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 be infectious or non-infectious, often presenting with pain, redness, and swelling.
- 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 tissue 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 as a cause of breast pain, it is crucial to consider, especially if the pain is persistent, localized, and accompanied by other symptoms like a lump or nipple discharge.
- Inflammatory breast cancer: A rare and aggressive form of breast cancer that presents with rapid onset of breast swelling, redness, and pain.
- Pectoralis muscle strain: While not directly a breast condition, strain of the pectoralis muscle can refer pain to the breast area and should be considered, especially in individuals with a history of physical activity.
- Rare diagnoses
- Sickle cell disease: Can cause breast pain due to vaso-occlusive crises affecting the breast tissue.
- Thrombophlebitis of the superficial veins of the breast (Mondor's disease): Inflammation of the superficial veins of the breast, which can cause pain, swelling, and a cord-like structure under the skin.
- Granulomatous mastitis: A rare inflammatory condition of the breast that can mimic breast cancer, presenting with pain, swelling, and nipple retraction.