines (caffeine, theobromine, theophylline, paraxanthine) that cause blood vessels to dilate^{[citation needed]}
• salt: increases swelling by causing fluid retention^{[citation needed]}
• pregnancy: Hormonal influences that cause vessels to dialate.

Treatments for cyclical breast pain

Specific treatment for cyclical breast pain will be determined by your physician(s) based on:^[1]

• your overall health and medical history
• extent of the condition
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition

Treatments vary significantly and may include the following:^[1]

• caffeine avoidance
• a low-fat diet
• evening primrose oil
• vitamin E
• any over-the-counter pain-reliever

In some cases, various supplemental hormones and hormone blockers are also prescribed. These may include:

• birth control pills
• Bromocriptin (which blocks prolactin in the hypothalamus)
• Danazol, a male hormone
• thyroid hormones
• Tamoxifen, an estrogen blocker

Supplemental hormones and hormone blockers may have side effects. In addition, the risks and benefits of such treatment should be carefully discussed with your physician.

Treatments for non-cyclical breast pain

Determining the appropriate treatment for noncyclical breast pain is more difficult, not only because it is hard to pinpoint where the pain is coming from, but also because the pain is not hormonal. Specific treatment for noncyclical breast pain will be determined by your physician(s) based on:

• your overall health and medical history
• extent of the condition
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition

Generally, physicians will perform a physical examination and may order a mammogram. In some cases, a biopsy of the area is also necessary. If it is determined that the pain is caused by a cyst, the cyst will be aspirated. Depending on where the pain originates, treatment may include analgesics, anti-inflammatory drugs, and compresses.

References

1. ^ ^{a b c d} http://www.childrenshospital.org/az/Site1274/mainpageS1274P0.html Children's Hospital Boston: My Child Has