Painful Breasts--Should I Worry?

Section: Talk To The Doctor Is breast pain a sign of breast cancer?
Just about every woman has breast pain at some point in her life. It is rarely a symp- tom of breast cancer. But because women tend to fear breast cancer more than any other disease, it's a natural question to ask.

The Hormonal Connection
Breast pain, or mastalgia, is more common in younger women who are still menstruating than in postmenopausal women. The pain is usually cyclic-associated with your menstrual cycle-and tends to occur in both breasts. We're not sure what the actual cause of the pain is, but it may be related to hormonal changes or premenstrual water retention. Fibrocystic breast changes that cause lumps or cysts to form in the breast can also cause this type of mastalgia.

Noncyclic breast pain, on the other hand, is unrelated to the menstrual cycle or to hormonal changes. It is less common in women than cyclic pain. The causes are not well known, but an infection, trauma to the breast, or an injury can cause it.

If you're not sure which type of pain it is, try keeping a daily diary for a month or two, and see if the pain comes and goes with your menstrual cycle. Note also the degree to which it interferes with your daily life.

It's certainly appropriate to see your doctor for a clinical breast exam and mammogram, if needed, to rule out any more-serious cause for your pain-not to mention your own peace of mind.

Try the "Breast Cocktail"
Breast pain often resolves on its own. If it doesn't, you may want to try what I call the "breast cocktail"-a combination of supplements that has brought relief to many of my patients.

Evening primrose oil. There is good research showing that this plant oil, taken in capsule form, helps soothe breast pain. It is rich in gamma linolenic acid, an essential fatty acid, and is available over-the-counter. I recommend two 500-mg capsules a day to start-but no more than six a day. For some women, it can take several months before they experience relief.
Vitamin E. Many of my patients swear by this remedy even though the research is less convincing about its effectiveness. It's recommended for treating symptoms of premenstrual syndrome, one of which is breast tenderness, so I think it's worth trying. I recommend 400 to 800 IU daily.
Vitamin B[sub6]. This is another supplement that my patients find helpful, although the evidence for its effectiveness is largely anecdotal. Try 100 mg a day.
For persistent breast pain, ask your doctor about taking the prescription medication Danocrine (danazol). I usually prescribe 200 mg a day.

PHOTO (COLOR): Mary Jane Minkin

PHOTO (COLOR): Soothe sore breasts with some simple remedies.

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By Mary Jane Minkin, MD, a board-certified obstetrician-gynecologist in New Haven, CT, clinical professor at Yale University School of Medicine, and coauthor of What Every Woman Needs to Know about Menopause (Yale University Press, 1996).

Adapted by MD

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