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Breast Pain Evaluation

The initial evaluation usually focuses on trying to classify the pain as cyclic or noncyclic.  Sometimes this is not as straightforward as you would think.  Some women can describe their pain very clearly and others cannot.  If you have a difficult time trying to decide, keep a pain diary for a month or more.  You may find a pattern emerges regarding your breast pain.

Once the history is obtained, an examination should follow.  Any abnormalities of the breast exam, such as a lump would prompt further evaluation . 

Some women with typical cyclic breast pain and a normal examination may not need any additional evaluation.  Strategies to reduce discomfort would be initiated.  However, older women, women with a strong family history of breast cancer and any abnormalities on the breast exam require additional evaluation in the form of a mammogram or ultrasound.

For women with severe cyclic breast pain, effective medications are available, including danazol and tamoxifen.  These therapies are associated with potentially serious side effects and should be reserved only for women with severe breast pain.