Common Breast problems --------Part 1

 

Breast pain (mastalgia)- is most common breast symptom for women to consult a physician .

More commonly seen in premenopausal women it is rarely a symptom of breast cancer.

The cause of breast pain may be related to hormonal changes but exact reason is often elusive.

 Some Causes of Breast Pain
  •  Hormone changes during your period
  •  Water retention , which may happen during your period
  •  Injury to your breast
  •  Pregnancy
  •  Breast feeding ( nursing )
  •  An infection in the breast
  •  Breast cancer ( not a usual cause of breast pain
A thorough h&p includes attention to type of pain, its location and relation to the menstrual cycle. Most commonly when associated with the menstrual cycle (cyclic) its more severe just before the menses. Breast pain unrelated to menses and postmenopausally is classified non-cyclic.Non cyclic breast pain (bp) may be related to fibro-adenoma or cysts., treatment of which can be therapeutic. Menstrual irregularity , emotional stress and changes in medication can exacerbate bp.Meticulous breast exam should screen for a mass- If no mass is appreciated imaging studies are advised in women > 35 years or whom at high risk for breast cancer.

 Test used to evaluate the Breast
  •  Doctor physically examines Breast
  • Mammogram
  • UltraSound
  • Breast biopsy

Fine needle Aspirate is a common means of getting breast cells for examination
In the vast majority of cases physical and imaging studies are negative for pathology, Treatment should ensue for pain severe enough to interfere with patients lifestyle or for pain that lasts more than just a couple days.Its a good idea to have patient document on a calender etc. severetity and frequency of pain

 one pain grading scale4444

 

do submit others!
  

 How is Breast pain treated?

  • Wearing a support Bra
  • Taking a "water pill"
  • Using less salt
  • Taking Vitamin E or Vitamin B6

Some of more commonly prescribed medication for breast pain includes

Danocrine (Danazol)-an antigonadatrophin is only FDA label led medication for breast pain.

Evening Primrose oil (EPO) in doses of up to 2 capsules 3 times daily for up to 3 months has been personally used and felt effective( reports of randomized British study of 58% cyclic and 38% non-cyclic bp +ve response to decrease bp.). Caffeine avoidance and Vitamin E are other therapies utilized ( not double blind tested proven effective). NSAID's are usually 1st line attempts at therapy.

 

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Breast Nipple Discharge

Breast mass

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