Differential Diagnosis for Under 30 Breast Pain

• Single most likely diagnosis
  • Fibrocystic changes: This is the most common cause of breast pain in young women, characterized by lumpy or rope-like breast tissue, often accompanied by cyclic breast pain that varies with the menstrual cycle.
• Other Likely diagnoses
  • Mastitis: An infection of the breast tissue, which can cause pain, swelling, and redness, often associated with breastfeeding 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.
  • Hormonal fluctuations: Changes in hormone levels during the menstrual cycle can lead to breast tenderness and pain.
  • Trauma: Direct injury to the breast can cause pain and may lead to hematoma or fat necrosis.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Breast cancer: Although rare in women under 30, breast cancer can occur and is more likely to be aggressive, making early detection crucial.
  • Inflammatory breast cancer: A rare and aggressive form of breast cancer that causes the breast to appear inflamed, which can be mistaken for an infection.
  • Puerperal mastitis: A severe infection of the breast tissue that occurs in breastfeeding women, which can lead to sepsis if not promptly treated.
• Rare diagnoses
  • Mondor's disease: A rare condition characterized by thrombophlebitis of the superficial veins of the breast, causing pain and a cord-like structure.
  • Granulomatous mastitis: A rare inflammatory condition of the breast that can mimic breast cancer or infection.
  • Breast abscess: A collection of pus in the breast tissue, which can occur in non-lactating women, often associated with underlying conditions like diabetes.