With the effect of high estrogen and progesterone hormones present in premenopausal women, very important changes occur in the breasts. Changes in the levels of these hormones in different periods such as the menstrual cycle, pregnancy and breastfeeding, and with the contribution of prolactin and oxytocin hormones, continuous changes occur in the breast. Before menstruation, which starts with adolescence and continues until menopause, there may be edema, tension and pain in the breast. During pregnancy, the breasts enlarge, the milk-producing tissues and their carrier channels become prominent and ensure breastfeeding. After menopause, the breast tissue leaves its place to wet tissue, the breasts soften and sag.
Structure and Function of the Breast
Breasts; They are located on both sides of the anterior chest wall and in front of the pectoral muscles, and are the symbol of motherhood and femininity. Their main function is to produce milk to feed babies after birth. For this reason, the glands (alveoli) that produce iron and the channels that will carry it form the main structure of the breast. Among them are adipose and connective tissues. glands of the breast; They are responsible for the production of breast milk when hormonal and physiological conditions are met after pregnancy. The milk produced reaches the nipple and the baby's mouth through the carrier channels. Fat and connective tissue support the breast tissue according to its size and determine the size of the breast. Apart from these, there are the skin, tail and suspensory ligaments of the breast, which determine the structure and shape of the breast tissue. Breast tissue is a well-blooded structure and dense lymph vessels reach the lymph nodes mostly under the armpit. After puberty in women, breasts continue to grow with the effect of estrogen and progesterone hormones secreted from the ovaries. The levels of these hormones in the blood are effective in the development of mammary structures and preparation for breast milk production. For these reasons, the menstrual cycle, which is responsible for hormonal changes in women, increases during pregnancy and lactation and ensures the delivery of milk. Reduction of enlarged breasts when the breastfeeding period is completed. light As a result of the breast tissue being so sensitive to hormones, small or large cysts, edema and tightness that develop suddenly in the breast can cause low level and sometimes severe pain in the breast.
How Does Breast Pain Develop?
Depending on the changes in hormone levels in women, edema and fluid accumulation develop in the breast tissue, enlargement or narrowing of the vascular structures in the region may also occur, in the breast and nipples. sensitivity occurs. Breast tenderness and pain may occur, especially in the few days before menstruation or in the middle of menstruation; During pregnancy, there may be pain due to rapid growth of the breasts. A similar situation can be seen in patients receiving hormone therapy. Again, as a result of frequent changes in hormone levels, differentiations may occur in the structure of the breast tissue, and structures filled with small or large amounts of fluid, called fibrocystic changes, may develop. The process of formation of fibrocystic changes can be painful; After it develops, mobile, elastic masses can be felt in the breast tissue. Because fibrocysts do not cause any health problems, they often do not require treatment. In addition, if the structures that make up the breast tissue become inflamed for various reasons, it is possible to develop breast pain due to inflammatory reaction and edema. Likewise, occlusion of vascular structures can cause pain due to the deterioration of nutrient and oxygen support in the tissue. can be counted among them. In this regard, breast pain can be observed in women in the following situations and in the presence of health problems:
Menstrual cycle: Hormonal changes related to the menstrual cycle come to mind, especially in the presence of cyclical, recurrent breast pain and tenderness. Hormonal imbalances in the adolescence or premenopausal period may cause an increase in breast pain complaints. Sometimes premenstrual pain may require taking painkillers (pre-menstrual syndrome).
Fibrocysts: Hormone drop Cystic structures that develop in the breast tissue due to poor breast tissue are another common cause of breast pain. Breastfeeding: Breast tenderness and nipple pain are among the most common complaints, especially after teething in infancy, along with incorrect breastfeeding methods.
Mastitis: Common during breastfeeding. Another problem is the formation of cracks in the nipple and inflammation of the breast tissue. This condition, called mastitis, can cause extreme breast pain. In cases where mastitis cannot be adequately treated, breast abscess characterized by high fever, severe breast pain and mass development may develop as a result of infection of the breast tissue by bacteria. Breast pain may occur due to the stretching of the structures that make up the tissue. Another related problem is gynecomastia, which means the development of female type breasts in men. The most common clinical problem in gynecomastia, which occurs with similar mechanisms, is the development of breast pain in men. It is one of the conditions that should be considered especially in cases localized to a certain side (for example, right breast pain as a result of frequent use of the right arm). This is among the causes of unilateral breast pain (eg, left breast pain as a result of trauma to the left side).
Nutrition: Breast pain may occur as a result of elevated free fatty acids in the blood, especially in women who have a rich diet for fat.
Smoking and alcohol use: It can seriously affect breast health. Smoking and alcohol consumption are the leading factors that negatively affect breast pain and cause breast pain. Inflammation and abscess may develop behind the nipple, especially due to smoking. ?
Since breast pain can be caused by various reasons, it may be present with various symptoms in the clinical picture. In this sense, the following symptoms may be observed in patients with breast pain depending on the underlying disease:
- Pain in certain quadrants of the breast or in the whole, in one breast or both, related or independent of the menstrual cycle, vague or severe pain
- Rash, dryness, crack development on the breast skin or nipple
- Redness, increased temperature and edema in the breast
- Clear, inflamed or bloody discharge from the nipple
- Feeling a mass in the breast tissue
How is Breast Pain Relief?
The underlying cause must be correctly identified in the treatment of breast pain. In this sense, the detailed disease history taken from the patient by a specialist physician and the detailed physical examination to be performed are of great importance. If the physician deems it necessary, he may apply to additional imaging methods such as mammography, ultrasonography and laboratory tests. In the light of the data obtained from all these examinations, the underlying cause is determined and the necessary treatment is planned. In cases where it is determined that the pain is not due to cancer, herbal medicines can be given to patients. Since the most common cause of breast pain is hormonal changes, the treatment approach is often in the form of lifestyle changes. In this context, it may be recommended to take the following measures:
- Suspending hormone therapy or other drug treatments for a while
- Using a breast-supporting bra compatible with breast size
- Limiting caffeine consumption as it can increase breast pain
- Preferring low-fat diets
- Choosing supportive sports bras while exercising
Read: 24
