Can woodworm cause breast pain?

Woodworm and Breast Pain

Woodworm is not a recognized cause of breast pain based on current medical evidence and guidelines. 1, 2

Understanding Breast Pain Causes

Breast pain (mastalgia) is an extremely common condition affecting 70-80% of women at some point in their lives. The causes of breast pain are well-documented in medical literature and include:

Common Causes of Breast Pain:

1. Hormonal variations - particularly cyclical pain related to menstrual cycles

2. Benign breast conditions:

   • Fibrocystic changes
   • Cysts
   • Periductal ectasia
   • Fibroadenomas

3. Musculoskeletal causes:

   • Costochondritis (Tietze syndrome)
   • Pectoral muscle strains
   • Intercostal nerve entrapment
   • Fibromyalgia

4. Referred pain:

   • Cervical or thoracic spine issues
   • Cardiac conditions
   • Gastrointestinal disorders (reflux, ulcers)
   • Gallbladder disease
   • Pulmonary conditions

5. Other causes:

   • Trauma
   • Post-surgical pain
   • Pregnancy-related changes
   • Herpes zoster (shingles)
   • Inflammatory conditions 1

Clinical Significance and Evaluation

It's important to note that breast pain as an isolated symptom has a very low association with breast cancer (0-3.0%). Some studies have found no increased risk of malignancy in patients with breast pain, while others have even found a decreased risk compared to those without pain 1.

When evaluating breast pain, clinicians should:

1. Determine if the pain is:

   • Cyclical (related to menstrual cycle) or non-cyclical
   • Focal (localized to one area) or diffuse/non-focal
   • Unilateral or bilateral

2. Assess for associated symptoms:

   • Presence of a palpable mass (increases cancer risk)
   • Skin changes
   • Nipple discharge
   • Signs of infection 2

Management Approach

For patients concerned about breast pain:

1. Reassurance is often the most important intervention, as most breast pain is benign and self-limiting

2. Supportive measures:

   • Well-fitted, supportive bra
   • Local heat or cold application
   • Over-the-counter pain medications (NSAIDs) 2

3. Imaging may be appropriate in certain cases:

   • Focal breast pain (slightly higher risk of malignancy)
   • Pain with associated palpable abnormality
   • Persistent unilateral pain 1

Common Pitfalls

A common pitfall is assuming all breast pain requires imaging. For diffuse, cyclical pain without other findings and with a normal recent screening mammogram, additional imaging may not be necessary and could lead to unnecessary follow-up visits and anxiety 2.

Conclusion on Woodworm

There is no medical evidence supporting woodworm (which typically refers to wood-boring beetle larvae that infest timber) as a cause of breast pain. The comprehensive guidelines from the American College of Radiology on breast pain do not mention woodworm or any insect-related causes in their extensive review of breast pain etiologies 1.

If a patient is concerned about woodworm causing breast pain, they should be reassured that this is not a recognized medical cause of breast pain, and evaluation should focus on the established causes listed above.