Why does breast pain arise? The main and also less common causes

Breast pain can have different causes and character.

Breast pain is called mastalgia.
The feeling of tightness in the breast is called mastodynia.

Stress, excessive intake of caffeine, nicotine and theophylline can contribute to these difficulties.

About the breasts

The breasts are located on the front wall of the chest, approximately between the second and sixth ribs.

It

consists of the mammary gland itself and the surrounding connective tissue.

The nipple and areola are found on the breast, with increased pigment and smooth muscle that allows the nipple to erect.

The glandular system consists of ducts, lobules and smaller lobules.

The

space between the glandular structures is made up of fat.

When you have breast pain, it is important to distinguish where the pain is coming from.

It

can either be primarily from the breast or radiate to the breast from other sites.

Pain directly in the breast is most commonly experienced by women, but can

also

occur in men.

In the case of long-standing breast pain, it is most important to rule out a serious cause, such as a malignant breast tumour.

When distinguishing the causes of breast pain, answer the following questions.

The

doctor will be able to make a differential diagnosis more quickly and can help you better.

Questions.

• We know acute (sudden onset) or chronic (long-term).
• What is the nature of the breast pain? Dull, pinching, throbbing, burning, stabbing, jerking, etc.
• When do I feel the pain? Is the pain constant or episodic?
• Does the pain have a triggering moment? Pain depending on menstrual cycle, exertion, food intake, activity, stress, breastfeeding, etc.
• and questions such as:
• Do I have a relief position?
• What is the pain intensity on a scale of 1 to 10?
• Is the pain accompanied by other symptoms in the breast area?
• Do I feel pain only when I palpate the breast?
• Do I feel a lump? Is it mobile, soft? Is it immobile, stiff?
• Do I feel pain in other parts of my body?
• Do I notice other unpleasant sensations and/or changes on my body?
• Do I have elevated body temperature, sweating, weight loss, fatigue, lack of appetite?
• Has anyone in my family had breast and/or ovarian disease?

The

main causes of breast pain

Pain can either come directly from the breast or it can radiate to the breast area from another location.

5x pain originating primarily from the breast

1. Developmental disorders and involution (atrophy) of the mammary gland

In developmental disorders of the mammary gland, women may experience various discomforts and pain in the breast area.

The

basic disorders include

• Protruding nipples (polytelia)
• an extra mammary gland (polymastia)
• absence of the nipple (athelia)
• defective muscle attachments, chest disorders
• juvenile stromal hyperplasia

It is this developmental disorder that can often cause neurological and orthopaedic difficulties in the breast area. Because of the weight of the breasts, patients often have to undergo breast reduction plastic surgery.

• congenital nipple incision
• fibroadenomas
• macromastia
• phyloid tumour
• adolescent breast hyperplasia

Disorders of involution (atrophy) include fibrocystic changes of the breast.

2. Menstrual cycle

The glandular system of the breast is sensitive to hormonal changes.

The

major hormones include estrogen, progesterone, prolactin.

In women, cyclic hormonal changes are caused by the menstrual cycle.

The gland changes due to the cycle. It gradually produces and accumulates smaller amounts of secretion. Eventually, abruptio n of cells occurs in the last days of the menstrual cycle.

Hormonal changes may be associated with increased breast tenderness to pain, menstrual migraine, abdominal discomfort to intense pain, spinal pain, mood changes, general weakness, and so on.

Breast pain is experienced by some women during ovulation, some before or during menstruation itself.

The

breast is bulkier, more engorged and more sensitive in the second phase of the cycle.

The breasts are also sensitive and painful to touch during the cycle.

Difficulty before the actual menstruation is called premenstrual syndrome (PMS).

Breast pain is more commonly experienced by women with fibrocystic changes.

With age, the character of the mammary gland gradually changes.

Initially in adolescence we find the juvenile type. From the period of sexual maturity onwards, we find the fertile type, then the transitional to atrophic type.

Breast pain may also accompany women in the menopause. They are associated with hot flushes, insomnia, increased body weight and headaches.

3. Pregnancy, lactation, pain associated with breast milk production

The breasts undergo dramatic changes during pregnancy and preparation for lactation.

Prolactin levels rise significantly until delivery. High levels of estrogens and gestagens produced by the placenta also affect this process.

During lactation, oxytocin acts on the mammary gland.

Changes and preparation of the mammary gland are often accompanied by pain, a feeling of intense tension and pressure.

Women may experience increased sensitivity and pain when breastfeeding.

Breastfeeding and breast pain...

Pain can be caused by several factors.

Improper breastfeeding technique on the part of the mother or inadequate and/or improper latching of the baby.

Inadequate emptying of the milk ducts, short intervals between breastfeeding, and transmission of infection at

the

hands of the mother or hospital staff also play a role.

The

mouth of the newborn is colonized with various bacteria in the delivery room. These are then transferred to the breast during breastfeeding.

Maternal exhaustion after childbirth or six months can contribute to these difficulties.

Often, the mother immediately develops small cuts to larger tears (ragades) in

the

breast.

The

injured breast then becomes inflamed, does not express milk adequately and hurts even more.

A

vicious circle develops.

A

breast that is engorged with milk is sensitive

to

touch, painful and hard. This can happen with insufficient pumping or excessive milk production.

What can help?

Siphoning milk under running water in the shower, nipple balm, acetate compresses, gauze soaked in medicine from the pharmacy can bring relief.

If the pain and discomfort persist, see a doctor. Inflamed breast (mastitis) should not be underestimated.

Bacterial infections, breast suppuration, abscess formation, increased temperature (febrility) in mastitis require treatment with antibiotics.

Even if problematic breastfeeding is a sensitive topic, seek advice! There is no reason to feel a sense of failure.

Consult your doctor, nurse or lactation consultant. Health advice and educational portals written by experts are also helpful.

Watch out for discussion forums. Wise advice from moms will sometimes provide misguided reassurance in addition to practical advice. Symptoms should not be ignored. Tumors don't take their time!

In some cases, tumours also appear during pregnancy or after childbirth during breastfeeding. Women mistakenly attribute long-term swollen breasts and persistent pain to hormonal changes during pregnancy and breastfeeding. Therefore, they often do not visit a gynaecologist.

4. Mastitis

Inflammation of the breast (mastitis) may not only occur during the above mentioned period during the six months of childbirth and lactation.

It is

painful mastitis that may bring a woman to a gynaecological examination outside this period.

Mastitis should not be underestimated. It can lead to the formation of purulent deposits (abscesses) and fistulas (fistulas).

Read also: Mastitis: inflammation of the mammary gland. What are the symptoms and risks of mastitis?

There are several types.

In case of advanced suppurative infection, surgical intervention is necessary.

B. puerperal mastitis

A common form of inflammation of the mammary gland after childbirth. Associated with poor breastfeeding technique as described above.

C. nonpuerperal mastitis

Can occur at any time during a woman's life.

In this type, infection can spread with irritation/damage to the nipple and other associated diseases, general weakness and exhaustion, viral illness, etc.

Treatment is anti-inflammatory, antibiotic and/or surgical depending on the condition.

5. Breast tumours

Breast pain can accompany benign and malignant breast tumours.

There are many histological types.

Depending on the type of tissue, we know epithelial, myoepithelial, mesenchymal, fibroepithelial, malignant lymphomas, nipple tumours, secondary lesions (metastases), which are further subdivided into other types.

In young women, benign fibroadenomas are a common finding.

Their number and nature can vary.

Approximately 10-20% of the female population has fibroadenomas.

They are more common between the ages of 15 and 35.

Growing, problematic fibroadenomas and especially atypical findings are indications for removal after evaluation by a specialist

.

It is important for a woman to know her breasts and to perform regular breast self-examinations as a preventive measure.

The basis of prevention is breast self-examination (self-palpation) by circular movements around the quadrants of the breast and armpit.

It is recommended preferably

on the

7th-8th day after menstruation.

This is the

simplest and most accessible method of early detection of breast cancer.

Read more:
Breast self-examination: a step-by-step guide to prevention and breast health

Breast cancer is the most common cancer in women.

The

highest incidence is between the ages of 55 and 65

.

Important information can be found in the article:
Causes and symptoms of breast cancer? Self-examination as a method of prevention

Breast cancer can rarely occur in men.

The

most common histological type is ductal invasive breast cancer.

We also encounter lobular invasive breast cancer and inflamatory breast cancer.

Women often find a lump in the breast by accident and do not feel pain. This does not mean that a lump without pain is benign.

Cancerous breast pain manifests as prolonged aching to severe persistent pain inside the breast.

Breast cancer most often occurs in the upper lateral part (quadrant) of

the

breast.

It

is often already associated with changes in the breast.

Alarming symptoms!

• Prolonged pain
• palpation of a lump (stiff, immobile, tends to get bigger over time)
• changes in the appearance of the nipple
• oozing of secretion from the nipple
• nipple retraction
• orange skin around the breast
• changes in the shape of part to all of the breast
• palpable lumps (enlarged lymph nodes) in the armpit
• general symptoms (general weakness, weight loss, lack of appetite)
• symptoms associated with the presence of distant metastases

What are the risk factors?

Increasing life expectancy, rising standards of living, postponement of starting a family, restrictions on breastfeeding and the so-called westernization of lifestyle all have an impact on the development of breast cancer.

• Positive family history
• Early menarche (onset of first menstruation)
• nulliparous (if the woman has not given birth)
• incorrect eating habits (lack of fruit and vegetables), excessive fat intake
• obesity
• lack of sporting physical activity
• prolonged excessive use of contraceptives at menopause
• influence of PCBs, pesticides
• influence of radiation

Medical research has made tremendous progress in the treatment of cancer. Modern surgical techniques, chemotherapy, radiation (radiotherapy), combinations of treatments and targeted biological therapies are being used in the treatment of breast cancer.

Nowadays,

earlier detection and new surgical options allow for breast conservation.

New findings are bringing personalized, tailored treatments through molecular genetic stratification of patients.

The challenge in oncology is immunotherapy and its potential use in the treatment of cancer.

12x Other causes

What are the other options?

Pain radiating (transmitted) to the breast

We list the 11 (12) most common causes of difficulty..

.

1. Musculoskeletal disorders (muscle, bone damage) spinal disorders, vertebral disc disorders, contusions, rib fractures (fractures), shoulder joint disorders, chondro-osseous inflammation in the chest wall (Tietz syndrome)
2. Cardiovascular causes of ischaemic pain, so called stenocardia (pain behind the sternum) when there is insufficient oxygen supply to the heart muscle
3. Lung diseases pneumonia (pneumonia), pleurisy (pleurisy)
4. Diseases of the digestive tract inflammation of the oesophagus (oesophagitis), inflammation of the stomach (gastritis)
5. Skin diseases skin diseases with breast damage, e.g. psoriasis of the breast
6. Neurological diseases neurological diseases with pain radiating to the breast
7. Rheumatological diseases Rheumatological diseases with pain radiating to the breast
8. Infectious causes of herpes zoster (shingles)
9. Diseases of the endocrine system disorders of hormone production and/or release causing breast pain
10. Diseases of the lymphatic system 97% of lymphatic drainage is directed to the armpit
11. After injuries, surgeries
12. Read more

Male breasts

In men, the rudimentary (stunted) form forms the basis of the mammary gland.

In men, the mammary gland regresses due to testosterone. Male breast tissue contains the same receptors for signaling molecules, so it can respond to the same stimuli.

Enlarged breasts in men are called gynecomastia.

Gynecomastia = enlarged breast in a man.

Breast and/or breastpain in men can be caused by excessive physical exertion.

Especially in younger men, breast pain can occur with improper exercise technique and overexertion.

Breast cancer is relatively rare. Men with breast cancer are usually treated in specialised cancer centres.

Breast enlargement (gynecomastia) in men can be caused by

:

• diseases of the endocrine system
• use of steroids, testosterone
• the effect of certain drugs, e.g. psychopharmaceuticals, digoxin, chemotherapy, spironolactone
• cirrhosis of the liver
• renal failure
• ulcerative colitis
• cancer

In men, increased breast tenderness or soreness and breast enlargement can be an alarming sign of testicular cancer!

Basic breast examination methods

The first basic step is a history and physical examination by a gynecologist.

Laboratory oncomarkers CEA, Ca 15-3 are useful.

Imaging methods used in breast examination include ultrasonography (USG) of the breast, mammography, and breast MRI. Chest X-ray, CT scan and other examinations are used to further assess the surrounding structures and rule out other causes.

Currently,

mammography has seen significant advances in radiology due to modern digital techniques and less radiation exposure.

Women over the age of 40 receive regular radiological findings as part of breast cancer screening. For women at risk with a genetic burden, there are stricter preventive and therapeutic measures.

Biopsy is important in the diagnostic process, as it provides definitive histology.

Modern approaches are now available using a fine needle that the patient does not feel or feels minimally.

Even the biopsy is performed under imaging control directly from the affected site.

The

BI-RADS score (a score of the likelihood of a benign or malignant lesion)

• BI-RADS 0 - incomplete finding, further examination required
• BI-RADS 1 - normal, negative finding
• BI-RADS 2 - benign finding
• BI-RADS 3 - probably benign finding, recommended follow-up at a shortened interval
• BI-RADS 4 - suspicious for malignancy
• BI-RADS 5 - malignant finding
• BI-RADS 6 - confirmed malignant finding

TNM classification to determine the extent of tumour involvement

:

• T tumor (tumor size)
• N nodus (lymph node involvement)
• M metastasis (no/absence of metastases)

Don't let fear win over pain!

If you have persistent breast pain or other problems, see a doctor!