Differential Diagnosis for Breast Pain

• Single most likely diagnosis
  • Fibrocystic changes: This is the most common cause of breast pain, characterized by lumpy or rope-like breast tissue. It is often associated with hormonal fluctuations during the menstrual cycle.
• Other Likely diagnoses
  • Cyclic mastalgia: Breast pain that varies with the menstrual cycle, often worsening premenstrually and improving after menstruation.
  • Mastitis: 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.
  • Breast cysts: Fluid-filled sacs within the breast that can cause pain, especially if they become large or rupture.
  • Trauma: Direct injury to the breast can cause pain, bruising, and swelling.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Breast cancer: Although less common, breast cancer can present with pain, especially if it is invasive or has spread to the chest wall or skin.
  • Inflammatory breast cancer: A rare and aggressive form of breast cancer that causes the breast to become red, swollen, and painful.
  • Pectoralis muscle strain: Strain of the chest muscle, which can cause referred pain to the breast area.
• Rare diagnoses
  • Sickle cell disease: A genetic disorder that can cause breast pain due to vaso-occlusive crises.
  • Tietze's syndrome: A rare condition characterized by inflammation of the cartilages that connect the ribs to the breastbone, causing chest and breast pain.
  • Mondor's disease: A rare condition characterized by thrombophlebitis of the superficial veins of the breast, causing pain, swelling, and a cord-like structure.