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Medical Author:

M Ruby Alvi, MD, CCFP, MHSc

Medical Reviewer:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Many possible causes exist for pain or tenderness in one of your breasts or in both breasts. Most often the pain can be attributed to harmless causes such as puberty or pregnancy. It can also be a recurrent problem for women with cyclical pain associated with the menstrual cycle. Although cancer is a major concern for most women, it is rarely the cause of isolated breast pain.

Some causes of breast pain are:

• Fibrocystic breast disease
• Premenstrual syndrome, cyclic mastalgia
• Normal hormonal fluctuations
• Onset of puberty or menopause
• Pregnancy
• Breastfeeding (nursing)
• Estrogen therapy
• Chest wall tenderness (costochondritis)
• Injury to the breast (trauma, after breast surgery)
• Shingles (pain is only in 1 breast, usually accompanied by a rash)
• Use of certain medications such as digoxin (Lanoxin), methyldopa (Aldomet), spironolactone (Aldactone), oxymetholone (Anadrol), and chlorpromazine (Thorazine)
• An infection in the breast (breast abscess, mastitis)
• Breast cancer

If you have a lump in your breast, your doctor will check for the following:

• Fibrocystic changes: Fibrocystic changes, previously called Fibrocystic Disease, are the most common benign or harmless (does not threaten health or life) condition of the breast. Changes can occur in one or both breasts, most commonly in the upper and outer sections. You may feel a thickening of the fibrous tissue that supports your glands. Common lumps, called fibroadenomas, occur during the reproductive years. They feel rubbery and movable. They often occur with fibrocystic changes.
• Cysts: Breast cysts are fluid-filled lumps. They can be tender, especially before your period.
• Breast cancer: Some lumps may be cancer. Breast cancer is usually associated with the risk factors of age, genetics, or hormones. About 75% of breast cancers occur in women older than 50 years, 23% occur in women ages 30 to 50 years, and 2% occur in women under 30 years of age.
  • Genetics is believed to play a role if your mother or sister (referred to as first-degree relatives) were diagnosed with breast cancer before menopause. You have a two to three times higher risk than the general population of developing breast cancer.
  • Hormonal factors may play a role. If you have had the following conditions, you may have an increased incidence of breast cancer (possibly because of longer exposure to a hormone called estrogen).
    • Had your first period at an early age
    • Had menopause at a later age
    • Have never had a child or your first pregnancy was after age 30
  • Cancer may also be explained by one of many theories including exposure to viruses, chemicals, radiation, dietary factors, and genes (for example, BRCA-1). No single theory explains all types of breast cancer.

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