Breast pain affects up to 70% of women at some time in their lives. It is so common that it is considered to be a normal function of the body, rather than a disease. Some women, however, can have severe discomfort due to extremes of these normal changes.

Breast pain is not usually a sign of breast cancer or of other breast disease. You must, however, talk to your doctor so that any causes of breast pain which need specific treatment can be excluded.

Types of breast pain

Most breast pain varies in its intensity with the menstrual cycle (that is, it is ‘cyclical’) and is usually relieved when the period begins.

Breast pain that does not vary with the menstrual cycle is called ‘noncyclical.’

The pain can come and go or may continue without a break.

Often no cause can be found for this type of breast pain. Occasionally it can be caused by benign breast changes such as cysts or a fibroadenomata.

Pain that is felt in the breast does not always come from the breast tissue. Causes of breast pain not related to the breast include musculoskeletal pain. This pain may occur after an injury or physical activity or it may be unexplained. You may take pain medication such as paracetamol or anti-inflammatory tablets to help relieve the symptoms. Heat treatment and physiotherapy can also help.

Treatment

Keep a pain chart
Mapping the pattern of pain will determine whether the breast pain is related to your cycle and on which days relief from the symptoms may be required.

Wear a well-fitting bra
Breast pain can be reduced by wearing a well-fitting, supportive bra particularly if you are sensitive to movement or your breasts feel heavy.

Changes to your diet
Restriction of caffeine (including coffee, tea and caffeine based soft drinks) may help in some cases.

Over the counter medications

Usually need to be taken for at least 2-3 months

• Vitamin B1 50mg, 1 tablet daily

• Vitamin B6 100mg, 1 tablet daily

• Evening Primrose Oil, 1000 mg taken 3 times daily.

Pain medication
Simple pain medication such as paracetamol or ibuprofen may help to make musculoskeletal or other noncyclical breast pain less severe.

Oral contraceptive pill
Some women with breast pain related to their cycle find that their symptoms improve on a low dose oral contraceptive pill. Other women find that the contraceptive pill makes their symptoms worse.

Other medication
When breast pain is so severe that it interferes with lifestyle, hormonal medications such as danazol, bromocriptine and tamoxifen are available. These may have significant side effects and their use needs to be strictly monitored.

Though uncommon, if breast pain is caused by cysts or fibroadenomata, aspirating or removing these can relieve the discomfort.