Mastalgia

Excerpt

Mastalgia is a medical term used for breast pain, one of the most common complaints among women of 15 to 40 years of age (child-bearing age). Approximately two-thirds of women during their reproductive lives suffer from this condition and seek medical help. It is 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. Most often, it is located in the upper outer quadrant of the breast and can sometimes radiate to an ipsilateral arm. It is most common in premenopausal and perimenopausal women, but postmenopausal women can also rarely develop such pain. The breast pain ranges from mild to severe, could be intermittent or constant throughout the day, and may interfere with the female's quality of life.

Many a time, it is not possible to determine the exact cause of such breast pain. However, it is generally believed that in the majority of cases, such breast pain is not a sign of cancer. Still, professionals recommend a detailed medical review with proper history and physical exam done by a primary caregiver to rule out any such possibility.

Classification

Cyclic Mastalgia

Breast pain that is associated with the menstrual cycle due to hormonal variation often associated with breast swelling, tenderness, and lumpiness and generally bilateral in nature. Pain intensifies a couple of weeks before the start of periods, decreasing on the day when bleeding starts and subsides over the next few days. Most commonly seen in premenopausal women in the third or fourth decades of life.

Non-Cyclic Mastalgia

Breast pain that is not associated with the menstrual cycle and does not vary with hormonal changes in the body. Instead, they are often related to internal anatomical changes, injuries, surgery, infections, or sometimes associated with other breast pathology, i.e., breast cysts or fibroadenoma. These are generally described as a localized sharp, burning breast pain. They are unilateral, constant, or intermittent, affecting one breast with a pinpoint localized area of involvement. Most likely affect women in their 30s and 50s.

Extramammary Mastalgia

It refers to the breast pain that is originating from a location outside the breast, such as the heart, lung, chest wall, or the esophagus. Extramammary breast pain feels as if it starts in the breast tissue, but in fact, it is a referred pain having its origin somewhere else. For example, pain originating from the chest wall (costochondritis), epigastric pain in GERD, or pain of gallbladder and stomach disease can be referred to give a false impression of breast pain.