Cyclical and Non-Cyclical Breast Pain in One Breast?

Scmommato3 - I have posted on one of the several other threads you started in the "Not Diagnosed but Worried" Forum under different topic names. it probably makes sense to stick with one thread rather than starting over again with your story in new threads so members can track the problem & follow the answers.

Hello. My doc told me I have fibrocystic breasts after I had my Mammo, US and MRI. And yes it is possible to have pain on only one breast. I have a cyst on my left breast, I have a few small ones on my right. They found enhancements on my right breast after MRI but they did not biopsy it because they said it is consistent with the characteristics of complicated cysts. They told me to come back after 6 mos. My left breast with one cyst is always the one that is painful. Sometimes it is painful before my period, sometimes during but most of the time right after my period. My right breast hurts once in a while. My breasts feel lumpy. They are also extremely dense accdg to the radiologist who read my tests. I understand the anxiety. Once you had a cancer scare, it is there for life. I still think of it once in a while and I still have the WHAT IF questions. But if you keep on thinking about it, you will lose precious time enjoying your life with family and friends.

Scmommato3, when I asked the radiologist about the lump I felt on my left breast, she said it is benign and she's 100% sure of it. I dug deeper and asked her follow up questions like how can you say 100% it's not cancer? She knows Im a nurse though so she went ahead and explained to me everything. She reviewed the US photos and described to me the characteristics of a cyst in comparison to adenomas and malignant tumors. She even went further and invited me to the reading room and showed me my MRI and Mammo photos and told me what concerns them and what not. It is your right as a patient to ask questions. It is not right for those doctors to laugh at you and your situation and I am so sorry you have to go through that. Both of my breasts are fibrocystic but only one hurts, the left because of the cyst. The right one has cysts but accdg to the radiologist they are very small. This is maybe the reason why my right breast doesn't hurt. I also cut down on caffeine intake which by the way is hard because I work nightshifts. I love coffee. Also my doc says they dont biopsy simple fluid filled cysts, they go away on their own or when it gets bigger and really becomes painful, they will try and drain it. Simple cysts she said are the most common and really benign, in short not a concern. But she says when it is a complicated cyst which is the one with thicker walls and some solid elements in it, it requires a shorter follow up and they may also recommend a fine needle aspiration to further evaluate. Most of them are benign but not all. Do you know what kind of cysts you have? Are you on follow up every 6 months?

Scmommato3, I don't know that I'd call it "normal" in the sense that having pain in general is not normal, and it always irked me to no end that I had multiple doctors tell me painful breasts were "normal" along with "almost impossible to treat". It's still worth loudly advocating for yourself, even if it's not cancer and is just painful cysts, to have something done about it. There are drugs that exist that can help some women, though they didn't help me, and they also recommend things like cutting out caffeine, cutting out a lot of processed foods, and generally the usual "eat well and exercise" not realizing that exercising can be excruciating if your complaint is breast pain and wearing a bra or having things bouncing around makes it WORSE.

I never even got anyone to take me seriously until I started getting, for lack of a more appropriate forum word...witchy...toward doctors about it and stopped letting them brush me off with, "Oh, it's normal to have breast pain!" because it most certainly is NOT normal to have painful breasts all the time. The condition may be benign in most cases, but benign still doesn't mean normal.

Other doctors tried to tell me I didn't know what I was talking about and it clearly couldn't be breast pain and I likely "pulled a pec muscle" (man, I'm too lazy to do that ) because I wasn't smart enough to differentiate between pain in the breast tissue and a pulled muscle on the chest. Fun fact, I am smart enough to tell the difference.

Honestly, if you don't mind the idea of being flat or having reconstruction, and BC runs in your family, it may be worth seeing if your insurance covers a prophylactic mastectomy without genetic testing; mine did, and when nobody else would/could do anything about the chronic pain, I jumped hard at the fact that I had a strong family history of BC to get the OK from the insurance company for a mastectomy.

Since they've been gone, I've had no pain at all. Surprise, surprise.

These were some of the sources I used when I had insurance appeals to try and use the actual primary reason for requesting a mastectomy which, in my case, was pain. I did this before I knew I had a family history and it was once I mentioned it to my mom that she told me there was a long family history of both painful, cystic breasts and freakin' breast cancer.

I'll past the relevant bits below the links; don't ever let any doctor tell you that constant, non-cyclical breast pain is "normal" because it isn't. It may not mean cancer, but it's not at all normal. Some of the articles mention drug (non-painkiller/opioid) therapies that, for most women, can help reduce or eliminate the pain; I was one of the unlucky 26% of non-cyclical breast pain patients that didn't respond to those treatments.

http://www.ncbi.nlm.nih.gov/pubmed/16163081

"Mastodynia is among the most frequently reported symptoms in women with breast complaints; it is usually classified as cyclic, noncyclic, or nonbreast in origin. A useful response with medical or conservative therapy is obtained in the majority of these patients. There is a subset of patients, however, who have exhausted every medical effort and psychiatric counseling and will desire mastectomy with breast reconstruction in the hope of alleviating their chronic pain.

METHODS:

Three patients with noncyclical, bilateral mastodynia referred for breast reconstruction options from December of 2000 to March of 2004 are presented in this article. Daily breast pain charts with a visual analogue scale for pain assessment were analyzed and recorded for all patients throughout the study period.

RESULTS:

Two patients underwent delayed reconstruction and had complete resolution of pain 6 to 8 weeks after bilateral mastectomy, with no recurrence of mastalgia after reconstruction. One patient underwent bilateral mastectomy with immediate reconstruction and achieved complete resolution of her pain 3 months postoperatively. Histopathologic findings of all breast specimens revealed benign breast tissue with proliferative breast disease consistent with mastodynia.

CONCLUSIONS:

This modality, which includes mastectomy with or without reconstruction, is a viable alternative after exhaustion of all other nonsurgical options and when quality of life is significantly affected. Although mastectomy for the treatment of mastodynia refractory to medical therapy does not guarantee alleviation of chronic breast pain, it should be considered in these often desperate patients."

http://sogc.org/wp-content/uploads/2013/01/170E-CPG-January20061.pdf

This source is most frequently cited in insurance denials, but if one actually reads the study, one finds that they do not, across the board, state that a bilateral mastectomy is never recommended; the statement is that it should not be recommended as the first course of treatment, and that it absolutely should be considered after all other possible avenues of treatment have been exhausted, including the methods most commonly prescribed to treat mastodynia and mastalgia.

"A retrospective chart analysis of this latter group found that only those women who had had a mastectomy for mastalgia were pain-free following surgery"

[...]

"Davies et al. concluded that surgery for mastalgia should be considered only in a minority of women who are resistant to all other forms of treatment. "

http://www.ncbi.nlm.nih.gov/pubmed/14965747

" Mastalgia is resistant to treatment in 6% of cyclical and 26% non-cyclical patients. Surgery is not widely used to treat this condition and only considered in patients with severe mastalgia resistant to medication. "

Scmommato3, if there are no lymphnodes under your armpit, then for sure it's not IBC, as they would have been enlarged. When you get your US/MRI, ask the docs to check on your auxiliary lymphnodes, too.

PS. I can't figure out how to send pms on this website.

Scmommato3, I laughed when she said that; I knew they were fibrous as I could feel that myself, but I'd never thought to compare them to wood.

My PS and general surgeon did say, after my BMX, that the tissue removed looked 'extremely dense and fibrous' (The PS used the word 'stringy' in describing it too!) and the pathology reports showed that as well, along with multiple benign cysts and a few microcalcifications.