Mastalgia causes

Mastalgia Microchapters
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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