Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Breast Pain and Discharge
Introduction
Synonyms and key words: Mastalgia
Breast pain is a common symptom in general surgical practice. Breast discharge is rarely normal except for lactating and pregnant women.
Differential Diagnosis
Differential Diagnosis
In alphabetical order. [1] [2]
Breast Discharge
- Breast Abscess
- Breast Cancer
- Chronic nipple stimulation
- Cirrhosis (or other hepatic disease)
- Duct ectasia
- Early pregnancy
- Fibroadenosis
- Fibrocystic change
- Galactorrhea
- Hypothalamic and pituitary abnormalities
- Hypothyroidism
- Intraductal papilloma
- Lactation
- Lactorrhoea
- Late pregnancy
- Medications
- Mondor’s Disease
- Paget’s Disease of the Nipple
- Prolactinoma
- Puberty
- Pseudocyesis
- Retroareolar Abscess
- Sarcoidosis
- Systemic lupus erythematosus
- Tuberculosis
Breast Pain
- Breast Abscess
- Breast Cancer
- Cyclical mastalgia
- Cyst
- Duct ectasia
- Extramammary causes of pain
- Fat necrosis
- Fibroadenoma
- Fibrocystic changes
- Herpes Zoster
- Intraductal papilloma
- Lactation
- Lipoma
- Mastitis
- Mondor’s Disease
- Non-cyclical mastalgia
- Pregnancy
- Phylloides tumor
- Rib secondaries
- Tietze’s Disease
- Trauma
- Unilateral or bilateral gynecomastia
Diagnosis
Diagnosis
History and Symptoms
History and Symptoms
- Thorough history examination
- Family history
- Menstrual history
- Pregnancy history
Physical Examination
Physical Examination
- Pattern and duration of pain (and/or discharge)
- Complete breast examination after menstrual flow (at least 7-9 days)
Laboratory Findings
Laboratory Findings
- Complete blood count (CBC)
- Erythrocyte sedimentation rate (ESR)
- Follicle stimulating hormone (FSH)
- Thyroid stimulating hormone (TSH)
- Liver function tests (LFTs)
- Prolactin levels
- Calcium
- Beta-human chorionic gonadotropin (HCG)
- Luteinizing hormone (LH)
Chest X Ray
- Chest x-rays may be indicated to rule out secondaries in lungs or ribs.
- Chest x-rays also show pleural effusion in cancer
Echocardiography or Ultrasound
- Ultrasounds distinguish between a cyst or a solid mass
Other Imaging Findings
- In patients older than 30 years, a diagnostic mammogram is indicated
- If available, compare with previous mammogram
Other Diagnostic Studies
- Breast biopsy
- Galactogram
- Ductogram
- Fine needle aspiration
- Cytologic exam (of discharge)
Treatment
Treatment
Pharmacotherapy
Pharmacotherapy
- Medical therapies as a means of pain relief for those patients with fibrocystic changes
Acute Pharmacotherapies
- Radiation, chemotherapy, hormonal therapy for those patients with breast cancer
- Antibiotics for those patients with a cyst or for those with mastitis (to take care of streptococci and Staphylococcus aureus)
Surgery and Device Based Therapy
Surgery and Device Based Therapy
- Aspirations for fibrocystic changes and for cysts
- Surgery may be required for those patients with breast cancer
- For patients with an abscess, incision and drainage are indicated
References
References
Acknowledgements
Acknowledgements
The content on this page was first contributed by
List of contributors:
Suggested Reading and Key General References
Suggested Reading and Key General References
Suggested Links and Web Resources
Suggested Links and Web Resources
For Patients
For Patients
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]