Breast pain (or mastalgia) is common problem faced by women at least once during their lifetime. It can range from mild pain to a chronic debilitating condition, which can even push a patient to the verge of depression. In fact, in the last one month, I have encountered two such patients, who have stopped socializing because of excruciating breast pain.
Mastalgia has varied causes and it can broadly be divided into cyclical & non cyclical causes. Cyclical mastalgia (breast pain) usually occurs because of hormonal fluctuations and the intensity of pain varies according to the menstrual cycle. On the other hand non-cyclical mastalgia usually occurs because of musculo-skeletal causes and the pain persists all throughout the month.
For the correct diagnosis and management of breast pain, it is important for the doctor to know certain points regarding the pain like:
duration of pain
location – restricted to one point or spread over the entire breast
intensity of pain
fluctuation in intensity of pain over a few days
Radiation of the pain – is the pain running to some other site from the breast
Is there a lump associated with the pain? Usually breast cancer does not lead to pain in the initial phases
what makes the pain better
what makes the pain worse
These facts along with clinical examination and an ultrasound/ mammography help the doctor in determining the cause of breast pain. The above mentioned points can easily be maintained in a “pain diary”, which is something which I ask all my patients to maintain.
Following is a format which I hand over to them and ask them to maintain it regularly for a period of 30-40 days.