Differential Diagnosis for Shifting Unilateral Breast Ache

• Single Most Likely Diagnosis
  • Fibrocystic Changes: This condition is very common and can cause shifting breast pain that varies with the menstrual cycle. The pain is often described as dull and aching, and it can move around the breast.
• Other Likely Diagnoses
  • Cyst: A breast cyst can cause a unilateral ache, especially if it becomes large or ruptures. The pain can shift as the cyst changes size.
  • Mastitis: Inflammation of the breast tissue, often associated with lactation, can cause unilateral breast pain that may shift as the inflammation progresses or resolves.
  • Breast Trauma: Injury to the breast can result in a unilateral ache that may shift as the injury heals or as the patient moves.
• Do Not Miss Diagnoses
  • Breast Cancer: Although less common, breast cancer can present with a unilateral ache. It's crucial to not miss this diagnosis, as early detection significantly improves outcomes.
  • Inflammatory Breast Cancer: A rare and aggressive form of breast cancer that can cause rapid onset of breast pain, swelling, and skin changes.
  • Pectoralis Muscle Strain: While not directly a breast issue, a strain in the pectoralis muscle can cause referred pain to the breast area, which might be perceived as shifting unilateral breast ache.
• Rare Diagnoses
  • Sickle Cell Disease Crisis: In patients with sickle cell disease, a crisis can cause vaso-occlusive episodes that might result in breast pain due to infarction of the breast tissue.
  • Granulomatous Mastitis: A rare inflammatory condition of the breast that can cause pain, swelling, and nipple retraction.
  • Diabetic Mastopathy: A condition associated with long-standing diabetes that can cause breast pain and lumps due to inflammatory changes in the breast tissue.