Is pain sign of breast cancer?

Majority of women will have some breast pain at some point in their lives. In this report by Sade Oguntola, experts say that its manifestation really depends on the cause and may not always be indicative of breast cancer.

 

Breast pain in women is very common, with around 70 percent of women experiencing breast pain at some time in their lives. Its effect can vary, and can, in some cases, make basic functions like getting dressed, walking and simple acts of intimacy very uncomfortable.

Certainly, the majority of women will have some breast pain at some point in their lives. But ”pain suggests that there is something in the breast but it is rarely a symptom of breast cancer,” said Dr Adeyinka Adaemola, a consultant surgeon, Breast Unit, University College Hospital (UCH), Ibadan, Oyo State.

Most times, breast pain in either or both of the breasts may be constant or it may occur only occasionally and it can range from mild to severe. It may occur just a few days a month in the two to three days leading up to the menstrual period. This normal, mild-to-moderate pain affects both breasts.

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Some women experience breast pain a week or longer each month, starting before the menstrual cycle and sometimes continuing through the menstrual cycle. The pain may be moderate or severe and may affect both breasts.  Still, breast pain can occur throughout the month and still not be related to the menstrual cycle.

Unfortunately, the fear of breast cancer makes women with breast pain hurry to go to the hospital for medical attention.

In 2016, researchers reported that breast pain constituted a small proportion of complaints to the breast clinic of the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State.

In the study, the researchers had assessed 664 patients at the breast clinic from January 2004 to December 2008 and reported that 127 had breast pain either as the sole symptom or in association with other symptoms.

The study published in the Nigerian Journal of Surgery stated: “the presenting complaints were a pain, pain with a lump, and pain with nipple discharge in 63 (49.6 percent), 59 (46.4 percent), and five (4.0 percent) patients respectively. The pain was noncyclical in 96 (75.6 percent) patients. The site of the pain was whole breast in 87 (68.5 percent) patients and a lump in 40 (31.5 percent).”

Still, when women talk about breast pain, Dr Ademola said it may be coming from the breast or structures around the breast.

“When it is coming from the breast we usually consider if it is primarily a breast problem or due to the breast reacting to hormonal changes in the body,” he said.

Many women relate breast pain with the onset of the menstrual cycle. “Before childbirth, especially in young people, the breast will be full, tender and heavy and because of that they feel a dull pain,” he added.

This is called cyclical breast pain because it comes in a menstrual cycle when the woman is about to have her cycle. So, the breast is reacting to the circulating hormones in the body.

These hormonal fluctuations can also contribute to fibrocystic breast changes that materialises as benign lumps in the breasts, which can make the chest feel sore, too.

On the other hand, some women find that hormonal birth control can contribute to breast pain because of the increased oestrogen.

However, experts say breast pain may be non-cyclical; in which case it is not due to the circulating hormone but due to problems in the breast such as age, breastfeeding or exercise, infection of the breast or an abscess, or injury.

Ageing and changes in the breast due to breastfeeding leave scars in the breast that eventually leads to pain.

Still,  there are conditions that occur around the breast that women think are due to breast pain. For example, if your bra is ill-fitting, that can cause a lot of discomfort, most especially people with big breasts.

Large breasts can stretch the Cooper’s ligaments — connective tissues that help give your breasts their shape — which may cause aches and pains.

Also, if there is an inflammation of the cartilage that connects the ribs to the breastbone, or even arthritis of the rib region, it is also felt as breast pain.

Dr Ademola, however, said several conditions affecting the chest wall, oesophagus, neck and upper back, and even the heart can produce symptoms that are felt as breast pain. These include heart disease, gastroesophageal reflux disease (GERD) and lung problems.

According to him, “people who have heart attack come to the clinic and say that they have breast pain. The pain is really not in either of the breasts but in the chest wall.

“Also, if there is acid reflux from the stomach into the oesophagus, the individual may think that it is pain in the breast. The lung is behind the breast, and so when there is a problem in the lung, such person may think it is due to breast pain.”

Dr Ademola, however, said pain, in whatever part of the body, should not be ignored. This is particularly more important when it is persistent, comes with lumps, nipple discharge, or as swollen, reddened breast with dimpled or orange-peel skin.

“You should not just ignore pain; you should always look for the cause of the pain and that pain must be treated appropriately and timely,.

“There are doctors who are specialities in breast conditions who can evaluate you properly. I always say that the days that one doctor knows everything in the body is long gone.”

Dr Ademola, however, urged that just as women with pains will hurry to seek medical attention, so also those with breast lumps should not ignore it.

According to him, doing this, we will have more women saved from breast cancer. Actually, deadly diseases do not pain.”

Moreover, during particularly harsh periods of anxiety, pressure and stress, breast pain is experienced. While science is not exactly sure on its cause, some researchers relate it to hormonal fluctuations.

Research has found correlation between the impact of stress and oestrogen levels. Increased stress during a specific time during the menstrual cycle could cause excess discomfort.

Certain prescription medications, including some infertility treatments oral birth control pills, cardiovascular and psychiatric medications, may be associated with breast pain.

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