What are the causes of mastalgia in a 40-year-old female?

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Differential Diagnosis for Breast Pain in a 40-year-old

Single Most Likely Diagnosis

  • Fibrocystic Changes: This is the most common cause of breast pain in women, especially those in their 40s. Fibrocystic changes are characterized by lumpy or rope-like breast tissue, which can cause cyclic or non-cyclic breast pain.

Other Likely Diagnoses

  • Hormonal Fluctuations: Hormonal changes during the menstrual cycle can lead to breast tenderness and pain. This is a common cause of breast pain in premenopausal women.
  • Breast Cysts: Breast cysts are fluid-filled sacs that can cause breast pain, especially if they become large or rupture.
  • Mastitis: Mastitis is an inflammation of the breast tissue, which can cause pain, swelling, and redness. It is more common in lactating women but can occur in non-lactating women as well.
  • Costochondritis: Costochondritis is an inflammation of the cartilage that connects the ribs to the breastbone, which can cause breast pain.

Do Not Miss Diagnoses

  • Breast Cancer: Although breast cancer is less likely to present with pain as the primary symptom, it is essential to consider it in the differential diagnosis, especially if there is a palpable mass or other suspicious findings.
  • Pectoral Muscle Strain: A strain of the pectoral muscle can cause breast pain, especially if the strain is severe.
  • Cardiac Causes: Cardiac conditions such as coronary artery disease or pericarditis can cause chest pain that radiates to the breast.

Rare Diagnoses

  • Sarcoidosis: Sarcoidosis is a rare condition that can cause breast pain, especially if there is granulomatous inflammation of the breast tissue.
  • Thyroid Disease: Certain thyroid conditions, such as hyperthyroidism, can cause breast pain.
  • Neurogenic Causes: Neurogenic causes, such as neuroma or nerve compression, can cause breast pain.
  • Inflammatory Breast Cancer: Inflammatory breast cancer is a rare and aggressive form of breast cancer that can cause breast pain, swelling, and redness.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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