Breast pain is not one of the early symptoms of breast cancer.
Sorting out the reason for breast pain, begins with your story. Pectoral pain referred from muscles, felt in your breast, is likely to be present during the whole of your menstrual cycle. It is likely to be on one side only. Examination of yourself and treatment are covered on the
musculoskeletal chest pain page
Sore breasts from fibrocystic breast disease is likely to be dull, heavy breast pain, plus fullness and tenderness, in the premenstrual fortnight.
Breastbone pain right in the middle between your breasts, is another thing. If this is where you have consistent pain, the causes are different and a medical check is advisable.
Infra-mammary pain is likely to be musculo-skeletal in origin. See on another page................
precordial catch syndrome.
Breast self examination
Breast examination is best done a few days after your menstrual period ends. At that time, the fluid retention in the breast and the cellular growth activity are minimal.
People usually suggest examining yourself in the shower, but if you have large pendulous breasts, do it laying down and turned slightly to the other side, and with that arm raised above your head.
Your breast is then spread out evenly. Examine it quarter by quarter, including in your armpit and right up to your collar bone.
Keep your fingers straight and together as you feel the breast. If you examine with fingertips, you are guaranteed to feel lumps, because breast tissue is arranged in lumps.
Your ribs and costal cartilages are also there, lumps under the breast. If you do feel a lump, rock your fingers from side to side to see if you can feel something slide from side to side under them. Ribs don't budge, and if you follow along them with your fingertips they are elongated and run across ways.
It only takes a few seconds to check in a mirror. With your arms at your sides, note the evenness (symmetry) of your breasts. Then raise your arms slowly overhead, checking for any areas of pulling in of the skin or any visible lumps or distortion.
Your breast in your armpit - the axillary tail
The full extent of your breast includes up to your collar bone and out into the front of your armpit, so ensure you examine it all.
Young women sometimes come in with tender lumps in their armpit, which turn out to be breast tissue under their pectoralis major muscle (which forms the front edge of the armpit.)
Apart from armpit breast pain, the other tender lumps people get in their armpit, are inflamed lymph nodes and sweat glands...
Painful axillary lymphadenitis, firstly, is likely to be due to a bacterial infection in that arm or on the adjacent trunk.
Look for tender lumps at the top of your armpit, a red line up your arm, tender lumps just above the inner side of your elbow and at the base of your thumb. Have you a cut or splinter or a recent bite, anywhere on your arm?
This condition is a good reason for some antibiotic. In a bygone era, people used to lose limbs from this sort of thing!
Axillary hidradenitis is probably caused mostly by shaving, depilatory treatment and deodorants.
The sweat glands here are a special type and are very deep in the skin. Their ducts can get blocked, and then the sweat cannot escape onto the skin and the gland swells up.
If you really need something for underarm body odor, look into things which discourage germs, as these are what change the perspiration and make it smell.
The Phisohex ads used to feature its use for this purpose by the first astronauts.
Fibrocystic breast disease
Breast pain from fibrocystic disease mainly affects women over 30, is most pronounced in women during their 40s, and regresses during the post menopausal period.
In addition fibrocystic breast symptoms, you can feel irregular and bumpy "cobblestone" consistency in the breast tissue. This is especially in the outer upper quarter of the breast, because there is more breast tissue here.
One major concern about this fibrocystic condition is that the breast lumps can mimic and mask breast cancer. One single breast lump is more concerning, however. A fibrocystic breast is full of them.
When women come with a new lump and a past history of cysts, I aspirate the cyst on the spot and send the fluid for cytology examination. This allows instant reassurance, as the lump disappears.
Treatment for the cause of fibrocystic breast disease
You can cure fibrocystic breast disease, or at least very adequately control it.
Diabetes and thyroid dysfunction may aggravate the symptoms of fibrocystic breast. These conditions need optimal treatment for health anyway – a win win situation here.
It's worth a trial of caffeine restriction to see if your breast pain diminishes. Coffee is not the only source of caffeine. Tea, chocolate, and certain soft drinks also contain caffeine.
The message about fibrocystic breast disease and iodine is that iodine, not iodide is needed. There is a good page on this at
Vitamin E in some studies, appears to give a measurable benefit for some patients with fibrocystic disease. Vitamin E is not just one discrete molocule, but a family of tocopherols and tocotrienols.
Our body can only use one shape of these molecules, one isomer.
Synthetic vitamin E is just one of the family (d alpha tocopherol) and is a mixture of shapes of that. Buy natural!
The suggestion has been made that therapy of fibrocystic breast disease with vitamin E is of value in patients with borderline or abnormal lipid profiles (low plasma levels of high-density lipoprotein* and high plasma levels of low-density lipoprotein).
In Australia certainly, supplementing selenium as well gives better results than vitamin E alone. Sodium selenite or selenium yeast tablets can be used.
Evening primrose oil was found useful in the Cardiff3 Mastalgia Clinic, with fewer side effects than drug treatment with danazol or bromocriptine.
Although it is not a primary cause, estrogen dominance is part of the process leading to this cause of breast pain.
The amount of progesterone produced during the second half of your menstrual cycle may be reduced, and the amount to estrogen increased.
If where you live the law allows sending blood and saliva samples by mail,
the ZRT laboratory
is a high quality establishment. Hormone assays may be of help here, certainly if transdermal progesterone therapy is used.
Synthetic progestins are best avoided, as they increase the risk of breast cancer.
If you're going to use progesterone for fibrocystic breast disease, it should be the real thing.
Breast cancer risk assessment
A breast risk assessment tool is available at http://www.cancer.gov/bcrisktool/
Early stages of breast cancer do not cause breast pain – painless lumps need checking.
Anything which is common, can co-exist with breast cancer, so pre-existing anything shouldn't delay your seeking advice about a lump (or breast pain, for that matter.)
breast cancer causes and prevention
Preventive measures shoudn't wait until the science is cut and dried, if they are good nutrition and lifetyle choices.
If you know you've work to do in these areas of your life, how about a decision right now. I should bite my tongue as I write this, but please – it's your life and you can likely benefit greatly and soon. It's not “pie in the sky when you die.”
Some specific measures which may be of use are selenium and iodine (not iodide) supplementation, eating olive oil, lots of cabbage and small amounts of fermented soy products.
Have a blood test for your vitamin D level. Many people are short of this, and lack of it increases breast cancer risk a lot.
Low HDL cholesterol*, as part of the metabolic syndrome, is associated with increased post menopausal breast cancer risk. The best way to correct this is increasing activity levels.
Based on the known doubling time of breast cancer, it is estimated that the average cancer has been present for years when it is found.
Because of this, for suitable tumors, the biology of the cancer rather than whether one has mastectomy v. lumpectomy followed by radiation, largely determines the risk for local recurrence.
There is no really good early detection available, so primary prevention is the way to go.
Premenstrual breast tenderness in PMS
Tender breasts before your menstrual periods is part of PMS or PMT.
Other things you may notice now are mood and energy changes, often related to
low blood sugar.
This breast pain responds to evening primrose oil1 and Vitex agnus-castus. The latter was tested clinically as Premular2 tablets (made in Switzerland by Zeller AG.)
Mood changes in PMS include...
• Angry outbursts
• Social withdrawal
Bodily changes include...
• Breast tenderness
• Abdominal bloating
• Swelling of extremities
. Weight gain
Natural remedies which have been shown to be useful...
• Vitamin B6 (safe at least up to 100 mg daily, not above 500mg.)
• Calcium 1 gm. daily
• Magnesium 400mg daily
• Evening Primrose oil 3 gm. daily
• Premular (vitex)
• St John’s wort extract
Revicimedical.com4 has a very good article on PMT, worth reading.
Support for breasts during sporting activities.
A University of Wollongong academic, Professor Julie Steele, is a good starting point if you are one of the 50% of women who get pain now.
See article from
The Sydney Morning Herald
References for breast pain page
1. The NIH says that "Although primrose oil is used for breast pain in several European countries, high-quality human studies using this treatment are lacking."
Who will pay the >6 figure sum for a high quality study? Evidence based medicine can only apply to very expensive, patented treatments.
Google "premular breast australian gynaecology college" for pdf on PMS.
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