Why do your breasts hurt?

Breast pain can happen anytime during a woman’s reproductive age. Usually it is cyclical mastalgia which appears a few days before the period and goes away when your cycle is done. Doctors recommend a good diet, avoiding obesity, eating fresh fruits and vegetables, and regular exercises to help with breast pain and even serious breast-related diseases.

• Tell us more about benign breast diseases
• What is the age group that these affect?
• Why do women experience pain in their breasts?
• But when should we speak to a doctor? Are there any symptoms which women should take into consideration and see a doctor?
• What are the kind of tests that we can expect if we go to a doctor for breast pain?
• You said that our diet and stress can be a factor in breast pain, could you tell us more about that?
• Even coffee is a factor?
• Do you believe that we should have regular checkups for our breasts or can we check them at home? If there should be a  proper exam with a doctor, how often should it be done?

Most women experience breast pain at some point; it is often more intense right before you get your period. Usually breast pain is benign and can be attributed to hormonal fluctuations due to the menstrual cycle, but sometimes it can be a symptom of something serious. The most common form of breast pain is called mastalgia.

While there isn’t much research available on mastalgia in Indian women, a study conducted on young female students aged 18–29 years in Karnataka found out that about half of them had mastalgia. Out of these close to 89% had cyclical mastalgia while the rest had acyclic mastalgia.

Another interesting finding from the study was that women with low body mass index (BMI) had higher risk for mastalgia compared to those with normal or high BMI. Those who were stressed were also at a higher risk, according to the study.

Most women experience breast pain at some point; it is often more intense right before you get your period. Usually breast pain is benign and can be attributed to hormonal fluctuations due to the menstrual cycle, but sometimes it can be a symptom of something serious.

We spoke to Delhi-based laparoscopic surgeon Dr. Usha Maheshwari about benign breast diseases, breast pain, and how can we examine our breasts for abnormalities ourselves. Edited excerpts:

Tell us about benign breast diseases

These can be problems in breasts which are not cancer. Benign is something which is not cancerous. Many benign diseases, if not treated on time, in due course, maybe in the later part of life, may turn into cancer. It is very important, therefore, to diagnose them early and treat them early.

These can be problems in breasts which are not cancer. Benign is something which is not cancerous. Many benign diseases, if not treated on time, in due course, maybe in the later part of life, may turn into cancer. It is very important, therefore, to diagnose them early and treat them early.

What is the age group that these affect?

Benign breast diseases can happen anytime in your reproductive age, starting from menarche till the end of life. There is no definite range as such. There are certain problems which are more common like pain in the breasts, sometimes there can be a lump in the breast, there can be discharge from the nipples, cracks in the nipples. All these can happen anytime in your lifetime. 

Why do women experience pain in their breasts?

Breast pain is a common problem. It can be of two types, one is constant pain, and the other is called cyclical mastalgia. It appears a few days before your period, maybe 5-6 days before the period, and it disappears once you are through with your cycle. The causes behind breast pain are mostly hormonal disturbances. It can happen because there are certain hormones in the body which are more active during the first phase of the cycle, before ovulation, and there are the hormones which are active during the rest of the cycle.

What happens when you have your period, is that – up till three days, it is the most silent time of the breast. After that, a certain hormone starts building up and it reaches its peak and then ovulation happens. After ovulation, if the ovum fertilises one will get pregnant. If fertilisation doesn’t happen, then the ovum dies. With the death of the ovum, these hormones which had increased in the first 14 days, they again come back to normal. Ideally speaking it should touch the basal level as soon as you reach your  next period cycle. But this kind of balance may not happen every time because there are so many things which govern your hormonal cycle in the body — mental stress, diet, and other factors.  So, it may not always come back to basal levels.

Because of that the changes in the breast which happen in the first 14 days ideally should have reverted  back to normal, premenstrual stage again, but if that doesn’t happen there is some amount of fluid retention and then again the next cycle starts. This can cause some stretch sensation in the breast and cause pain. This is why cyclical mastalgia happens.

Non-cyclical mastalgia is something that can happen all around the month. It can be a hormonal imbalance but the pain in the breast without any lump is nothing to really worry about. Some lifestyle changes, eating right, meditation, relieving stress can help. In these cases the patient needs to be reassured and usually doesn’t need any treatment.

When should we speak to a doctor? Are there any symptoms which women should take into consideration and see a doctor?

It is generally advised that if you have regular pain in the breasts, then you should definitely go and discuss it with the doctor and understand what the reason behind it is. Whether there is something serious or it is hormonal, that can be judged only by a clinician. With cyclical mastalgia, if you go to a doctor, you may get a little reassurance. If you are scared all the time, it is not good for you either. All hormones are secreted by the brain, so if you are mentally tense about something then your hormonal balance in the body goes haywire. In those cases some kind of assurance from a person who knows about it may help in resolving your problem. I think that a person who has any  pain in the breasts should at least once go and see a doctor and get oneself checked properly. 

It is generally advised that if you have regular pain in the breasts, then you should definitely go and discuss it with the doctor and understand what the reason behind it is. Whether there is something serious or it is hormonal, that can be judged only by a clinician.

What are the kind of tests that we can expect if we go to a doctor for breast pain?

If you are below 40, then an ultrasound is the first test, it is a totally  non-invasive test, no poking, no x-rays, nothing. Just a plain simple breast ultrasound is what is required. After that whatever the results of the ultrasound are, then we proceed accordingly. After 40, there is a mammography and an ultrasound. Generally, before 40, if a person has dense breasts, mammography may not be a good indicator of things. Then ultrasound is a better modality. After 40, both are recommended as glandular tissue goes a little down because of hormonal changes; mammography is more informative and a better tool.

If you are below 40, then an ultrasound is the first test, it is a totally  non-invasive test, no poking, no x-rays, nothing. Just a plain simple breast ultrasound is what is required. After that whatever the results of the ultrasound are, then we proceed accordingly. After 40, there is a mammography and an ultrasound.

You said that our diet and stress can be a factor in breast pain, could you tell us more about that?

Lifestyle management in any breast diseases has become the gold standard. Basically, a good diet, avoiding obesity, eating lots of fresh foods and vegetables, regular exercises, these all help in improving  your lifestyle. As your lifestyle improves, your hormonal levels get better, so you start feeling better. In general as well, a healthy lifestyle means that all kinds of health problems can be avoided. For breasts, there are certain food products which are good, like beans, broccoli, and kiwis. Soya, in any form, is very good as well. It has flavonoids which are very good for breast tissue. Avoid fatty food, chocolates, too much coffee, cigarettes and alcohol. Smoking  is a complete no-no; a lot of new studies say that smoking is a definite factor (for breast cancer).

Even coffee is a factor?

Of late there have been studies which say that coffee may be increasing your risk for breast cancer. Too much coffee, that should be avoided.

As Indian women, we always refrain from seeing a gynae or any doctor until there is a real problem that presents itself. Do you believe that we should have regular checkups for our breasts or can we check them at home? If there should be a  proper exam with a doctor, how often should it be done?

Ideally speaking, every woman, right from menarche till we are alive, we should all make a habit of checking our breasts at least once a month thoroughly. The monthly examination should be immediately after your period. Suppose you start your period today, the next 6-8 days are the most silent time for the breast, that’s the best time to examine them. Now, how should we examine our breasts? You will have to learn from somebody. I generally advise everyone to go once to a specialist who can guide you on how to do it yourself, and with practice gradually you come to know what your normal breasts look and feel like, and then you can keep doing it so gradually your hands are trained.

You can do it once a month and daily while having a bath. When you have soap on your body, glide your hand on your breast with some pressure, if there is any lump or any tenderness or anything that feels abnormal (if you feel it’s something abnormal and that it wasn’t there yesterday), then you must see your doctor. That should be the schedule that you should follow all your life.

Ideally speaking, every woman, right from menarche till we are alive, we should all make a habit of checking our breasts at least once a month thoroughly. The monthly examination should be immediately after your period. Suppose you start your period today, the next 6-8 days are the most silent time for the breast, that’s the best time to examine them.

The age of cancer has actually moved. Earlier, we used to think that after 40 or 50 is when someone can get cancer. But, now gradually the age has come down to 30. Now we say that even after  30, you should make it a routine to go to your doctor at least once a year and get an ultrasound of our breasts.

Sources:

1. Prevalence of mastalgia in young Indian females. Sukanya Raghunath, Nagarathna Raghuram, Sandhya Ravi, Nidhi C Ram, Amritanshu Ram.

YOU MAY ALSO LIKE

What is rheumatoid arthritis and why does it impact more women

Read More >> What is rheumatoid arthritis and why does it impact more women

Is sugar bad for us?

Read More >> Is sugar bad for us?

How does endometriosis impact fertility?

Read More >> How does endometriosis impact fertility?