However, the exact hormonal cause of cyclic mastalgia remains a mystery. Other theories for this phenomenon include increased sensitivity of the breast tissue to hormonal stimulation. Lastly, it appears that weight gain2 and women with a larger bra size had a higher rate of mastalgia.3 Proper evaluation includes a detailed history and physical exam. The exam should delineate any areas of increased discomfort and seek to identify areas of concern. Identifying cysts, solid enlargement, skin changes nipple discharge and asymmetry between breasts is important.
Potential modalities used to further the evaluation include mammography, ultrasound and biopsy.
Treatment options are varied. Initial treatments include a well fitting bra. This is especially important with vigorous exercise. A properly fitting sport bra can reduce pain symptoms dramatically. Dietary treatments include reducing dietary saturated fat levels.