Differential Diagnosis for Breast Pain
Single Most Likely Diagnosis
- Fibrocystic Breast Changes: This is the most common cause of breast pain, characterized by intermittent, bilateral burning pain that can occur throughout the day. The pain is often cyclic, but in this case, it's intermittent and not clearly related to the menstrual cycle. However, the description of burning pain and its occurrence at rest and with activity aligns with fibrocystic changes.
Other Likely Diagnoses
- Hormonal Fluctuations: Hormonal changes throughout the menstrual cycle can cause breast pain. Although the patient's pain is described as intermittent and not clearly cyclic, hormonal fluctuations could still be a contributing factor.
- Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone can cause breast pain, especially if the pain is burning in nature and occurs with movement or deep breathing.
- Musculoskeletal Pain: Strain or injury to the muscles of the chest wall can cause breast pain, although the patient denies any trauma or injury.
Do Not Miss Diagnoses
- Breast Cancer: Although breast cancer is less likely to present with bilateral, intermittent burning pain, it is crucial not to miss this diagnosis. Any new or changing breast symptom warrants further investigation, including imaging and potentially a biopsy.
- Thyroid Disease: Thyroid disorders, particularly hyperthyroidism, can cause breast pain. Although less common, thyroid disease is a critical diagnosis not to miss due to its potential impact on overall health.
- Cardiac Disease: In rare cases, breast pain can be referred from the heart, such as in coronary artery disease or pericarditis. Although the patient's pain pattern does not strongly suggest cardiac disease, it is essential to consider this possibility, especially if the patient has risk factors for heart disease.
Rare Diagnoses
- Sarcoidosis: This autoimmune disease can cause breast pain, among other symptoms, due to inflammation of various tissues, including the breasts.
- Neuroma: A benign growth of nerve tissue can cause localized pain, including in the breast area, although this is a rare cause of breast pain.
- Inflammatory Breast Cancer: A rare and aggressive form of breast cancer that can cause pain, swelling, and skin changes. Although the patient's symptoms do not strongly suggest this diagnosis, any persistent or changing breast symptom warrants thorough evaluation.