Breast pain (sometimes called mastalgia) is very common, affecting two out of every three women to some degree, at some time in their life. It is hardly ever associated with breast cancer.

There are two main types of breast pain: cyclical breast pain (related to your menstrual cycle) and non cyclical breast pain (unrelated to your menstrual cycle).

Breast pain can affect people in different ways. The pain can feel like a throbbing, a heavy discomfort, a stabbing or a burning sensation. It can be constant or intermittent.
Severe symptoms can interfere with everyday activities.

What causes breast pain?
It is now generally accepted that the cause of breast pain is an increased sensitivity of the breast tissue to normal hormone levels. This is thought to be linked to the balance of fatty acids in the bloodstream. In particular there appears to be a low level of a fatty acid known as GLA (gamolenic acid) in women with breast pain. This is believed to be due to the body not processing the GLA from the diet as efficiently as it should.

What can be done?
The doctor will question you about the nature of your breast pain, how it affects you and will then examine you. A mammogram or ultrasound scan may be suggested to rule out any other problems in the breast. Otherwise you will be reassured that there is nothing to indicate any underlying abnormality and a course of capsules of evening primrose oil (Efamast) will be recommended. It is important that this is taken regularly for at least two or three months to allow therapeutic levels to be accumulated. It is then usually continued for a further three months.

Evening primrose - Oenothera erythrosepala

For pain that does not respond to Efamast, or in situations where more rapid relief is needed, hormonal treatments may be used. Hormonal treatments can be very effective
but are associated with side effects such as weight gain, nausea, dizziness, voice and skin changes. They should not be combined with the pill but it is important that other forms of contraception are used to avoid becoming pregnant during treatment.

Advice for self help.
Keep a pain chart or pain diary to chart the days when you have pain, and, whether it is mild, moderate or severe. You also need to note the days of your period to help establish whether the pain follows a particular pattern.

It is important that you have a well fitting bra that gives adequate support and try wearing it day and night. Ask to see the breast care nurse for advice, otherwise specialist bra fitters are available in most department stores.

Reducing the amount of saturated fats (such as butter, cream, fatty meat) and increasing the amount of fresh fruit and vegetables can be helpful.

Reducing the amount of caffeine containing products (tea, coffee, cola drinks, chocolate etc.) appears to help some people.

Mild pain killers such as Paracetamol or ibuprofen can sometimes help tide over an uncomfortable period.

Relaxation techniques have been found to be effective for some women.

Many cases of breast pain can be successfully treated.

If you require further advice or information please contact the
Macmillan Breast Care Nurses, Hazel Ricard and Hilary Rickwood on 020 8565 5885