Pain in the mammary gland (mastalgia) is a unilateral or bilateral pain in the chest in women. The symptom is accompanied by heaviness and swelling of the mammary gland, discharge from the nipple. Mastalgia is caused by hormonal changes, inflammatory and infectious diseases, benign and malignant neoplasms of the breast. To verify the cause of pain, ultrasound, radiography, invasive methods, and laboratory tests are used. To eliminate the pain syndrome, analgesics, hormonal drugs, physiotherapy are used.
Women with breast size 4 or more experience heaviness and soreness of the mammary glands by the end of the day. Unpleasant sensations occur when there is insufficient support for the chest, because of which it sags and creates an additional load on the spine. The pain is dull, non-intense, significantly reduced in a horizontal position. The symptom is accompanied by painful aching sensations in the scapular region.
The appearance of pain in the mammary glands is provoked by an incorrectly selected bra, which either does not hold the breast at all, or squeezes it too much. Patients complain of bursting pain of moderate intensity in the mammary glands, which are aggravated by accidental careless touch. If such signs are observed daily or the pain increases sharply, you should consult a specialist.
Women who go in for sports intensively and pump their pectoral muscles often complain of pain in the projection of the mammary glands. Muscle pain is caused by the accumulation of lactic acid in the tissues and swelling of myofibrils after overexertion. Symptoms disappear on their own after rest. Prolonged sharp pain after training can be caused by pathological causes, so in this case, you need to consult a specialist.
The development of mastalgia before menstruation is promoted by hormonal causes. A sharp decrease in the amount of estrogen provokes swelling and swelling of the breast tissue, dull pains of moderate intensity occur. Patients note increased sensitivity of the breast and increased pain during touching, wearing a bra. In most cases, the symptom disappears 2-3 days after the onset of menstrual bleeding.
In some women, cyclic pain is also observed in the middle of the monthly cycle, which corresponds to ovulation. During this period, the preparation of the mammary glands for possible fertilization takes place, the volume of secretory cells increases. Such changes are manifested by discomfort and a feeling of fullness, an increase in the size of the mammary glands. Strengthening or paroxysmal nature of cyclic pain indicates pathological causes that require medical attention.
Starting from the first trimester of pregnancy, both breasts undergo structural changes necessary for milk production. This is accompanied by constant heaviness and pain, the chest seems to “fill up” and swell. Pain in the mammary glands is moderate, does not cause severe discomfort. As labor approaches, a few drops of a yellowish liquid may come out of the nipple.
Normally, there is no pain during breastfeeding. Discomfort is associated with a violation of the interval between feedings, when a large amount of milk accumulates in the ducts and alveolar tissue, causing bursting and heaviness. Sharp local pain in the areolar region is caused by cracks in the nipple and erosion of the delicate skin, which are formed when the feeding technique is violated and when the first teeth of the child erupt.
Fibrocystic changes in the glandular tissue are the most common pathological causes of pain. With nodular mastopathy, the pain is localized in one mammary gland. The symptom is noted in the second phase of the menstrual cycle, when unilateral edema increases, and the breast increases in size. Pain is aching, stabbing, often radiating to the shoulder or shoulder blade.
Diffuse mastopathy is characterized by excruciating bursting or stabbing pains that spread throughout the chest. Before menstruation, the breast swells, its tissue becomes dense, with the slightest touch, the pain syndrome intensifies. With the onset of bleeding, the pain gradually subsides. Regular severe pain disrupts sleep and appetite, some patients develop a fear of oncological pathology.
Infectious causes cause severe pain in the mammary gland in women due to a purulent process and the accumulation of pathological inflammatory mediators that irritate the nerve endings. Pain in purulent mastitis is sharp, twitching, unbearable. They are aggravated in an upright position and subside a little with an elevated position of the mammary gland. From the nipples a foul-smelling yellow-green liquid is discharged.
Due to severe pain, the patients stop sleeping, the condition worsens due to high fever and intoxication. With non-purulent mastitis, the pain is less pronounced, constant dull pains are felt in the chest against the background of an increase in body temperature to 38.5 ° C. Discomfort increases with squeezing the areola area, touching the affected part of the mammary gland. Such symptoms are an indication for emergency medical care.
In advanced situations, purulent inflammation turns into an abscess of the mammary gland, as evidenced by increased and clearer localization of pain in one area. The skin over this place acquires a red or purple color, touching causes severe pain. Discharge from the nipple is usually absent. Against the background of the pain syndrome, a high fever occurs, sometimes of the hectic type.
With eczema of the nipples, itching and discomfort first appear in the areolar region (the darker skin surrounding the nipple), and after a few days, polymorphic rashes form, combined with sharp pain. Then the bubbles turn into erosion and small sores, while there is an increase in pain. As you recover, the soreness gradually subsides and is replaced by intense itching, mainly at night.
Pain in the mammary gland on the side of the lesion is characteristic of inflammation of the nipple of a bacterial and viral cause. Symptoms are localized in the areola, sometimes the pathological process spreads to the surrounding breast tissue. When pressing on the nipple, a purulent or bloody secret is released. The disease requires examination by a specialist, since without treatment there is a risk of massive purulent inflammation or sepsis.
With blows to the chest area, a sharp, severe pain first occurs, which lasts from hours to several days, depending on the degree of bruising of the mammary gland. In uncomplicated cases, a bruise forms on the skin, and the glandular parenchyma remains intact. With strong blows, the pain syndrome lasts a week or more, bloody fluid is released from the nipple.
Pain in the mammary glands occurs not only with direct mechanical influences, but also when wearing a tight bra. Prolonged traumatic compression of the chest leads to microcirculation disorders, which is manifested by bursting painful sensations and heaviness. Symptoms are aggravated in the evening, when there is marked swelling and increased sensitivity of the skin of the gland.
In the initial stages of adenoma and cysts of the mammary gland, pain does not always bother. Discomfort and heaviness that are observed before menstruation are characteristic. As the formation increases in size and the hormonal imbalance develops, a constant pain syndrome develops, the chest thickens and swells. Sometimes the patient independently finds a dense node in the mammary gland, on palpation of which the pain becomes stronger.
Unpleasant sensations for a long time remain the only symptom of the disease, then the periodic release of a transparent or whitish secret from the nipple joins the pain. With intraductal papilloma, pain is accompanied by the outflow of a thick greenish secret that occurs when the contents stagnate in the lactiferous tubules. With a lipoma, a slight soreness is felt in the area of the volumetric formation.
In the advanced stages of breast cancer, tumor causes cause severe excruciating pain, leading to neurasthenia and insomnia. But at the beginning, non-specific symptoms predominate in the form of discomfort and soreness, heaviness in the chest in the late afternoon. These manifestations are similar for many diseases, so it is important to observe oncological alertness.
When self-examination of the mammary gland, the patient discovers the formation of an irregular shape and a dense consistency, which does not move in relation to the skin, it hurts very much. In this area, typical changes in the skin cover are formed: “lemon peel”, retraction of the skin area. Sometimes the pain spreads to the area of the armpits, which indicates the involvement of the lymph nodes in the process.
Degenerative changes in the connective tissue of vertebral cartilages lead to damage to nerve fibers. The pain that occurs with thoracic osteochondrosis is localized not only in the back, but also along the anterior surface of the chest in the area of the mammary gland. Pain is strong, paroxysmal, usually aggravated by sharp turns and tilts of the body.
This disease is sometimes a provoking factor in the development of intercostal neuralgia, which is characterized by stabbing or burning pains in the ribs and mammary glands. Soreness is localized along the anterolateral side of the chest, aggravated by careless touches and squeezing with tight clothing. Pain often radiates to the shoulder blades and collarbones.
Basically, mastalgia is associated with the use of preparations of female sex hormones. Symptoms occur at the stage of selection of oral contraceptives, with the appointment of estrogen derivatives during menopause. Pain in the mammary glands is mild, in nature reminiscent of soreness in the premenstrual period. The symptom is also provoked by other medicinal causes: taking antipsychotics, antidepressants, tranquilizers.
A mammologist is engaged in establishing the cause of the development of pain in the mammary glands, if necessary, the doctor attracts other specialists for consultation. A comprehensive laboratory and instrumental approach allows you to examine in detail not only the chest, but also the endocrine system, the musculoskeletal system. The most informative are such studies as:
Examination of the breast by a mammologist
Minor soreness in the mammary glands, due to hormonal causes and the approach of the menstrual cycle, is not dangerous. To reduce discomfort, it is recommended to choose a larger bra with good breast support that will not compress the breast tissue and aggravate the symptoms. With severe swelling 3-4 days before menstruation, it is necessary to limit the consumption of spicy and salty foods.
To prevent pain in the breast area associated with the development of lactational mastitis, it is important to follow the rules of personal hygiene after each feeding, to prevent milk stagnation. It is advisable to use special underwear for nursing from natural materials. Prolonged pain, accompanied by general malaise, indicates the presence of a pathological cause. You should definitely consult a doctor and find out why the symptom arose.
Medical tactics depend on the etiological factor of pain in the mammary gland. Predominantly prescribe etiotropic and pathogenetic eliminate the causes of pain and promote rapid recovery. Medicines are combined with physiotherapeutic effects (electrophoresis, compresses), which are used only after the exclusion of tumor pathology. The most common pain management regimens include:
Breast cancer is an absolute indication for surgery. In rare cases, at the initial stage of the process, a sectoral resection of the breast is performed. In most situations, a radical mastectomy with removal of regional lymph nodes is necessary. Sometimes, with an unstable hormonal background and a high risk of malignancy, a benign tumor is removed.
To reduce pain in the mammary gland with purulent inflammation, opening and drainage of mastitis is shown, which involves a skin incision at the site of fluctuation and washing the cavity with an antiseptic solution, followed by the installation of drainage. With the gangrenous form of mastitis, the removal of the entire mammary gland is required, followed by plastic surgery. Large hematomas formed after chest injuries are opened to prevent suppuration.