Breast Pain And Breast Cancer Risk

When you frequently experience breast pain, you might wonder if it raises your risk for breast cancer. Breast pain, or mastalgia, is very common and is often related to benign causes. Having hormonal breast pain or discomfort related to fibrocystic tissue or breast infections does not raise your breast cancer risk.

Between puberty and menopause, most women have some cyclical breast pain and tenderness as hormone levels change. At menopause, when your menstrual periods end, most breast pain also ceases. Your ovaries will produce lower levels of estrogen during menopause, which results in less swelling and tenderness in your breasts and tummy. Menopausal breast pain is noncyclical and usually hurts in only one breast. Noncyclical breast pain is not hormonal and can be caused by illness, injury, weight gain or certain medications.

At the Breast Care Center of University Hospital, Syracuse, New York, researchers did a study with 5463 women who visited their clinic. There were 861 of these women who were diagnosed with breast cancer, and of that group, only 14% of those women reported any breast pain.  The majority of women who complained of breast pain did not have breast cancer. Having breast pain is uncomfortable and upsetting, but it is rarely a sign of breast cancer, and seldom increases cancer risk.

Certain benign breast conditions can cause breast pain, but these have a very small impact on your risk for developing breast cancer. These breast conditions are made of non-proliferative cells, which grow and divide at a normal rate.

  Causes pain and affects breast cancer risk over normal: Very Slight Increase
  Non-proliferative cells - normal rate of cell growth and division

• Abscess beneath areola or within breast tissue
• Ductal ectasia - blocked milk duct, sometimes with nipple discharge
• Fat necrosis - fatty tissue that has died and become thick or hard
• Fibrocystic changes - cyclical symmetrical swelling and tenderness
• Mastitis - breast infection
• Sebaceous cyst with infection - bump below skin containing keratin
• Simple fibroadenoma - lump made of fibrous and lobular tissue

  Causes pain and raises risk over normal: 150 - 200% Increase
  Proliferative cells without atypia - faster than normal rate of cell growth with no abnormal cells

• Complex fibroadenoma - lump made of mixed fibrous and lobular tissue, cysts, lobes, etc.
• Multiple fibroadenomas - two or more simple fibroadenomas
• Radial scar - a star-shaped dense mass within breast (rare)

Fibroadenomas and scar tissue can be removed with surgery or non-invasive ablation by laser, freezing, radio waves, or vacuum. A breast fibroadenoma must be diagnosed with a breast biopsy, so the cells can be tested to rule out other conditions.

  Causes pain and raises risk greatly: 4 to 5 Times Normal
  Proliferative with atypia - faster than normal rate of cell growth and having abnormal cells

• Atypical ductal hyperplasia (ADH)
• Atypical lobular hyperplasia (ALH)

Hyperplasia is a benign condition in which cells grow faster than normal. Atypical hyperplasia is considered a precancerous condition. Atypical cells are abnormal and have the potential to develop into noninvasive breast cancer, such as ductal carcinoma in situ. Discuss the benefits of surgically removing any atypical hyperplasia with your doctor.

  Other sources of breast pain that do not increase cancer risk:

• Breast injury
• Healing from breast surgery

_Sources:

_{Cyclical mastalgia and breast cancer risk: results of a French cohort study.  Plu-Bureau G, Lê MG, Sitruk-Ware R, Thalabard JC. Cancer Epidemiol Biomarkers Prev. 2006 Jun;15(6):1229-31.}

_{Mastalgia and breast cancer: a protective association? Khan SA, Apkarian AV. Cancer Detect Prev. 2002;26(3):192-6.}

_{What are the risk factors for breast cancer?   American Cancer Society. Last Revised: 02/09/2011.}