What Is Cycle-Independent Breast Pain/ Non-Cyclic Mastodynia: Causes And Symptoms, Diagnosis And Treatment, Non-Pharmacological Remedies

This article intends to provide the reader with general information and purely hypothetical interpretations of cycle-independent breast pain. The advice and remedies given must not in any way replace the opinion of a doctor or a specialist in the field.

Causes And Symptoms

We have seen that cycle-independent breast pain is often an ambiguous symptom, not always attributable to an easily identifiable cause.
Furthermore, this type of breast pain takes on a different connotation based on the triggering cause and the subjective perception of the pain.
Depending on the causative agent, breast pain can be intermittent or continuous, mild or acute, appear in the form of twinges or slight soreness; moreover, the disturbance can be felt only in one breast or in both, and be localized in a specific area of ​​the breast or even spread along the arm.
Period-independent breast pain can ideally occur in women of all ages: although this disorder is statistically more frequent in over forties, many young girls also experience the same symptoms.
Given that cyclic-independent forms of breast pain always require specialist assessment, the most frequent causes of non-cyclic mastodynia are listed below:

• Drug therapy with contraceptive pills , birth control patches , hormonal IUD : A typical side effect of hormonal contraceptive methods is precisely breast pain. Sometimes, even hormone replacement therapy (indicated for example for the treatment of menopause symptoms , for the treatment of hypogonadism and for hot flashes ) can cause an annoying and constant pain in the breast. There have also been some reports of mastodynia during therapy with antidepressants, particularly serotonin reuptake inhibitors , fluoxetine andsertraline .
• Inadequate bras: often, the cause of breast pain simply lies in underwear that is not suitable for the shape and size of the breasts . In fact, women with a lot of breasts should avoid wearing push-up bras and prefer those that are soft and not too tight. During physical activity , it is recommended to use a sports bra, capable of adequately supporting the breasts.
• Exaggerated weight gain : Even weight gain can sometimes cause an unpleasant tenderness in the breasts . To preserve health as much as possible, it is recommended to follow an adequate and balanced diet.
• Costochondritis : This is an inflammation of the cartilage that connects the ribs to the breastbone . Many women suffering from this disease complain (incorrectly) of an unpleasant pain in the breast when, in reality, it is not a question of real mastodynia: the pain is concentrated in the chest at the precise point that connects the ribs to the sternum. To avoid unpleasant misunderstandings, it is advisable to report all the symptoms to the doctor, trying to be as precise as possible to avoid undergoing useless and superfluous diagnostic tests.
• Breast trauma: Car accidents, injuries and breast surgery can clearly favor the onset of mastodynia.
• Joint affections: having a negative impact on the breast, even osteo-articular disorders can cause unpleasant breast soreness.
• Herpes zoster infections (shingles) at the breast level: in this case, the breast pain takes on a connotation and a clinical meaning completely different from the previous ones. The “false” mastodynia – always accompanied by a particularly evident bullous local rash – is easily reversible with adequate and specific treatment against the virus .
• Breast engorgement (typical disorder of the immediate post- partum period ): the strong and stinging pain in the breast is the result of the stagnation of milk in the breast which, in addition to being sore, appears oedematous , shiny and tense. This condition, even if rather frequent after giving birth to a child, must not be neglected to minimize the risk of complications, such as mastitis in particular ( potentially fatal breast infection).
• Breast cancer : as reiterated several times, breast cancer only rarely begins with clear and easily identifiable symptoms such as breast pain. However, in case of suspected mastodynia – especially in association with signs such as milky or greenish discharge from the nipple , multiple breast lumps and nipple retraction – it is recommended to book a specialist check-up as soon as possible to ascertain any breast abnormalities.
• Stress and tension: even daily stress, depression and anxiety can somehow aggravate or even favor the onset of breast pain, regardless of the menstrual cycle.
• Anti-estrogen therapy: the anti-estrogen drug tamoxifen , although indicated for the treatment and prevention of breast cancer in predisposed women, can sometimes accentuate or even cause breast pain.

Diagnosis And Treatment

Fortunately, most of the time breast pain turns out to be a completely reversible condition within a few days. However, when the disturbance becomes rather heavy and annoying, analgesic drugs can help: NSAIDs such as paracetamol , ibuprofen and diclofenac ( known prostaglandin inhibitors) are indicated to reduce inflammation and relieve pain in the breast.
When breast pain becomes particularly aggressive and difficult to bear, so much so that not even common analgesics are able to relieve the discomfort, the doctor can certainly direct the patient towards a more effective and targeted treatment based on the triggering cause.
Before undertaking any therapeutic procedure for cycle-independent breast pain, the woman is subjected to specific diagnostic tests, such as breast ultrasound and mammography in particular .
After shedding light on the root causes, the patient can follow a specific drug treatment.
When breast pain depends on hormone therapy, the doctor will correct the treatment or replace the drugs with others more suitable for the patient. The same goes for antidepressant drugs : let us briefly recall that some drugs prescribed for the treatment of depression can cause a certain tenderness in the breast.
The FDA ( Food and Drug Administration) designated danazol as a drug indicated to treat cycle-independent breast pain; however, its excessive side effects – such as acne , weight gain, hirsutism , voice change – drastically limit its use in therapy.
In the unlikely event that breast pain depends on a tumour, the woman will have to follow a different and much more aggressive treatment: based on the patient’s age, the type of cancer (benign/malignant) and the severity of the tumour, the woman will be treated with surgery (which involves the surgical removal of the tumor mass), chemotherapy or radiotherapy .

Non-Pharmacological Remedies

In support of drug therapy, the patient must be educated on the correct behavior to adopt to relieve breast pain.
First of all, following an adequate diet, free of excesses and low in hyperlipidic foods (rich in fats) can only promote the general well-being of the person, minimizing the risk of developing unpleasant ailments such as breast pain.

Particular attention must also be paid to the use of undergarments: every woman should choose a bra based on her physique, regardless of what is advertised by the mass media. A bra that is too tight or unsuitable for the size of the breast can in fact be a reason for non-cyclical mastodynia.
In the presence of breast pain that tends to recur often, it is advisable to write down the frequency, intensity and location of the pain in a notepad: the data reported may possibly be useful to the doctor at a later time to facilitate the diagnosis, establishing for example whether or not the pain depends on the menstrual cycle.
Among the natural remedies against breast pain , hot compresses cannot be missing: many women affected by this type of disorder benefit from the action of heat applied directly to the chest. According to an ancient popular remedy, a multi-daily supplementation of evening primrose
oil capsules (to be taken at a dose of 1 gram, up to 3 times a day) can be a valid complement to breast pain therapy: this vegetable substance, rich in polyunsaturated fatty acids , is particularly suitable for the treatment of numerous inflammatory morbid conditions, including cycle-independent breast pain.