Materiały źródłowe

• #1 Breast pain: assessment, management, and referral criteria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7384817/

  Breast pain (mastalgia) is experienced by 70% of women during their lifetime and may be considered a physiological symptom rather like painful menses, but remains a common presentation in primary care. […] Despite an absence of evidence suggesting that mastalgia alone is associated with breast cancer, it is still commonly referred to secondary care breast units in one study it accounted for 41% of referrals. […] Careful assessment is essential to avoid unnecessary referral, which can lead to anxiety or over-investigation. […] The National Institute for Health and Care Excellence (NICE) states that: breast pain is not a criteria for urgent referral, with a positive predictive value of 3% for breast cancer; and referral is recommended if cyclical breast pain is affecting quality of life or sleep, and has been ongoing for more than 3 months if the pain is unresponsive to first-line treatment. […] Explanation and support alone has a vital role to play in the management of mastalgia. […] Breast pain can usually be safely managed in the primary care setting.

• #2 Mastalgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562195/

  Mastalgia, or breast pain, affects up to 70% of women and is a frequent concern in primary care, though it is rarely linked to breast cancer. […] Assessment involves a detailed history and examination to rule out malignancy and differentiate between causes. […] While a referral is rarely urgent, persistent pain impacting the quality of life may require specialist evaluation. […] Most cases resolve over time, and a stepwise treatment approach ensures effective management with minimal unnecessary intervention. […] Mastalgia is typically characterized as a dull, aching pain, while some women may describe it as heaviness, tightness, discomfort, or burning sensation in the breast tissue, which may be unilateral or bilateral. […] Based on the pattern of breast pain, associated factors, and location, mastalgia is classified into 3 categories: cyclic, noncyclic, and extramammary pain.

• #3 The Evaluation of Common Breast Problems | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0415/p2371.html

  The most common breast problems for which women consult a physician are breast pain, nipple discharge and a palpable mass. Most women with these complaints have benign breast disease. Breast pain alone is rarely a presenting symptom of cancer, and imaging studies should be reserved for use in women who fall within usual screening guidelines. […] Breast pain is the most common breast symptom causing women to consult primary care physicians and surgeons. Mastalgia is more common in pre-menopausal women than in postmenopausal women, and it is rarely a presenting symptom of breast cancer. […] The evaluation of breast pain begins with a thorough history and a careful physical examination. Special attention should be given to the type of pain, its location and its relationship to the menstrual cycle.

• #4 Mastalgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562195/

  Assessment of mastalgia begins with a detailed history to understand the nature of the pain, associated symptoms, and contributing factors like medication use or family history of breast disease. […] The clinical examination focuses on identifying indications for further diagnostic evaluation, differentiating between mastalgia that may be addressed with reassurance and breast pain with suspicious features. […] In patients with cyclic or diffuse noncyclic mastalgia and no abnormal findings on clinical breast examination (eg, breast mass, skin changes, nipple discharge) or high-risk factors, no further diagnostic studies are necessary; reassurance is typically sufficient. […] However, diagnostic imaging is indicated in women with noncyclical focal mastalgia or an abnormal finding on clinical examination.

• #5 Breast pain – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/breast-pain/diagnosis-treatment/drc-20350426

  Tests to evaluate your condition may include: […] Your doctor checks for changes in your breasts, examining your breasts and the lymph nodes in your lower neck and underarm. […] If your doctor feels a breast lump or unusual thickening, or detects a focused area of pain in your breast tissue, you’ll need an X-ray exam of your breast that evaluates the area of concern found during the breast exam (diagnostic mammogram). […] An ultrasound exam uses sound waves to produce images of your breasts, and it’s often done along with a mammogram. […] Suspicious breast lumps, areas of thickening or unusual areas seen during imaging exams may require a biopsy before your doctor can make a diagnosis. […] If you have breast pain that is new, that persistently affects just a particular part of your breast or that affects your quality of life, see your doctor for an evaluation. […] Your doctor may ask you questions such as: Where in your breast do you feel pain? […] Your doctor may also assess your personal risk of breast cancer, based on factors such as your age, family medical history and prior history of precancerous breast lesions.

• #6 Mastalgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562195/

  Assessment of mastalgia begins with a detailed history to understand the nature of the pain, associated symptoms, and contributing factors like medication use or family history of breast disease. […] The clinical examination focuses on identifying indications for further diagnostic evaluation, differentiating between mastalgia that may be addressed with reassurance and breast pain with suspicious features. […] In patients with cyclic or diffuse noncyclic mastalgia and no abnormal findings on clinical breast examination (eg, breast mass, skin changes, nipple discharge) or high-risk factors, no further diagnostic studies are necessary; reassurance is typically sufficient. […] However, diagnostic imaging is indicated in women with noncyclical focal mastalgia or an abnormal finding on clinical examination.

• #7 Breast pain – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/breast-pain/diagnosis-treatment/drc-20350426

  Tests to evaluate your condition may include: […] Your doctor checks for changes in your breasts, examining your breasts and the lymph nodes in your lower neck and underarm. […] If your doctor feels a breast lump or unusual thickening, or detects a focused area of pain in your breast tissue, you’ll need an X-ray exam of your breast that evaluates the area of concern found during the breast exam (diagnostic mammogram). […] An ultrasound exam uses sound waves to produce images of your breasts, and it’s often done along with a mammogram. […] Suspicious breast lumps, areas of thickening or unusual areas seen during imaging exams may require a biopsy before your doctor can make a diagnosis. […] If you have breast pain that is new, that persistently affects just a particular part of your breast or that affects your quality of life, see your doctor for an evaluation. […] Your doctor may ask you questions such as: Where in your breast do you feel pain? […] Your doctor may also assess your personal risk of breast cancer, based on factors such as your age, family medical history and prior history of precancerous breast lesions.

• #8 Breast Pain (Mastalgia): Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/breast-pain/guide/

  Breast pain (mastalgia) is any pain or discomfort that occurs in one or both breasts. Only rarely is breast pain a sign of breast cancer. […] In most cases, breast pain is caused by a benign condition, such as changing hormone levels around the time of menstruation, or lifestyle habits such as wearing a poor-fitting bra. Only rarely is breast pain a sign of breast cancer. […] To diagnose breast pain, a doctor will likely start by taking a detailed medical history and performing a physical exam, paying close attention to its location and severity, as well as when it appears. […] If a physical exam turns up something abnormal, doctors can order additional testing, including a mammogram or breast ultrasound. These tests are used to take images of the breast tissue and can rule out more serious causes of breast pain, such as breast cancer.

• #9 Breast Pain: Tenderness, Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15469-breast-pain-mastalgia

  Rarely, cancer can cause breast pain. For this reason, if you experience breast pain for longer than two weeks or have symptoms like a lump, skin dimpling and nipple changes, contact a healthcare provider. […] Your provider may order a mammogram or an ultrasound, but whether you need either of these imaging tests will depend on a few different factors, including your specific type of pain, the findings from the breast exam, your age, and the length of time since your last breast-imaging procedure. […] If your breast pain is even more severe, your provider may suggest danazol or tamoxifen, which are two prescription medications. […] If you have noncyclic breast pain, your healthcare provider may suggest using similar treatment methods as they would for cyclic breast pain. But if they find the underlying cause of your pain is due to things like an infection or a benign cyst, sometimes a more specific treatment is necessary for that cause (like antibiotics or surgery).

• #10 Breast pain – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/breast-pain/diagnosis-treatment/drc-20350426

  Tests to evaluate your condition may include: […] Your doctor checks for changes in your breasts, examining your breasts and the lymph nodes in your lower neck and underarm. […] If your doctor feels a breast lump or unusual thickening, or detects a focused area of pain in your breast tissue, you’ll need an X-ray exam of your breast that evaluates the area of concern found during the breast exam (diagnostic mammogram). […] An ultrasound exam uses sound waves to produce images of your breasts, and it’s often done along with a mammogram. […] Suspicious breast lumps, areas of thickening or unusual areas seen during imaging exams may require a biopsy before your doctor can make a diagnosis. […] If you have breast pain that is new, that persistently affects just a particular part of your breast or that affects your quality of life, see your doctor for an evaluation. […] Your doctor may ask you questions such as: Where in your breast do you feel pain? […] Your doctor may also assess your personal risk of breast cancer, based on factors such as your age, family medical history and prior history of precancerous breast lesions.

• #11 Common Breast Problems | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0415/p505.html

  The first step in the diagnostic evaluation of patients with nipple discharge is classification of the discharge as pathologic or physiologic. Nipple discharge is classified as pathologic if it is spontaneous, bloody, unilateral, or associated with a breast mass. Patients with pathologic discharge should undergo diagnostic imaging. […] Breast masses are associated with an increased risk of breast cancer. Patients presenting with a palpable breast mass should be evaluated with a detailed history, clinical breast examination (CBE), and, for almost all women, imaging. […] Although CBE has poor predictive value for determining whether a breast mass is cancerous, some features of breast masses may help distinguish between benign and malignant lesions. […] Diagnostic mammography is the most appropriate initial imaging modality for women 40 years and older who present with a breast mass, whereas ultrasonography is recommended for women younger than 30 years.

• #12 Breast pain – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/breast-pain/diagnosis-treatment/drc-20350426

  Tests to evaluate your condition may include: […] Your doctor checks for changes in your breasts, examining your breasts and the lymph nodes in your lower neck and underarm. […] If your doctor feels a breast lump or unusual thickening, or detects a focused area of pain in your breast tissue, you’ll need an X-ray exam of your breast that evaluates the area of concern found during the breast exam (diagnostic mammogram). […] An ultrasound exam uses sound waves to produce images of your breasts, and it’s often done along with a mammogram. […] Suspicious breast lumps, areas of thickening or unusual areas seen during imaging exams may require a biopsy before your doctor can make a diagnosis. […] If you have breast pain that is new, that persistently affects just a particular part of your breast or that affects your quality of life, see your doctor for an evaluation. […] Your doctor may ask you questions such as: Where in your breast do you feel pain? […] Your doctor may also assess your personal risk of breast cancer, based on factors such as your age, family medical history and prior history of precancerous breast lesions.

• #13 Breast pain – UpToDate

  https://www.uptodate.com/contents/breast-pain/print

  Breast pain (mastalgia) is common in women and occasionally occurs in men. Although it is usually mild and self-limited, approximately 15 percent of affected women require treatment. Evaluation of breast pain is important to determine whether the pain is due to normal physiological changes related to hormonal fluctuation or to a pathologic process such as breast cancer. Unfortunately, studies specific to breast pain are limited and often small in number, not well designed, and with limited follow-up. […] Breast pain is a rare symptom of breast cancer. Women who present with breast pain but who have a normal examination and imaging studies can be reasonably assured that their risk of breast cancer is similar to that of a woman without breast pain. Most patients do not seek further medical attention for the pain once they are assured that they do not have breast cancer. […] This topic will discuss the etiology, evaluation, and treatment of breast pain in women. Evaluation of a breast mass or cancer is discussed separately. […] Breast pain caused by inflammatory or infectious etiologies (ie, mastitis) is discussed in other topics.

• #14 Mastalgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562195/

  The most common radiological modalities for imaging breast tissue are mammography, ultrasound, and magnetic resonance imaging (MRI). […] In the infrequent case of a patient with mastalgia and imaging findings suspicious of malignancy, a tissue biopsy is required. […] Depending on the results of clinical assessment and any diagnostic studies performed, patients without any identifiable pathology typically can be managed with reassurance and supportive therapies, if desired. […] The remaining 15% will require treatment apart from reassurance, mainly because of the negative impacts on physical activity (30%) and sexual activity (up to 40%), as well as their life quality in work and social activities (10%). […] Following the exclusion of an underlying breast malignancy or significant etiology, patients with persistent mild to moderate mastalgia may be treated with conservative interventions.

• #15 Mastalgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562195/

  Assessment of mastalgia begins with a detailed history to understand the nature of the pain, associated symptoms, and contributing factors like medication use or family history of breast disease. […] The clinical examination focuses on identifying indications for further diagnostic evaluation, differentiating between mastalgia that may be addressed with reassurance and breast pain with suspicious features. […] In patients with cyclic or diffuse noncyclic mastalgia and no abnormal findings on clinical breast examination (eg, breast mass, skin changes, nipple discharge) or high-risk factors, no further diagnostic studies are necessary; reassurance is typically sufficient. […] However, diagnostic imaging is indicated in women with noncyclical focal mastalgia or an abnormal finding on clinical examination.

• #16 Breast pain – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/breast-pain/diagnosis-treatment/drc-20350426

  Tests to evaluate your condition may include: […] Your doctor checks for changes in your breasts, examining your breasts and the lymph nodes in your lower neck and underarm. […] If your doctor feels a breast lump or unusual thickening, or detects a focused area of pain in your breast tissue, you’ll need an X-ray exam of your breast that evaluates the area of concern found during the breast exam (diagnostic mammogram). […] An ultrasound exam uses sound waves to produce images of your breasts, and it’s often done along with a mammogram. […] Suspicious breast lumps, areas of thickening or unusual areas seen during imaging exams may require a biopsy before your doctor can make a diagnosis. […] If you have breast pain that is new, that persistently affects just a particular part of your breast or that affects your quality of life, see your doctor for an evaluation. […] Your doctor may ask you questions such as: Where in your breast do you feel pain? […] Your doctor may also assess your personal risk of breast cancer, based on factors such as your age, family medical history and prior history of precancerous breast lesions.

• #17 Breast Pain: Types, Causes, and Treatment Options

  https://www.verywellhealth.com/causes-for-sharp-breast-pain-429843

  If you have a breast mass or lump, you might have a diagnostic mammogram, and/or ultrasound. […] A breast biopsy is a procedure during which cells are removed from an area of concern. This is the only definitive way to diagnose or rule out breast cancer. […] The treatment plan for your breast pain will depend on your diagnosis. While some conditions may require simple self-care strategies, other conditions require medical or surgical interventions. […] If your breast pain is due to cyclic or noncyclic mastalgia, your healthcare provider may suggest one or more of the following strategies: Wearing a well-fitted bra with steel underwire during the day and a soft, supportive bra at night. […] Surgery may be needed for the treatment of certain types of breast pain. For example, if an abscess is found on the breast, surgical drainage could be necessary.

• #18 Common Breast Problems | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0415/p505.html

  Because of the imperfect sensitivity and specificity of CBE and imaging, patients should be referred for tissue sampling if suspicious findings are noted at any stage of the evaluation, regardless of benign findings at other stages. […] Imaging should be performed before biopsy because postbiopsy changes in the breast tissue may distort imaging findings. In most cases, a core needle biopsy should be performed for evaluation of a suspicious mass. […] Mastalgia is the second most common breast symptom leading to medical evaluation in the primary care setting. […] Evaluation of breast pain begins with a detailed history: pain profile (location, quality, severity, laterality, and temporal relation to menses), medication history, musculoskeletal triggers, impact on daily function, and family history of breast cancer.

• #19 Breast Pain (Causes, Symptoms and Treatment)

  https://patient.info/doctor/breast-pain-pro

  Breast pain is one of the most common breast symptoms experienced by women, and management requires careful assessment and diagnosis. […] The risk of cancer in a woman presenting with breast pain as an isolated symptom is extremely low as breast pain is one of the least associated symptoms of breast cancer, present only in 0.5% to 2% of patients later diagnosed with cancer. […] The classification is important because the assessment, management and response to treatment are different for the different types of breast pain. […] The most important conditions to exclude are breast cancer, pregnancy and infection. […] Management will depend on the cause but a variety of measures which have been routinely advised by some in the past should no longer be recommended. […] Reassurance that the pain is not due to breast cancer and an explanation as to its hormonal nature may be all the management that some women require. Studies have shown that reassurance alone is effective management in 70% of women. […] Non-cyclical breast pain responds poorly to treatment but resolves spontaneously in 50% of women. […] This can be difficult to predict as it will depend on the many potential underlying pathological and psychological issues.

• #20 Common breast problems. A systematic approach to diagnosis and treatment | Medicine Today

  https://medicinetoday.com.au/mt/2019/october/feature-article/common-breast-problems-systematic-approach-diagnosis-and-treatment

  True breast pain can be cyclical (varying over the menstrual cycle) or noncyclical. However, in many women who present with breast pain, the pain is actually chest wall related. […] Cyclical mastalgia refers to breast pain that occurs in relation to a woman’s menstrual cycle. It usually affects women in their 30s, although it can occur at any age during the premenopausal period. […] If the pain is persistent and significant and affects quality of life, referral of the patient to a breast specialist is indicated. […] Noncyclical mastalgia is not as well characterised as cyclical mastalgia and has few associated factors. […] Chest wall pain is one of the most common causes of perceived breast pain. […] It is important to exclude other causes of chest wall pain, and importantly to reassure the patient.

• #21 Mastalgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562195/

  Mastalgia, or breast pain, affects up to 70% of women and is a frequent concern in primary care, though it is rarely linked to breast cancer. […] Assessment involves a detailed history and examination to rule out malignancy and differentiate between causes. […] While a referral is rarely urgent, persistent pain impacting the quality of life may require specialist evaluation. […] Most cases resolve over time, and a stepwise treatment approach ensures effective management with minimal unnecessary intervention. […] Mastalgia is typically characterized as a dull, aching pain, while some women may describe it as heaviness, tightness, discomfort, or burning sensation in the breast tissue, which may be unilateral or bilateral. […] Based on the pattern of breast pain, associated factors, and location, mastalgia is classified into 3 categories: cyclic, noncyclic, and extramammary pain.

• #22 Mastalgia – Classification – Differential Diagnosis – TeachMeSurgery

  https://teachmesurgery.com/breast/presentations/mastalgia/

  Mastalgia refers to breast pain and is a common presenting complaint among female patients. […] A primary concern for patients with mastalgia is that it is related to breast cancer. However, the incidence of a breast malignancy associated with a presenting complaint of mastalgia is low. A thorough assessment is required to determine the cause of the pain, explore any potential associated symptoms, and hopefully to reassure and manage their symptoms. […] There are multiple causes for breast pain, however a common way to categorise types of breast pain is as cyclical, non-cyclical, or extra mammary. […] Breast pain in isolation with no other relevant features on history or examination is not an indication for imaging. […] Mastalgia in isolation with no other clinical features is not an indication for imaging. […] Simple analgesics and reassurance are first line treatments.

• #23 Breast Pain Treatment Melbourne, VIC | Mastalgia Treatment Melbourne, VIC

  https://www.melbournebreastcancersurgery.com.au/breast-painmastalgia.html

  Most breast complaints are benign in nature. […] Mastalgia means breast pain. Breast pain is extremely common, and for many women who attend this is their main and only symptom. […] Mastalgia is not usually a sign of breast cancer or other significant breast disease. […] Doctors often think it a trivial symptom, but for many women mastalgia causes significant discomfort and anxiety. […] It should not be forgotten that mastalgia is a symptom, and therefore is not a specific disease in its own right. […] If you are not sure which type of breast pain you have, it may be worth keeping a pain diary (below) for 2-3 months. […] Any woman with a breast symptom, including significant mastalgia, requires a full breast assessment including clinical breast examination and breast imaging to exclude cancer and other significant breast pathology as an explanation for the symptoms.

• #24 Breast Pain (Sore Breasts): Cyclical and Non Cyclical

  https://patient.info/womens-health/breast-problems/breast-pain

  Most women develop breast pain (mastalgia) at some stage in life. In most cases the pain develops in the days just before a period. […] In some cases the pain is not related to periods. The pain is often mild but in some women it is more severe and can affect quality of life. If needed, treatment options include pain reliever and rub-on (topical) anti-inflammatory drugs. […] Up to 7 in 10 women develop breast pain (mastalgia) at some stage in their lives. Breast pain is usually classed as either cyclical or non-cyclical. […] If you are not sure which type of breast pain you have, it may be worth keeping a pain diary for 2-3 months. Record the days when you have breast pain, and highlight the days when the pain is severe enough to affect your lifestyle. See what pattern emerges. […] Women with breast pain often worry that the pain is a sign of breast cancer. However, the first symptom of breast cancer is usually a painless lump. Pain is not usually an early symptom. […] However, even though breast pain is not likely to be caused by cancer, you should see your doctor if you have any concerns about breast pain or any other breast symptoms.

• #25 Mastalgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562195/

  Mastalgia, or breast pain, affects up to 70% of women and is a frequent concern in primary care, though it is rarely linked to breast cancer. […] Assessment involves a detailed history and examination to rule out malignancy and differentiate between causes. […] While a referral is rarely urgent, persistent pain impacting the quality of life may require specialist evaluation. […] Most cases resolve over time, and a stepwise treatment approach ensures effective management with minimal unnecessary intervention. […] Mastalgia is typically characterized as a dull, aching pain, while some women may describe it as heaviness, tightness, discomfort, or burning sensation in the breast tissue, which may be unilateral or bilateral. […] Based on the pattern of breast pain, associated factors, and location, mastalgia is classified into 3 categories: cyclic, noncyclic, and extramammary pain.

• #26 Mastalgia (Breast Pain) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/breast-disorders/mastalgia-breast-pain

  Mastalgia (breast pain) is common and can be localized or diffuse and unilateral or bilateral. […] Localized breast pain is usually caused by a focal disorder that causes a mass, such as a breast cyst, or an infection (eg, mastitis, abscess). Most breast cancers do not cause pain. […] Diffuse bilateral pain may be caused by fibrocystic changes or, uncommonly, diffuse bilateral mastitis. However, diffuse bilateral pain is very common in women without breast abnormalities. The most common causes in these women are hormonal changes that cause breast tissue proliferation (eg, during the luteal phase or early pregnancy, in women taking estrogens or progestins) and large, pendulous breasts that stretch Cooper ligaments. […] Examination focuses on the breast, looking for abnormalities such as mass, nipple inversion or discharge, skin changes including erythema, rash, eczematous appearance, edema, or dimpling (sometimes termed peau dorange [orange peel]), and signs of infection, such as redness, warmth, and tenderness.

• #27 Common Breast Problems | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0415/p505.html

  Noncyclic/focal mastalgia should trigger diagnostic imaging because of its rare but occasional association with underlying malignancy. […] Although spontaneous resolution of breast pain is common, mastalgia can be chronic, necessitating a stepwise approach to management. […] Nipple discharge is a common symptom among women of reproductive age, with most women experiencing at least one episode. Although nipple discharge is predominantly physiologic or due to a benign etiology, an underlying malignancy is identified in up to 21% of patients with pathologic discharge who undergo biopsy. The initial workup includes a comprehensive history and physical examination, with the primary aim of distinguishing between normal lactation, nonpuerperal galactorrhea, and pathologic discharge. […] Pathologic discharge is generally spontaneous and unilateral, and originates from a single duct opening on a nipple. It may be bloody, serous, serosanguineous, or watery. If discharge is deemed pathologic, age-appropriate diagnostic imaging with mammography and/or ultrasonography is indicated.

• #28 Common breast problems. A systematic approach to diagnosis and treatment | Medicine Today

  https://medicinetoday.com.au/mt/2019/october/feature-article/common-breast-problems-systematic-approach-diagnosis-and-treatment

  True breast pain can be cyclical (varying over the menstrual cycle) or noncyclical. However, in many women who present with breast pain, the pain is actually chest wall related. […] Cyclical mastalgia refers to breast pain that occurs in relation to a woman’s menstrual cycle. It usually affects women in their 30s, although it can occur at any age during the premenopausal period. […] If the pain is persistent and significant and affects quality of life, referral of the patient to a breast specialist is indicated. […] Noncyclical mastalgia is not as well characterised as cyclical mastalgia and has few associated factors. […] Chest wall pain is one of the most common causes of perceived breast pain. […] It is important to exclude other causes of chest wall pain, and importantly to reassure the patient.

• #29 Mastalgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562195/

  Mastalgia, or breast pain, affects up to 70% of women and is a frequent concern in primary care, though it is rarely linked to breast cancer. […] Assessment involves a detailed history and examination to rule out malignancy and differentiate between causes. […] While a referral is rarely urgent, persistent pain impacting the quality of life may require specialist evaluation. […] Most cases resolve over time, and a stepwise treatment approach ensures effective management with minimal unnecessary intervention. […] Mastalgia is typically characterized as a dull, aching pain, while some women may describe it as heaviness, tightness, discomfort, or burning sensation in the breast tissue, which may be unilateral or bilateral. […] Based on the pattern of breast pain, associated factors, and location, mastalgia is classified into 3 categories: cyclic, noncyclic, and extramammary pain.

• #30 Breast pain | Breast Cancer Now

  https://breastcancernow.org/about-breast-cancer/breast-lumps-and-benign-not-cancer-breast-conditions/breast-pain

  Breast pain is very common in women of all ages and can also affect men. […] It can have lots of different causes but, on its own, breast pain is rarely a sign of breast cancer. […] Make an appointment with your GP if you’re concerned about breast pain that’s new or different for you, or you’ve also got other symptoms in your breast, like a lump, swelling, changes to the nipple or a change in colour. […] Your GP will examine your breasts and ask you about the type of pain you have and how often you get it. […] To check how long the pain lasts, how severe the pain is or if the pain is linked to your periods, your GP may ask you to fill in a simple pain chart. […] If your GP thinks you may have non-cyclical breast pain or chest wall pain, they may ask you to lean forward during the examination. This is to help them assess if the pain is inside your breast or in the chest wall. […] Your GP may refer you to a breast clinic where you’ll be seen by specialist doctors or nurses for a more detailed assessment.

• #31 Breast pain | Breast Cancer Now

  https://breastcancernow.org/about-breast-cancer/breast-lumps-and-benign-not-cancer-breast-conditions/breast-pain

  Breast pain is very common in women of all ages and can also affect men. […] It can have lots of different causes but, on its own, breast pain is rarely a sign of breast cancer. […] Make an appointment with your GP if you’re concerned about breast pain that’s new or different for you, or you’ve also got other symptoms in your breast, like a lump, swelling, changes to the nipple or a change in colour. […] Your GP will examine your breasts and ask you about the type of pain you have and how often you get it. […] To check how long the pain lasts, how severe the pain is or if the pain is linked to your periods, your GP may ask you to fill in a simple pain chart. […] If your GP thinks you may have non-cyclical breast pain or chest wall pain, they may ask you to lean forward during the examination. This is to help them assess if the pain is inside your breast or in the chest wall. […] Your GP may refer you to a breast clinic where you’ll be seen by specialist doctors or nurses for a more detailed assessment.

• #32 Breast Pain (Sore Breasts): Cyclical and Non Cyclical

  https://patient.info/womens-health/breast-problems/breast-pain

  Most women develop breast pain (mastalgia) at some stage in life. In most cases the pain develops in the days just before a period. […] In some cases the pain is not related to periods. The pain is often mild but in some women it is more severe and can affect quality of life. If needed, treatment options include pain reliever and rub-on (topical) anti-inflammatory drugs. […] Up to 7 in 10 women develop breast pain (mastalgia) at some stage in their lives. Breast pain is usually classed as either cyclical or non-cyclical. […] If you are not sure which type of breast pain you have, it may be worth keeping a pain diary for 2-3 months. Record the days when you have breast pain, and highlight the days when the pain is severe enough to affect your lifestyle. See what pattern emerges. […] Women with breast pain often worry that the pain is a sign of breast cancer. However, the first symptom of breast cancer is usually a painless lump. Pain is not usually an early symptom. […] However, even though breast pain is not likely to be caused by cancer, you should see your doctor if you have any concerns about breast pain or any other breast symptoms.

• #33 Work-up and management of breast pain – Li – Annals of Breast Surgery

  https://abs.amegroups.org/article/view/6968/html

  Breast pain is a common symptom experienced by women of all ages. Moderate to severe breast pain can impact quality of life. Breast pain is also frequently reported because of the fear of breast cancer. Though breast pain alone is rarely a sign of breast cancer, there is always a role for a thorough assessment of a patients symptoms. […] A thorough medical history, surgical history, and review of systems should be obtained. Medications should be confirmed. A breast cancer risk assessment should also be completed. Questions specific to breast pain should help to define if pain is cyclical, noncyclical, or extramammary in nature. Quality/nature/severity of pain, aggravating or alleviating factors, and associated symptoms should be explored. […] A thorough history and physical exam helps to determine whether imaging studies are indicated. Any findings on physical exam warrant further evaluation with diagnostic breast imaging.

• #34 Breast pain – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/breast-pain/diagnosis-treatment/drc-20350426

  Tests to evaluate your condition may include: […] Your doctor checks for changes in your breasts, examining your breasts and the lymph nodes in your lower neck and underarm. […] If your doctor feels a breast lump or unusual thickening, or detects a focused area of pain in your breast tissue, you’ll need an X-ray exam of your breast that evaluates the area of concern found during the breast exam (diagnostic mammogram). […] An ultrasound exam uses sound waves to produce images of your breasts, and it’s often done along with a mammogram. […] Suspicious breast lumps, areas of thickening or unusual areas seen during imaging exams may require a biopsy before your doctor can make a diagnosis. […] If you have breast pain that is new, that persistently affects just a particular part of your breast or that affects your quality of life, see your doctor for an evaluation. […] Your doctor may ask you questions such as: Where in your breast do you feel pain? […] Your doctor may also assess your personal risk of breast cancer, based on factors such as your age, family medical history and prior history of precancerous breast lesions.

• #35 When to Worry About Breast Pain: Causes, Diagnosis, Treatment

  https://www.healthline.com/health/womens-health/when-to-worry-about-breast-pain

  Occasional breast pain is normal. However, if this pain becomes persistent or grows, it may be time to talk with a doctor. […] This article will explore the causes of breast pain, as well as when to contact a doctor and how theyll diagnose your symptoms. […] Most causes of breast pain will go away on their own with time, medications, or lifestyle changes. However, if youre experiencing any of the following symptoms, schedule an appointment with a doctor for an evaluation and diagnosis: […] Your doctor will begin an examination for breast pain by asking you about your personal and family medical history. […] Your doctor may suggest a one-time or regular mammogram to examine your breast tissue more closely. […] Other tools that can help identify tissue changes, breast cancer, or other conditions may include:

• #36 Breast pain – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/breast-pain/symptoms-causes/syc-20350423

  Breast pain can range from mild to severe. […] Most times, breast pain signals a noncancerous (benign) breast condition and rarely indicates breast cancer. Unexplained breast pain that doesn’t go away after one or two menstrual cycles, or that persists after menopause, or breast pain that doesn’t seem to be related to hormone changes needs to be evaluated. […] Make an appointment with your doctor if breast pain: Continues daily for more than a couple of weeks, Occurs in one specific area of your breast, Seems to be getting worse over time, Interferes with daily activities, Awakens you from sleep. […] Breast cancer risk is very low in people whose main symptom is breast pain, but if your doctor recommends an evaluation, it’s important to follow through.

• #37 Breast pain – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/breast-pain/symptoms-causes/syc-20350423

  Breast pain can range from mild to severe. […] Most times, breast pain signals a noncancerous (benign) breast condition and rarely indicates breast cancer. Unexplained breast pain that doesn’t go away after one or two menstrual cycles, or that persists after menopause, or breast pain that doesn’t seem to be related to hormone changes needs to be evaluated. […] Make an appointment with your doctor if breast pain: Continues daily for more than a couple of weeks, Occurs in one specific area of your breast, Seems to be getting worse over time, Interferes with daily activities, Awakens you from sleep. […] Breast cancer risk is very low in people whose main symptom is breast pain, but if your doctor recommends an evaluation, it’s important to follow through.

• #38 Breast pain – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/breast-pain/symptoms-causes/syc-20350423

  Breast pain can range from mild to severe. […] Most times, breast pain signals a noncancerous (benign) breast condition and rarely indicates breast cancer. Unexplained breast pain that doesn’t go away after one or two menstrual cycles, or that persists after menopause, or breast pain that doesn’t seem to be related to hormone changes needs to be evaluated. […] Make an appointment with your doctor if breast pain: Continues daily for more than a couple of weeks, Occurs in one specific area of your breast, Seems to be getting worse over time, Interferes with daily activities, Awakens you from sleep. […] Breast cancer risk is very low in people whose main symptom is breast pain, but if your doctor recommends an evaluation, it’s important to follow through.

• #39 Breast pain – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/breast-pain/symptoms-causes/syc-20350423

  Breast pain can range from mild to severe. […] Most times, breast pain signals a noncancerous (benign) breast condition and rarely indicates breast cancer. Unexplained breast pain that doesn’t go away after one or two menstrual cycles, or that persists after menopause, or breast pain that doesn’t seem to be related to hormone changes needs to be evaluated. […] Make an appointment with your doctor if breast pain: Continues daily for more than a couple of weeks, Occurs in one specific area of your breast, Seems to be getting worse over time, Interferes with daily activities, Awakens you from sleep. […] Breast cancer risk is very low in people whose main symptom is breast pain, but if your doctor recommends an evaluation, it’s important to follow through.

• #40 Breast Pain: Tenderness, Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15469-breast-pain-mastalgia

  Breast pain is common and can happen to anyone. Its usually not a sign of breast cancer. Rather, its due to hormonal changes, medications or infection. Seek care if you experience breast pain that lasts longer than two weeks or when it comes with symptoms like a lump, nipple discharge or changes to the texture of the skin on your breast. […] Breast pain that doesn’t go away can also point to an underlying condition that needs treatment from a healthcare provider. […] Breast pain that sticks around for longer than two weeks or pain that’s unpredictable could be a signal that it’s time to contact a healthcare provider. It’s also worth calling your provider if you have painful breasts after menopause. […] If you have concerns about breast pain (especially if you’re at risk for breast cancer), you should schedule a visit with your healthcare provider for breast examination.

• #41 Breast Pain: Tenderness, Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15469-breast-pain-mastalgia

  Rarely, cancer can cause breast pain. For this reason, if you experience breast pain for longer than two weeks or have symptoms like a lump, skin dimpling and nipple changes, contact a healthcare provider. […] Your provider may order a mammogram or an ultrasound, but whether you need either of these imaging tests will depend on a few different factors, including your specific type of pain, the findings from the breast exam, your age, and the length of time since your last breast-imaging procedure. […] If your breast pain is even more severe, your provider may suggest danazol or tamoxifen, which are two prescription medications. […] If you have noncyclic breast pain, your healthcare provider may suggest using similar treatment methods as they would for cyclic breast pain. But if they find the underlying cause of your pain is due to things like an infection or a benign cyst, sometimes a more specific treatment is necessary for that cause (like antibiotics or surgery).

• #42 Breast pain | Breast Cancer Now

  https://breastcancernow.org/about-breast-cancer/breast-lumps-and-benign-not-cancer-breast-conditions/breast-pain

  Breast pain is very common in women of all ages and can also affect men. […] It can have lots of different causes but, on its own, breast pain is rarely a sign of breast cancer. […] Make an appointment with your GP if you’re concerned about breast pain that’s new or different for you, or you’ve also got other symptoms in your breast, like a lump, swelling, changes to the nipple or a change in colour. […] Your GP will examine your breasts and ask you about the type of pain you have and how often you get it. […] To check how long the pain lasts, how severe the pain is or if the pain is linked to your periods, your GP may ask you to fill in a simple pain chart. […] If your GP thinks you may have non-cyclical breast pain or chest wall pain, they may ask you to lean forward during the examination. This is to help them assess if the pain is inside your breast or in the chest wall. […] Your GP may refer you to a breast clinic where you’ll be seen by specialist doctors or nurses for a more detailed assessment.

• #43 Breast pain

  https://www2.hse.ie/conditions/breast-pain/

  Breast pain by itself is very unlikely to be a symptom of cancer. […] Breast pain caused by periods is common. It’ll usually affect both breasts. Sometimes the pain spreads to your armpits. It can affect the whole breast or just the outer part of the breast. […] Hormone changes before menopause can cause breast pain. Once you have reached menopause the pain usually stops. […] Conditions like mastitis or a breast abscess can cause breast pain along with other symptoms. […] Sometimes no cause is found for breast pain. […] Non-urgent advice: Contact a GP about breast pain if: it’s not improving or painkillers are not helping; you have a very high temperature (40 degrees Celsius or higher) or feel hot and shivery; your breast or part of it is red, hot, hard or swollen; you might be pregnant – you could do a pregnancy test first; you have a lump in your breast or armpit; you have discharge from your nipple; you have itchy or red areas around your nipple; your nipple recently turned in, pulled up or down; the skin of your breast has changed – it is dimpled (like orange peel) or scaly; you have a family history of breast cancer.

• #44 Breast Pain Treatment Melbourne, VIC | Mastalgia Treatment Melbourne, VIC

  https://www.melbournebreastcancersurgery.com.au/breast-painmastalgia.html

  Most breast complaints are benign in nature. […] Mastalgia means breast pain. Breast pain is extremely common, and for many women who attend this is their main and only symptom. […] Mastalgia is not usually a sign of breast cancer or other significant breast disease. […] Doctors often think it a trivial symptom, but for many women mastalgia causes significant discomfort and anxiety. […] It should not be forgotten that mastalgia is a symptom, and therefore is not a specific disease in its own right. […] If you are not sure which type of breast pain you have, it may be worth keeping a pain diary (below) for 2-3 months. […] Any woman with a breast symptom, including significant mastalgia, requires a full breast assessment including clinical breast examination and breast imaging to exclude cancer and other significant breast pathology as an explanation for the symptoms.

• #45 Mastalgia (Breast Pain) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/breast-disorders/mastalgia-breast-pain

  Mastalgia (breast pain) is common and can be localized or diffuse and unilateral or bilateral. […] Localized breast pain is usually caused by a focal disorder that causes a mass, such as a breast cyst, or an infection (eg, mastitis, abscess). Most breast cancers do not cause pain. […] Diffuse bilateral pain may be caused by fibrocystic changes or, uncommonly, diffuse bilateral mastitis. However, diffuse bilateral pain is very common in women without breast abnormalities. The most common causes in these women are hormonal changes that cause breast tissue proliferation (eg, during the luteal phase or early pregnancy, in women taking estrogens or progestins) and large, pendulous breasts that stretch Cooper ligaments. […] Examination focuses on the breast, looking for abnormalities such as mass, nipple inversion or discharge, skin changes including erythema, rash, eczematous appearance, edema, or dimpling (sometimes termed peau dorange [orange peel]), and signs of infection, such as redness, warmth, and tenderness.

• #46 Breast Pain (Mastalgia) | Baylor Scott & White Health

  https://www.bswhealth.com/conditions/breast-pain-mastalgia

  Not usually. It’s rare to have breast pain as a symptom of breast cancer. […] If you’re concerned about cancer, having routine screening mammograms can give you peace of mind about your breast health. […] Having mild breast pain related to hormone changes or your period is expected. But ongoing pain, severe pain or pain along with other symptoms can also be signs of a medical condition. […] Make an appointment with your doctor if something feels off. […] Yes. There’s evidence that stress and anxiety increase breast pain. […] This may be because of the effect of stress on hormones, which leads to worsening breast pain symptoms. […] Yes, breast pain may be an early sign of pregnancy before you miss your period. […] Hormonal changes in early pregnancy often cause breast pain. However, since breast pain is also very common leading up to your period, it could be caused by normal cyclical changes, not pregnancy.

• #47 Mastalgia (Breast Pain) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/breast-disorders/mastalgia-breast-pain

  Mastalgia (breast pain) is common and can be localized or diffuse and unilateral or bilateral. […] Localized breast pain is usually caused by a focal disorder that causes a mass, such as a breast cyst, or an infection (eg, mastitis, abscess). Most breast cancers do not cause pain. […] Diffuse bilateral pain may be caused by fibrocystic changes or, uncommonly, diffuse bilateral mastitis. However, diffuse bilateral pain is very common in women without breast abnormalities. The most common causes in these women are hormonal changes that cause breast tissue proliferation (eg, during the luteal phase or early pregnancy, in women taking estrogens or progestins) and large, pendulous breasts that stretch Cooper ligaments. […] Examination focuses on the breast, looking for abnormalities such as mass, nipple inversion or discharge, skin changes including erythema, rash, eczematous appearance, edema, or dimpling (sometimes termed peau dorange [orange peel]), and signs of infection, such as redness, warmth, and tenderness.

• #48 Breast Pain: Diagnosis & Treatment

  https://www.breasthealth.in/blog/breast-pain-diagnosis-treatment.html

  Also called Fibrocystic breast changes, this condition is characterized by painful lumps in the breast before the onset of the menstrual cycle. […] In rare cases, breast pain may also be linked to breast cancer. […] CK Birla Hospital For Women and Vardaan Hospital have set up dedicated breast clinics for the diagnosis and treatment of breast-related disorders. […] He believes in thorough health checkup and review of the medical history of the patient to find the root cause of the pain and manage it accordingly. […] Book an appointment with Dr Rohan Khandelwal at CK Birla Hospital for Women or Vardaan Hospital for expert medical diagnosis and treatment.

• #49 Mastalgia (Breast Pain) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/breast-disorders/mastalgia-breast-pain

  Mastalgia (breast pain) is common and can be localized or diffuse and unilateral or bilateral. […] Localized breast pain is usually caused by a focal disorder that causes a mass, such as a breast cyst, or an infection (eg, mastitis, abscess). Most breast cancers do not cause pain. […] Diffuse bilateral pain may be caused by fibrocystic changes or, uncommonly, diffuse bilateral mastitis. However, diffuse bilateral pain is very common in women without breast abnormalities. The most common causes in these women are hormonal changes that cause breast tissue proliferation (eg, during the luteal phase or early pregnancy, in women taking estrogens or progestins) and large, pendulous breasts that stretch Cooper ligaments. […] Examination focuses on the breast, looking for abnormalities such as mass, nipple inversion or discharge, skin changes including erythema, rash, eczematous appearance, edema, or dimpling (sometimes termed peau dorange [orange peel]), and signs of infection, such as redness, warmth, and tenderness.

• #50 Diagnosis and Management of Benign Breast Disease | GLOWM

  https://www.glowm.com/section-view/heading/Diagnosis%20and%20Management%20of%20Benign%20Breast%20Disease/item/17

  Mastalgia is a common breast symptom for women during their reproductive years. It is usually cyclic but can be noncyclic. The cyclic variant is usually diffuse and most intense during the immediate premenstrual phase of the cycle. […] Most women presenting with cyclic mastalgia have an intense variant of physiologic breast changes that occur during the menstrual cycle. After complete evaluation and examination including a mammogram for a woman aged 35 or older, the patient can be reassured that there is no evidence of cancer and that her symptoms are physiologic. […] Cysts, both macro and micro, are perceived on mammograms as distinct masses with smooth regular borders. However, mammography does not differentiate a cyst from a solid mass. Ultrasound is effective in differentiating a cyst from a solid mass. A symptomatic cyst requires therapeutic FNA.

• #51 Breast Pain: Diagnosis & Treatment

  https://www.breasthealth.in/blog/breast-pain-diagnosis-treatment.html

  If youre experiencing stiffness, burning sensation and a dull ache in breast tissues, you might be suffering from breast pain, also known as mastalgia. […] Breast pain is a common problem in teenage girls and can be linked to various conditions including but not limited to menstruation, fibromyalgia, puberty, pregnancy, and diet. […] If breast pain keeps recurring during the onset of the menstrual cycle, it is known as cyclical mastalgia. […] A number of underlying factors may affect breast health in women. […] For the benefit of the patient, even a dull pain shouldnt be left unchecked as it may be a symptom of other disorders of the breast. […] The patient may experience a sensation of pain under the breast, which should be duly checked by a medical professional. […] Bacterial infection may lead to the formation of a pus-filled lump in your breast. It is mainly observed on breastfeeding mothers and can be diagnosed with an ultrasound scan.

• #52 Diagnosis and Management of Benign Breast Disease | GLOWM

  https://www.glowm.com/section-view/heading/Diagnosis%20and%20Management%20of%20Benign%20Breast%20Disease/item/17

  Persistent or recurrent spontaneous nipple discharge, particularly from a single duct is pathologic and should be evaluated. The most common etiology of spontaneous nipple discharge is an intraductal papilloma or papillomas. These are benign lesions. […] The diagnosis is made by histologic tissue biopsy (incisional or punch biopsy). There is often an underlying palpable mass or a radiological abnormality. […] A breast abscess presents as a flocculent sometimes-bulging mass usually located in the central area of the mastitis. Focused ultrasound can verify a fluid-filled (pus) center. Aspiration with a number 18-gauge needle using local anesthesia is diagnostic and can be therapeutic if all the pus is aspirated.

• #53 Common breast problems. A systematic approach to diagnosis and treatment | Medicine Today

  https://medicinetoday.com.au/mt/2019/october/feature-article/common-breast-problems-systematic-approach-diagnosis-and-treatment

  True breast pain can be cyclical (varying over the menstrual cycle) or noncyclical. However, in many women who present with breast pain, the pain is actually chest wall related. […] Cyclical mastalgia refers to breast pain that occurs in relation to a woman’s menstrual cycle. It usually affects women in their 30s, although it can occur at any age during the premenopausal period. […] If the pain is persistent and significant and affects quality of life, referral of the patient to a breast specialist is indicated. […] Noncyclical mastalgia is not as well characterised as cyclical mastalgia and has few associated factors. […] Chest wall pain is one of the most common causes of perceived breast pain. […] It is important to exclude other causes of chest wall pain, and importantly to reassure the patient.

• #54 Breast Pain – Causes and Symptoms – National Breast Cancer Foundation

  https://www.nationalbreastcancer.org/breast-pain/

  Breast pain is any discomfort, tenderness, or pain in the breast or underarm region, and it may occur for a number of reasons. Breast pain usually isn’t a sign of breast cancer. […] Although many women with pain in one or both breasts may be concerned that it is breast cancer, breast pain is NOT commonly a symptom of cancer. […] Breast pain is usually present to some degree with Inflammatory Breast Cancer which has other distinct symptoms as well. Rarely, a breast tumor may cause pain, but generally, cancerous tumors are not reported as painful. […] If you experience breast pain, contact your physician. […] If You Experience Pain Along With Any Of The Following Symptoms, You Should Contact Your Physician. […] Redness of the skin of the breast that may appear as a rash, with dilated pores, and possibly skin thickening. (These are signs of inflammatory breast cancer and it commonly does cause pain)

• #55 ‘How I knew I had inflammatory breast cancer’: 6 survivors’ symptoms | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/how-i-knew-i-had-inflammatory-breast-cancer—6-survivors-describe-their-symptoms.h00-159699912.html

  Inflammatory breast cancer symptoms tend to appear very quickly. […] Pain and lumps are not always symptoms of inflammatory breast cancer, but they can be. […] Nipple inversion is one of two inflammatory breast cancer symptoms that Lim says warrants an immediate call to your doctor. […] Inflammatory breast cancer is frequently misdiagnosed as mastitis, clogged milk ducts, and abscesses, among other things. […] A quick and accurate diagnosis is essential because the disease is also very aggressive. […] If your symptoms improve significantly after you’re prescribed antibiotics or steroids, it’s very unlikely you had cancer, says Lim. But talk to your provider about scheduling a diagnostic mammogram or ultrasound, or even a breast biopsy, before starting the medication. You don’t want to wait any longer for an accurate diagnosis, if you see no changes in your symptoms after two weeks.

• #56

  https://www.singhealth.com.sg/patient-care/conditions-treatments/breast-pain

  Breast pain can cause a lot of anxiety. Many women worry that they may have breast cancer. You may find it reassuring to know that breast pain alone is usually not a sign of breast cancer and does not increase your risk of breast cancer. […] The diagnosis is reached after a detailed history and physical examination. Breast imaging may be required if there are other associated symptoms such as a breast lump etc.

• #57 Breast Pain Treatment Melbourne, VIC | Mastalgia Treatment Melbourne, VIC

  https://www.melbournebreastcancersurgery.com.au/breast-painmastalgia.html

  Once assessment has been performed, and no serious abnormality found, the question of treatment then arises. […] The first and most successful treatment is the sympathetic reassurance that their symptoms are not due to cancer. […] Often, cyclical mastalgia will settle over the course of a few months, returning to normal pre-menstrual breast discomfort without any specific treatment. […] Simple pain medication such as paracetamol can reduce mastalgia. […] Research has shown that non-steroidal anti-inflammatory pain relief, such as ibuprofen, can help breast pain, particularly non-cyclical pain. […] For severe cases of mastalgia that interfere with lifestyle, there are strong hormonal medications such as tamoxifen, danazol and bromocryptine. […] Tamoxifen is a drug more commonly used to treat and prevent breast cancer, however, research has shown it is also effective in the treatment of cyclical breast pain. […] Danazol, which was often used in the past, is very effective in treating breast pain, relieving symptoms in around 70% of patients but is associated with significant side-effects in about 25% of patients. […] Another drug also used in the past to treat cyclical mastalgia is bromocriptine.

• #58 Breast Pain (Causes, Symptoms and Treatment)

  https://patient.info/doctor/breast-pain-pro

  Breast pain is one of the most common breast symptoms experienced by women, and management requires careful assessment and diagnosis. […] The risk of cancer in a woman presenting with breast pain as an isolated symptom is extremely low as breast pain is one of the least associated symptoms of breast cancer, present only in 0.5% to 2% of patients later diagnosed with cancer. […] The classification is important because the assessment, management and response to treatment are different for the different types of breast pain. […] The most important conditions to exclude are breast cancer, pregnancy and infection. […] Management will depend on the cause but a variety of measures which have been routinely advised by some in the past should no longer be recommended. […] Reassurance that the pain is not due to breast cancer and an explanation as to its hormonal nature may be all the management that some women require. Studies have shown that reassurance alone is effective management in 70% of women. […] Non-cyclical breast pain responds poorly to treatment but resolves spontaneously in 50% of women. […] This can be difficult to predict as it will depend on the many potential underlying pathological and psychological issues.

• #59 Breast pain: assessment, management, and referral criteria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7384817/

  Breast pain (mastalgia) is experienced by 70% of women during their lifetime and may be considered a physiological symptom rather like painful menses, but remains a common presentation in primary care. […] Despite an absence of evidence suggesting that mastalgia alone is associated with breast cancer, it is still commonly referred to secondary care breast units in one study it accounted for 41% of referrals. […] Careful assessment is essential to avoid unnecessary referral, which can lead to anxiety or over-investigation. […] The National Institute for Health and Care Excellence (NICE) states that: breast pain is not a criteria for urgent referral, with a positive predictive value of 3% for breast cancer; and referral is recommended if cyclical breast pain is affecting quality of life or sleep, and has been ongoing for more than 3 months if the pain is unresponsive to first-line treatment. […] Explanation and support alone has a vital role to play in the management of mastalgia. […] Breast pain can usually be safely managed in the primary care setting.

• #60 Breast pain: assessment, management, and referral criteria | British Journal of General Practice

  https://bjgp.org/content/70/697/419

  Breast pain (mastalgia) is experienced by 70% of women during their lifetime and may be considered a physiological symptom rather like painful menses, but remains a common presentation in primary care. […] Despite an absence of evidence suggesting that mastalgia alone is associated with breast cancer, it is still commonly referred to secondary care breast units in one study it accounted for 41% of referrals. […] The management of extra-mammary pain requires a positive diagnosis and exclusion of breast pain by clinical assessment. […] Careful assessment is essential to avoid unnecessary referral, which can lead to anxiety or over-investigation. […] The National Institute for Health and Care Excellence (NICE) states that breast pain is not a criteria for urgent referral, with a positive predictive value of 3% for breast cancer; and referral is recommended if cyclical breast pain is affecting quality of life or sleep, and has been ongoing for more than 3 months if the pain is unresponsive to first-line treatment. […] Explanation and support alone has a vital role to play in the management of mastalgia. […] Breast pain can usually be safely managed in the primary care setting.

• #61 Common Breast Problems | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0415/p505.html

  Noncyclic/focal mastalgia should trigger diagnostic imaging because of its rare but occasional association with underlying malignancy. […] Although spontaneous resolution of breast pain is common, mastalgia can be chronic, necessitating a stepwise approach to management. […] Nipple discharge is a common symptom among women of reproductive age, with most women experiencing at least one episode. Although nipple discharge is predominantly physiologic or due to a benign etiology, an underlying malignancy is identified in up to 21% of patients with pathologic discharge who undergo biopsy. The initial workup includes a comprehensive history and physical examination, with the primary aim of distinguishing between normal lactation, nonpuerperal galactorrhea, and pathologic discharge. […] Pathologic discharge is generally spontaneous and unilateral, and originates from a single duct opening on a nipple. It may be bloody, serous, serosanguineous, or watery. If discharge is deemed pathologic, age-appropriate diagnostic imaging with mammography and/or ultrasonography is indicated.

• #62 Work-up and management of breast pain – Li – Annals of Breast Surgery

  https://abs.amegroups.org/article/view/6968/html

  If there are no concerning findings on physical exam or breast imaging, management is based on the type of breast pain and severity. Frequently, reassurance is all that is required. Breast pain often spontaneously resolves, but if severe or persistent, conservative therapies should be attempted first. If pain is persistent or severe, there are several pharmacological therapies that can be considered, but patient should be appropriately counseled regarding the side effects of these medications.

• #63 Mastalgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562195/

  Recommended supportive therapies include well-fitting bras, relaxation therapy, exercise, dietary modifications, and nutritional supplements. […] For patients with severe pain or mastalgia unresponsive to supportive therapy, the following pharmacologic treatments may be considered: analgesics, tamoxifen, danazol, and goserelin. […] The prognosis of mastalgia depends on the underlying pathological or psychological cause. […] Noncyclical pain, although it shows a poor response to therapy, will result in spontaneous resolution in up to 50% of women. […] For women with cyclical breast pain, around 60% of patients will show a relapsing and remitting course of pain episodes, with some presenting with recurrent symptoms 2 years after therapy.

• #64 Breast Pain Treatment Melbourne, VIC | Mastalgia Treatment Melbourne, VIC

  https://www.melbournebreastcancersurgery.com.au/breast-painmastalgia.html

  Once assessment has been performed, and no serious abnormality found, the question of treatment then arises. […] The first and most successful treatment is the sympathetic reassurance that their symptoms are not due to cancer. […] Often, cyclical mastalgia will settle over the course of a few months, returning to normal pre-menstrual breast discomfort without any specific treatment. […] Simple pain medication such as paracetamol can reduce mastalgia. […] Research has shown that non-steroidal anti-inflammatory pain relief, such as ibuprofen, can help breast pain, particularly non-cyclical pain. […] For severe cases of mastalgia that interfere with lifestyle, there are strong hormonal medications such as tamoxifen, danazol and bromocryptine. […] Tamoxifen is a drug more commonly used to treat and prevent breast cancer, however, research has shown it is also effective in the treatment of cyclical breast pain. […] Danazol, which was often used in the past, is very effective in treating breast pain, relieving symptoms in around 70% of patients but is associated with significant side-effects in about 25% of patients. […] Another drug also used in the past to treat cyclical mastalgia is bromocriptine.

• #65 Mastalgia (Breast Pain) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/breast-disorders/mastalgia-breast-pain

  Absence of abnormal findings suggests that pain is due to hormonal changes or large, pendulous breasts. […] Pregnancy testing should be done if pain is unexplained and has lasted less than several months, particularly if other symptoms or signs are consistent with pregnancy. […] For menstrual-related mastalgia, acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID) is usually effective. If pain is severe, a brief course of danazol or tamoxifen may be given. […] For pregnancy-related breast pain, wearing a firm, supportive brassiere, taking acetaminophen, or both, can help. […] Diffuse, bilateral breast pain is usually caused by hormonal changes or large, pendulous breasts. […] First-line treatment is acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID). […] Severe pain caused by hormonal factors is treated by stopping estrogen or a progestin (if either is being taken) or by giving tamoxifen or danazol.

• #66 Mastalgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562195/

  Recommended supportive therapies include well-fitting bras, relaxation therapy, exercise, dietary modifications, and nutritional supplements. […] For patients with severe pain or mastalgia unresponsive to supportive therapy, the following pharmacologic treatments may be considered: analgesics, tamoxifen, danazol, and goserelin. […] The prognosis of mastalgia depends on the underlying pathological or psychological cause. […] Noncyclical pain, although it shows a poor response to therapy, will result in spontaneous resolution in up to 50% of women. […] For women with cyclical breast pain, around 60% of patients will show a relapsing and remitting course of pain episodes, with some presenting with recurrent symptoms 2 years after therapy.

• #67 Mastalgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562195/

  Recommended supportive therapies include well-fitting bras, relaxation therapy, exercise, dietary modifications, and nutritional supplements. […] For patients with severe pain or mastalgia unresponsive to supportive therapy, the following pharmacologic treatments may be considered: analgesics, tamoxifen, danazol, and goserelin. […] The prognosis of mastalgia depends on the underlying pathological or psychological cause. […] Noncyclical pain, although it shows a poor response to therapy, will result in spontaneous resolution in up to 50% of women. […] For women with cyclical breast pain, around 60% of patients will show a relapsing and remitting course of pain episodes, with some presenting with recurrent symptoms 2 years after therapy.

• #68 Breast Pain Treatment Melbourne, VIC | Mastalgia Treatment Melbourne, VIC

  https://www.melbournebreastcancersurgery.com.au/breast-painmastalgia.html

  Once assessment has been performed, and no serious abnormality found, the question of treatment then arises. […] The first and most successful treatment is the sympathetic reassurance that their symptoms are not due to cancer. […] Often, cyclical mastalgia will settle over the course of a few months, returning to normal pre-menstrual breast discomfort without any specific treatment. […] Simple pain medication such as paracetamol can reduce mastalgia. […] Research has shown that non-steroidal anti-inflammatory pain relief, such as ibuprofen, can help breast pain, particularly non-cyclical pain. […] For severe cases of mastalgia that interfere with lifestyle, there are strong hormonal medications such as tamoxifen, danazol and bromocryptine. […] Tamoxifen is a drug more commonly used to treat and prevent breast cancer, however, research has shown it is also effective in the treatment of cyclical breast pain. […] Danazol, which was often used in the past, is very effective in treating breast pain, relieving symptoms in around 70% of patients but is associated with significant side-effects in about 25% of patients. […] Another drug also used in the past to treat cyclical mastalgia is bromocriptine.

• #69 Mastalgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562195/

  Recommended supportive therapies include well-fitting bras, relaxation therapy, exercise, dietary modifications, and nutritional supplements. […] For patients with severe pain or mastalgia unresponsive to supportive therapy, the following pharmacologic treatments may be considered: analgesics, tamoxifen, danazol, and goserelin. […] The prognosis of mastalgia depends on the underlying pathological or psychological cause. […] Noncyclical pain, although it shows a poor response to therapy, will result in spontaneous resolution in up to 50% of women. […] For women with cyclical breast pain, around 60% of patients will show a relapsing and remitting course of pain episodes, with some presenting with recurrent symptoms 2 years after therapy.

• #70 Breast Cancer Screening and Diagnosis, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology in: Journal of the National Comprehensive Cancer Network Volume 16 Issue 11 (2018)

  https://jnccn.org/view/journals/jnccn/16/11/article-p1362.xml

  If the breast pain is focal in nature, the NCCN Panel recommends age-appropriate diagnostic imaging (diagnostic mammogram with or without ultrasound for those 30 years of age; and ultrasound for those 30 years of age). For those with BI-RADS assessment category 1 (negative findings), the panel recommends appropriate symptom management of breast pain. For a simple cyst (benign or BI-RADS assessment category 2) geographically correlated with focal pain, drainage may be considered for symptom relief. For complicated cysts (probably benign or BI-RADS 3), the panel recommends appropriate imaging every 6 months for 1 to 2 years along with symptomatic management of the breast pain, if desired. A tissue (core needle) biopsy should be performed if imaging findings are consistent with an overall BI-RADS assessment category 4 or 5 (suspicious or highly suggestive of malignancy).

• #71 Breast Pain: Tenderness, Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15469-breast-pain-mastalgia

  Rarely, cancer can cause breast pain. For this reason, if you experience breast pain for longer than two weeks or have symptoms like a lump, skin dimpling and nipple changes, contact a healthcare provider. […] Your provider may order a mammogram or an ultrasound, but whether you need either of these imaging tests will depend on a few different factors, including your specific type of pain, the findings from the breast exam, your age, and the length of time since your last breast-imaging procedure. […] If your breast pain is even more severe, your provider may suggest danazol or tamoxifen, which are two prescription medications. […] If you have noncyclic breast pain, your healthcare provider may suggest using similar treatment methods as they would for cyclic breast pain. But if they find the underlying cause of your pain is due to things like an infection or a benign cyst, sometimes a more specific treatment is necessary for that cause (like antibiotics or surgery).

• #72 Mastalgia (Breast Pain) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/breast-disorders/mastalgia-breast-pain

  Absence of abnormal findings suggests that pain is due to hormonal changes or large, pendulous breasts. […] Pregnancy testing should be done if pain is unexplained and has lasted less than several months, particularly if other symptoms or signs are consistent with pregnancy. […] For menstrual-related mastalgia, acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID) is usually effective. If pain is severe, a brief course of danazol or tamoxifen may be given. […] For pregnancy-related breast pain, wearing a firm, supportive brassiere, taking acetaminophen, or both, can help. […] Diffuse, bilateral breast pain is usually caused by hormonal changes or large, pendulous breasts. […] First-line treatment is acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID). […] Severe pain caused by hormonal factors is treated by stopping estrogen or a progestin (if either is being taken) or by giving tamoxifen or danazol.

• #73 Mastalgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562195/

  Recommended supportive therapies include well-fitting bras, relaxation therapy, exercise, dietary modifications, and nutritional supplements. […] For patients with severe pain or mastalgia unresponsive to supportive therapy, the following pharmacologic treatments may be considered: analgesics, tamoxifen, danazol, and goserelin. […] The prognosis of mastalgia depends on the underlying pathological or psychological cause. […] Noncyclical pain, although it shows a poor response to therapy, will result in spontaneous resolution in up to 50% of women. […] For women with cyclical breast pain, around 60% of patients will show a relapsing and remitting course of pain episodes, with some presenting with recurrent symptoms 2 years after therapy.

• #74 Breast Pain (Causes, Symptoms and Treatment)

  https://patient.info/doctor/breast-pain-pro

  Breast pain is one of the most common breast symptoms experienced by women, and management requires careful assessment and diagnosis. […] The risk of cancer in a woman presenting with breast pain as an isolated symptom is extremely low as breast pain is one of the least associated symptoms of breast cancer, present only in 0.5% to 2% of patients later diagnosed with cancer. […] The classification is important because the assessment, management and response to treatment are different for the different types of breast pain. […] The most important conditions to exclude are breast cancer, pregnancy and infection. […] Management will depend on the cause but a variety of measures which have been routinely advised by some in the past should no longer be recommended. […] Reassurance that the pain is not due to breast cancer and an explanation as to its hormonal nature may be all the management that some women require. Studies have shown that reassurance alone is effective management in 70% of women. […] Non-cyclical breast pain responds poorly to treatment but resolves spontaneously in 50% of women. […] This can be difficult to predict as it will depend on the many potential underlying pathological and psychological issues.

• #75 Common breast problems. A systematic approach to diagnosis and treatment | Medicine Today

  https://medicinetoday.com.au/mt/2019/october/feature-article/common-breast-problems-systematic-approach-diagnosis-and-treatment

  True breast pain can be cyclical (varying over the menstrual cycle) or noncyclical. However, in many women who present with breast pain, the pain is actually chest wall related. […] Cyclical mastalgia refers to breast pain that occurs in relation to a woman’s menstrual cycle. It usually affects women in their 30s, although it can occur at any age during the premenopausal period. […] If the pain is persistent and significant and affects quality of life, referral of the patient to a breast specialist is indicated. […] Noncyclical mastalgia is not as well characterised as cyclical mastalgia and has few associated factors. […] Chest wall pain is one of the most common causes of perceived breast pain. […] It is important to exclude other causes of chest wall pain, and importantly to reassure the patient.

• #76 When to Worry About Breast Pain: Causes, Diagnosis, Treatment

  https://www.healthline.com/health/womens-health/when-to-worry-about-breast-pain

  Occasional breast pain is normal. However, if this pain becomes persistent or grows, it may be time to talk with a doctor. […] This article will explore the causes of breast pain, as well as when to contact a doctor and how theyll diagnose your symptoms. […] Most causes of breast pain will go away on their own with time, medications, or lifestyle changes. However, if youre experiencing any of the following symptoms, schedule an appointment with a doctor for an evaluation and diagnosis: […] Your doctor will begin an examination for breast pain by asking you about your personal and family medical history. […] Your doctor may suggest a one-time or regular mammogram to examine your breast tissue more closely. […] Other tools that can help identify tissue changes, breast cancer, or other conditions may include:

• #77 Work-up and management of breast pain – Li – Annals of Breast Surgery

  https://abs.amegroups.org/article/view/6968/html

  If there are no concerning findings on physical exam or breast imaging, management is based on the type of breast pain and severity. Frequently, reassurance is all that is required. Breast pain often spontaneously resolves, but if severe or persistent, conservative therapies should be attempted first. If pain is persistent or severe, there are several pharmacological therapies that can be considered, but patient should be appropriately counseled regarding the side effects of these medications.

• #78 Common breast problems. A systematic approach to diagnosis and treatment | Medicine Today

  https://medicinetoday.com.au/mt/2019/october/feature-article/common-breast-problems-systematic-approach-diagnosis-and-treatment

  A systematic approach is required to diagnose and treat common breast problems. Conveying confidence, listening carefully to the patients concerns and giving measured reassurance will reduce patient anxiety. If any features of concern are noted, prompt referral of the patient to a breast specialist is indicated.

• #79 Breast pain – UpToDate

  https://www.uptodate.com/contents/breast-pain

  Breast pain (mastalgia) is common in women and occasionally occurs in men. […] Evaluation of breast pain is important to determine whether the pain is due to normal physiological changes related to hormonal fluctuation or to a pathologic process such as breast cancer. […] Breast pain is a rare symptom of breast cancer. Women who present with breast pain but who have a normal examination and imaging studies can be reasonably assured that their risk of breast cancer is similar to that of a woman without breast pain. […] This topic will discuss the etiology, evaluation, and treatment of breast pain in women. […] Evaluation of a breast mass or cancer is discussed separately. […] Breast pain caused by inflammatory or infectious etiologies (ie, mastitis) is discussed in other topics.

• #80 Breast pain: assessment, management, and referral criteria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7384817/

  Breast pain (mastalgia) is experienced by 70% of women during their lifetime and may be considered a physiological symptom rather like painful menses, but remains a common presentation in primary care. […] Despite an absence of evidence suggesting that mastalgia alone is associated with breast cancer, it is still commonly referred to secondary care breast units in one study it accounted for 41% of referrals. […] Careful assessment is essential to avoid unnecessary referral, which can lead to anxiety or over-investigation. […] The National Institute for Health and Care Excellence (NICE) states that: breast pain is not a criteria for urgent referral, with a positive predictive value of 3% for breast cancer; and referral is recommended if cyclical breast pain is affecting quality of life or sleep, and has been ongoing for more than 3 months if the pain is unresponsive to first-line treatment. […] Explanation and support alone has a vital role to play in the management of mastalgia. […] Breast pain can usually be safely managed in the primary care setting.

• #81 Breast pain: assessment, management, and referral criteria

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7384817/

  Breast pain (mastalgia) is experienced by 70% of women during their lifetime and may be considered a physiological symptom rather like painful menses, but remains a common presentation in primary care. […] Despite an absence of evidence suggesting that mastalgia alone is associated with breast cancer, it is still commonly referred to secondary care breast units in one study it accounted for 41% of referrals. […] Careful assessment is essential to avoid unnecessary referral, which can lead to anxiety or over-investigation. […] The National Institute for Health and Care Excellence (NICE) states that: breast pain is not a criteria for urgent referral, with a positive predictive value of 3% for breast cancer; and referral is recommended if cyclical breast pain is affecting quality of life or sleep, and has been ongoing for more than 3 months if the pain is unresponsive to first-line treatment. […] Explanation and support alone has a vital role to play in the management of mastalgia. […] Breast pain can usually be safely managed in the primary care setting.

• #82 Breast pain: assessment, management, and referral criteria | British Journal of General Practice

  https://bjgp.org/content/70/697/419

  Breast pain (mastalgia) is experienced by 70% of women during their lifetime and may be considered a physiological symptom rather like painful menses, but remains a common presentation in primary care. […] Despite an absence of evidence suggesting that mastalgia alone is associated with breast cancer, it is still commonly referred to secondary care breast units in one study it accounted for 41% of referrals. […] The management of extra-mammary pain requires a positive diagnosis and exclusion of breast pain by clinical assessment. […] Careful assessment is essential to avoid unnecessary referral, which can lead to anxiety or over-investigation. […] The National Institute for Health and Care Excellence (NICE) states that breast pain is not a criteria for urgent referral, with a positive predictive value of 3% for breast cancer; and referral is recommended if cyclical breast pain is affecting quality of life or sleep, and has been ongoing for more than 3 months if the pain is unresponsive to first-line treatment. […] Explanation and support alone has a vital role to play in the management of mastalgia. […] Breast pain can usually be safely managed in the primary care setting.

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