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] Hilda Mahmoudi M.D., M.P.H.[3]
Overview
Two thirds of breast pains are cyclical and one third have non cyclical cause.[1]
Cyclical breast pain is very often associated with fibrocystic breast changes or duct ectasia and believed to be caused by aberrations in dynamic hormonal changes mainly involving prolactin response to thyrotropin. Some degree of cyclical breast tenderness is normal in the menstrual cycle, and is usually associated with menstruation and/or premenstrual syndrome (PMS).
Noncyclical breast pain has various causes and is harder to diagnose.It is more likely to be unilateral and variable in its location in the breast.Some degree of non-cyclical breast tenderness can normally be present due to hormonal changes in puberty (both in girls and boys), in menopause, during pregnancy and breastfeeding. Other causes of non-cyclical breast pain include alcoholism with liver damage (likely due to abnormal steroid metabolism), mastitis, shingles and some medications.
Causes
Common Causes
- Fibrocystic changes
Causes by Organ System
| Cardiovascular | No underlying causes |
| Chemical / poisoning | Alcoholism |
| Dermatologic | No underlying causes |
| Drug Side Effect | Antibiotics, Antidepressants, Cardiovascular agents, Chlorpromazine, Cyclosporine , Digitalis, Drospirenone and Ethinyl estradiol, Estradiol topical , Estradiol transdermal, Estradiol valerate and estradiol valerate/dienogest, Estrogen injection , Estrogen vaginal, Ethinyl estradiol and etonogestrel, Etonogestrel, Hormone replacement therapy , Medroxyprogesterone injection , Methyldopa, Norethindrone acetate and Ethinyl estradiol, Norgestrel and Ethinyl estradiol, Oral contraceptives, Oxymetholone, Pramipexole, Ramelteon , Spironolactone, Tamoxifen , Tiagabine |
| Ear Nose Throat | No underlying causes |
| Endocrine | Diabetes mellitus, Puberty |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | Mondor's disease, Thrombophlebitis |
| Iatrogenic | No underlying causes |
| Infectious Disease | Shingles |
| Musculoskeletal / Ortho | Chest wall pain, Costochondritis, Spinal and paraspinal disorders, Thoracic spine arthritis, Tietze's syndrome |
| Neurologic | Intercostal neuralgia, Referred chest pain |
| Nutritional / Metabolic | No underlying causes |
| Obstetric/Gynecologic | Breast abscess, Breast cancer, Breast feeding, Breast fibroadenoma, Duct ectasia, Endometrial cancer, Fat necrosis, Fibroadenoma, Fibrocystic changes, Hidradenitis suppurativa, Intraductal papilloma, Lactation, Large pendulous breasts, Lipoma, Macrocyst, Mastitis,Menopause, Menstruation, Mondor's disease, Nodular sensitive breast, phylloides tumor, Polycystic ovary syndrome, Pregnancy, Premenstrual syndrome, Prior breast surgery |
| Oncologic | No underlying causes |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | Pleuritic pain |
| Renal / Electrolyte | No underlying causes |
| Rheum / Immune / Allergy | Thoracic spine arthritis |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Dental | No underlying causes |
| Miscellaneous | Caffeine, Postthoracotomy syndrome, Trauma |
Causes in Alphabetical Order
- Breast fibroadenoma
- Cardiovascular agents
- Chest wall pain
- Estradiol transdermal
- Estrogen vaginal
- Ethinyl estradiol and etonogestrel
- Fibrocystic changes
- Large pendulous breasts
- Macrocyst
- Nodular sensitive breast
- Postthoracotomy syndrome
- Prior breast surgery
- Referred chest pain
- Spinal and paraspinal disorders
- Thoracic spine arthritis
References
- ↑ Davies EL, Gateley CA, Miers M, Mansel RE. The long-term course of mastalgia. J R Soc Med 1998; 91:462.