Breast tenderness with menstruation

Introduction Premenstrual breast pain: There are many women in the menstrual cramps with strong breasts, hard, tenderness; severe breasts with slight vibration or collision can be painful and uncomfortable, the original granules or nodular sensation is more obvious. This is due to increased estrogen levels in the premenstrual body, hyperplasia of the mammary glands, and interstitial edema. After the menstrual period, the above changes disappeared.

Cause

As the menstrual cycle changes, the mammary gland also has changes in hyperplasia, degeneration, and recovery like the endometrium. The premenstrual period is the pre-menstrual proliferative phase, which refers to the 7-10 days before the menstrual cramps, mainly the proliferative changes of the mammary gland, which is characterized by the expansion of the mammary gland, the epithelial cells continue to differentiate and proliferate, the formation of new acinar, the mammary gland and the acinar The accumulation of secretions can be seen. The connective tissue around the milk duct is hyperplastic and edematous, which causes the mammary gland to become large and swollen, with a tough texture, a knot-like knot, and mild pain and tenderness. This is the cause of breast pain in premenstrual period.

an examination

Related inspection

Breast ultrasound examination breast palpation

The clinical feature of this disease is that breast pain is repeated with the menstrual cycle, and gradually disappears after menstruation. If the breast has nodules or lumps, and can not disappear after menstruation, it is necessary to exclude "mammary hyperplasia" or "malignant breast lesions", which must be checked regularly and prevented early.

Differential diagnosis

Differential diagnosis of breast pain with menstruation:

1, acute mastitis: most occur in lactation, the pain in the beginning of the disease, pus and ulceration often have different manifestations in different periods, but also have their different systemic and local symptoms and signs: At the beginning of the disease, the pain is often persistent pain or pulsating pain, and the tenderness is obvious. It may be accompanied by fear of cold and fever, local redness and swelling of the breast, etc. The pain gradually increases with the development of the disease, and even the torso and the night are not met; To the pus, after the pain is extremely, the abscess ruptures itself or cuts the pus. As the local pus is drained, the pain can be relieved, only the light tingling, the systemic fever is gradually reduced; to the later stage, the abscess The wound gradually healed, the pain was only mild and painful, and gradually relieved, and eventually it was completely relieved, and the systemic symptoms disappeared.

2, mammary gland hyperplasia: breast pain in breast hyperplasia, often with multiple breasts on both sides of the size of the nodules, local can have tenderness, and its breast pain can often change with the menstrual cycle, in the premenstrual breast Pain occurs or worsens, and can be significantly reduced or even disappeared after menstruation.

3, plasma cell mastitis: the incidence of more than non-lactation, its pain often occurs suddenly, the beginning of local pain or tingling, and soon developed into obvious local pain, but its pain is generally not like acute mastitis As severe as this, and the history of the disease, most patients have congenital one or both nipples complete or incomplete depression; before the onset of pain, there is often a small amount of intermittent nipple discharge, often found at the same time when pain occurs In the areola mass; later, after the mass becomes pus and ulceration, the fistula leading to the milking hole can be formed. After long-term refractory, the breast pain in the fistula period is often pain or light tingling.

4, breast benign tumors usually have no obvious pain or other discomfort, larger fibroadenomas can have mild pain or soreness before menstruation. Breast malignant tumors often have no obvious symptoms such as obvious pain in the early stage, and some have only mild discomfort. Therefore, they are often found in physical examination or inadvertently. However, once breast pain occurs, most of them are pain caused by local infiltration and ulceration in the late stage of the tumor. Diagnosis It is not difficult; if it is inflammatory breast cancer, it occurs mostly in young women, especially in pregnancy and lactation, often manifested as breast burning pain, the lesion develops rapidly, the whole breast rapidly increases and hardens in a short time, the skin Edema, congestion, redness or purple, may have tenderness, generally without systemic inflammatory response, tumors can metastasize quickly.

5, in addition, there are some non-breast factors caused by breast pain, such as costal cartilage inflammation, recessive herpes zoster and heart disease, and sometimes can also be expressed as a side of breast pain, should pay attention to its differential diagnosis, Avoid treating it as a breast disease and mistreatment.

It can be seen that the single symptom of breast pain is difficult to make a diagnosis. The clinical history and accompanying symptoms must be comprehensive. According to the characteristics and changes of breast pain during the evolution of different diseases, the cause of pain can be judged and a correct diagnosis and identification can be made. diagnosis.

The clinical feature of this disease is that breast pain is repeated with the menstrual cycle, and gradually disappears after menstruation. If the breast has nodules or lumps, and can not disappear after menstruation, it is necessary to exclude "mammary hyperplasia" or "malignant breast lesions", which must be checked regularly and prevented early.

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