Mastalgia causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

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Causes

Causes Related to the Breast

  • Fibrocystic changes
    • Increased number of cysts or fibrous tissue in otherwise normal breasts
    • Can be associated with pain or nipple discharge - fibrocystic disease
    • If fibrocystic changes are cause of pain- found in 50-90% asymptomatic women
    • Hormonal etiology - pain often cyclic; most severe during luteal phase
    • Tissue edema/water retention with dilated/blocked ducts - not proven
  • Mastitis or breast abscess
    • Acute onset, usually due to Staphylococcus aureus (S. aureus) or streptococci
    • Erythema, local tenderness induration
    • Most common in lactating women
  • Pendulous breasts
    • Pain due to stretching of Cooper’s ligaments
  • Hidradenitis suppurativa
    • Can involve the breast
    • Presents with painful breast nodules

Causes Unrelated to the Breast

  • Trauma to chest wall
  • Fat Necrosis
    • Usually induced by trauma
    • Tender, firm mass, +/- calcification on mammogram
  • Costochondritis
  • Intercostal neuralgia
    • Usually due to a respiratory infection
  • Pleuritic pain from underlying pulmonary/pleural disease
  • Thoracic spine arthritis
  • Referred chest pain
    • Gallbladder disease
    • Ischemic heart disease

Flowchart

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Breast Pain
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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References