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Women's Health

Armpit pain

05/15/2007

Question:

I am a 25 year old female. Several months ago I noticed a dull pain in my right armpit. I ignored it until it got worse and I realized that there were four different areas in my armpit and along the breast tissue that were extremely painful when I touched them. After the course of a few weeks, it spread to my left armpit and all of the spots that hurt in my right armpit were mirrored exactly in my left armpit. I went to my family doctor, who sent me for a mammogram, an ultrasound and a CAT scan. All came back normal and they did not show any masses or even enlarged lymphnodes. My doctor gave me doxycycline for 1 week, but this did nothing. I am now scheduled for an MRI, however I am not optimistic this will reveal anything either. This has been ongoing for the past three months (at least) and the pain is keeping me up at night. I have no fever, no swollen lymphnodes elsewhere in my body and I do not feel sick. There are no cuts, scrapes, boils or any visible marks on my armpits or the surrounding skin. The only other symptom I have been experiencing are heart palpitations, which started with one or two a week and now have progressed to one nearly every half hour. This could be related to stress, however. I know that you cannot diagnose anything, but I was wondering what my next step should be if the MRI does not reveal anything. What type of specialist (if any) should I go see? I am sort of lost as to where to go from here and my family doctor has no idea either.

Any suggestions would be much appreciated. Thank you.

Answer:

Breast pain has the medical term mastalgia, and it is a very common occurrence. My first suggestion is that you look at the fit of your bras and what you wear when you exercise. Many times, breast pain like that comes from a poorly fitting bra or lack of adequate support when you are exercising. The ligaments stretch and become sore to the touch.

If you don't have a mechanical reason for the pain, the next step is to do what you have done to rule out a malignancy or other tumor activity. It sounds like you've been doing that and that's a good thing. I'd also be careful to check for nipple discharge.  (You shouldn't have any unless you are pregnant or producing milk for a baby.)  Sometimes, if the pain comes and goes, the pain can be hormonally triggered.

If you don't have any nipple discharge, that's good. If you do, you have to determine if it's from one or both breasts as that's really significant. Let your provider know. It doesn't have to be cancer, and it can be treated.

Another cause of breast pain like that is called costocondritis. It is an inflammation of the cartilage between the breast bone and the rib. If there is no other cause for the pain, then it may help to try a non steroidal anti-inflammatory like Motrin or Naprosyn. Your health care provider can give you the correct dosage and frequency for the medication.

But again, check your bras--that's a common and often overlooked cause of breast pain in women. Hope this helps.

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Response by:

Elizabeth R Barker, APRN, BC, FNP, FAANP, CHE, PhD Elizabeth R Barker, APRN, BC, FNP, FAANP, CHE, PhD
Professor of Clinical Nursing
College of Nursing
The Ohio State University