Breast pain

Question 1

what is the nerve supply to the breast

Answer 1

anterolateral + anteromedial branches of intercostal nerves T3-T5

Question 2

3 types of breast pain

Answer 2

a) cyclical
b) non cyclical
c) chest wall

Question 3

discomfort, lumpiness, bilaterally a week prior to period, tender

Answer 3

cyclical breast pain

Question 4

pain described as…. in cyclical breast pain

Answer 4

• heaviness
• tender
• stabbing/tightness
• may radiate to axilla

Question 5

causes of cyclical breast pain

Answer 5

• hormonal changes in menstrual cycle
• usually stops are menopause
• HRT can cause it
• assoc with starting/stopping contraception

Question 6

non cyclical breast pain is described as …

Answer 6

• burning/stabbing/tightness

…

Question 7

cause of non cyclical breast pain

Answer 7

• unclear
• benign breast condition
• injury to breast
• larger breasts
• SE certain drugs

Question 8

causes of chest wall pain (2)

Answer 8

Causes:

• muscle pulled
• tietze syndrome

Question 9

management of chest wall pain

Answer 9

• reassurance as no serious underlying cause
• NSAIDs
• supportive: supportive bra @ night as this stops the breast pulling downwards on chest wall + supports tender breast tissue

Question 10

non breast causes of chest pain

Answer 10

• cervical/thoracic spondylosis
• lung pathology
• gall stones
• costochondritis
• thoracic outlet syndrome

Question 11

management of cyclical breast pain

Answer 11

• topical NSAIDs
• change OCP or try non hormonal methods
• well fitting bra
• diet + lifestyle changes: low fat, increasing fibre, reducing alcohol + caffeine
• relaxation therapies