A 30 year old female patient presents to the clinic with bilateral breast pain, she gave a history of giving birth to a child recently, and she is now breast feeding him. She also reported the her milk is normal in consistency (not yellow, there is no blood). On examination every thing was normal, with NO lump to be felt. Whats the cause of this pain...
Most of the time, it's a benign pain due to stretch of the soft tissue during pregnancy and lactation ( esp. among first time moms ). What can aggravate this pain ? 2 reasons that i know of a) the mother is not feeding her child frequently enough, leading to engorgement of the breasts and will cause pain even if there are no palpable lumps. This kind of pain will disappear with feeding ). b) incorrect method of breast feeding - the child is latching on to he nipple ( instead of having the entire areola in the mouth ) and this traction can cause pain. Other possibilities: a) subtle infection, esp Candida of the lactatory system ( check the baby's mouth for thrush ) b) Raynaud's like vasospastic phenomenon of the nipple during suckling ( which can radiate to the breast ).
mammography is a very painful procedure and u can't do it on a breast that hurts. U can do an ultrasound instead and culture the milk to look for organisms and can always do an mri if the situation so warrants. P.S B/L painful breasts during lactation - the cause is likely to be benign. Even otherwise mammography is not done in the setting of pregnancy and lactation or in young women - as the breast is very dense. On a lighter note - Women hate mammography anyway and if one were to tell a pregnant or lactating woman that u want a mammography done, then she would put the head of the person who is asking for it in between the 2 mammography plates and squeeze it. P:
