This pain may be mild or severe, on one or both sides and cyclical or random. The breast is a structure which is undergoing changes throughout the reproductive life of the woman and superimposed on these changes, it is subjected to the cyclical changes every month due to the menstrual cycle.The pathological changes that the breast tissue undergoes range from cyst formation, fibrosis, hyperplasia of the lining epithelium and papillomatosis. These changes may be associated with lumpy breasts and various degrees of breast pain.
Cyclical breast pain is associated with the menstrual cycle and during the premenstrual phase, there is an increase in lumpiness, pain, and tenderness in the breast. The changes regress once the periods commence and there is an associated diminishing of the severity of the symptoms.
Non-cyclical mastalgia is more common in perimenopausal women. Breast pain may sometimes be due to referred pain from the musculoskeletal system.
Proper counseling of the patient after adequate history and examination to confirm the cause of the breast pain goes a long way in the treatment. The patient needs to understand that this is due to the hormonal changes happening in her body and it is not due to any serious disease. Once she is convinced of this, it is easier for her to accept the small changes required to make herself comfortable. A well-fitting and comfortable breast supporting bra is necessary. If the pain is intractable, then a mild anti-inflammatory medication can be given.