Mastalgia

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Written by Du Rui Xia
Obstetrics
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How many days after conception do the breasts start to feel sore?

Generally, after seven weeks of pregnancy, patients will begin to experience breast tenderness and pain. At this time, patients will feel that their breasts are noticeably swollen and increase in size gradually. The nipples will start to darken and enlarge. Around the areola, sebaceous glands will appear, and deep brown nodules known as Montgomery's tubercles will also develop. The color of the areola will begin to darken, which is related to the significant increase in hormones, particularly estrogen and progesterone, in the body after pregnancy. It is recommended that women protect their breasts from being compressed and avoid excessive massaging after pregnancy.

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Written by Sun Shan Shan
Obstetrics and Gynecology
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Is breast swelling and pain before menstruation a sign of pregnancy?

Breast tenderness before menstruation is not necessarily a sign of pregnancy. Elevated levels of estrogen and progesterone before menstruation can also cause breast tenderness, as can the early stages of pregnancy. Therefore, if women of childbearing age experience a delay in menstruation and breast tenderness, they should promptly take a urine pregnancy test and, if necessary, have a blood HCG test to check for pregnancy. If pregnancy is not the case, they should wait to see if menstruation occurs. It is advisable to avoid getting cold, refrain from eating spicy and irritating foods, and maintain cleanliness of the external genitalia.

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Written by Lin Yang
Breast Surgery
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Breast pain and bleeding after intercourse, what could be the reason?

Breast pain and nipple bleeding during intercourse are considered types of nipple discharge, possibly caused by intraductal papilloma or chronic inflammation of the ducts. Diagnosis can be made through mammography or ductoscopy. Generally, we choose ductoscopy, which allows direct observation on a computer screen whether the cause is inflammation or intraductal papilloma. If the issue is solely inflammation, it can be treated by flushing through ductoscopy. If intraductal papilloma is suspected, ductoscopy can be used to collect a tissue sample for pathology to determine whether it is due to intraductal papilloma or cancer within the ducts.

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Written by Du Rui Xia
Obstetrics
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Can pseudopregnancy cause breast pain?

During pseudopregnancy, women may also experience symptoms of breast tenderness. As women may experience delayed menstruation, along with nausea, vomiting, and abdominal bloating, it is necessary to consider the possibility of pregnancy. If it is a pseudopregnancy, then it is due to the rise in hormone levels around the time menstruation is due, coupled with psychological factors in women, which can also cause false breast tenderness. When patients experience this condition, there is no need for excessive worry. They should rest adequately, enhance their nutrition, eat a light diet, keep warm, avoid overexertion, stay away from cold, and not stay up late. They can go to the hospital for a blood test to measure human chorionic gonadotropin (hCG) to determine whether they are pregnant.

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Written by Liu Hong Mei
Neurology
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What's the matter with headache, nausea, and breast pain?

Headaches, nausea, and breast pain may be related to autonomic dysfunction and cardiac neurosis. It is important to rest well, ensure sufficient sleep, and further exclude cardiovascular diseases, myocardial ischemia, myocardial infarction, and insufficient cardiac blood supply, which can also cause headaches, nausea, breast pain, cerebral infarction, cerebral hemorrhage, insufficient cerebral arterial blood supply, and cerebral vascular stenosis. These conditions can also trigger migraines and ischemic hypoxic changes in cerebrovascular health, causing headaches, nausea, and breast pain. Blood pressure and blood sugar should be monitored, and blood pressure should be actively controlled to prevent hypertensive encephalopathy.

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Written by Lin Yang
Breast Surgery
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Can cupping therapy be used for breast distension and pain?

Breast pain can be treated with cupping, but it is ineffective because breast pain is related to fibrocystic breast changes, which are often caused by endocrine disorders leading to elevated levels of estrogen. Generally, we can treat it with traditional Chinese medicine, using methods to soothe the liver and regulate qi, and harmonize the thoroughfare and conception vessels to alleviate the pain. Endocrine treatment can also be used, though it is generally avoided if possible. However, for significant pain during the pre-menopausal period, therapy can be initiated before the menstrual period. Treatment with vitamins B, C, and E can improve liver function, regulate sex hormone metabolism, and enhance autonomic nervous system functions. These serve as supplementary medication for this condition. Vitamin E in particular also helps alleviate pain.

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Written by Lin Yang
Breast Surgery
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What's going on with breast swelling and pain and also arm soreness?

Breast swelling and pain, as well as arm soreness, are considered to be caused by mammary gland hyperplasia and accessory breast syndrome. Mammary gland hyperplasia often manifests as cyclical swelling and pain in the breasts, commonly occurring or worsening before menstruation and alleviating or disappearing after menstruation. While mild cases might not be noticed by patients, severe cases can impact daily life and work. However, some patients do not exhibit obvious cyclical changes, and symptoms can include unilateral or bilateral breast swelling and pain, resembling needle pricks, which can extend to the shoulder, upper limbs, or chest and back areas. A few patients might experience nipple discharge, which can be yellow-green, brown, or bloody. The condition can sometimes persist for a long time, with symptoms automatically disappearing or reducing after menopause. When breast swelling and pain occur, it is necessary to regularly recheck the breast with ultrasound and mammography.

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Written by Zhang Lu
Obstetrics
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Does an ectopic pregnancy cause breast tenderness in the early stages?

Ectopic pregnancy, as the name implies, refers to the implantation of the gestational sac outside the uterine cavity, with common implantation sites including the fallopian tubes, ovaries, and the pelvic abdomen. Although an ectopic pregnancy is a pathological condition, it still falls within the category of pregnancy. Therefore, the common early pregnancy symptoms, such as those seen in early pregnancy, still occur in ectopic pregnancies. Whether it's an intrauterine pregnancy or an ectopic pregnancy, breast pain during early pregnancy is common in most cases, primarily due to increased levels of estrogen and progesterone in women during early pregnancy. This leads to stimulation of the mammary glands and the proliferation of some mammary ducts, resulting in breast pain, which is normal. However, since the hormone levels in women with ectopic pregnancies are relatively lower, the sensation of breast pain is less than that in normal intrauterine pregnancies.

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Written by Lin Yang
Breast Surgery
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Is massage useful for breast distension pain?

Breast pain massage can be effective, but the effect is not very clear. Breast pain is generally related to breast hyperplasia, which is often linked to increased levels of estrogen due to endocrine disorders. Under normal circumstances, for symptoms that are quite obvious, we can use traditional Chinese medicine for treatment, which alleviates the pain through methods such as soothing the liver and regulating Qi, as well as harmonizing vital energy. Vitamin treatment can also be used. Vitamins B, C, and E improve liver function, regulate sex hormone metabolism, and enhance autonomic nervous function, serving as auxiliary medications for this condition. Vitamin E also has a pain-relieving effect. Endocrine treatment can also be used, although it is generally best avoided if possible. However, for patients in the pre-menopausal period who experience significant pain, it can be taken before the onset of menstruation.

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Written by Lin Yang
Breast Surgery
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What is causing breast swelling, pain, and discharge of pus?

Breast pain and hyperplasia are related, while purulent discharge might be caused by inflammation within the ducts. Usually, this can be diagnosed through ductoscopy. If it is inflammation, the lesions can be identified under ductoscopy, and then can be treated through washing with metronidazole and gentamicin, achieving a cure. However, there is a scenario where the issue is due to previously forcefully suppressing milk expulsion, leading to a large amount of milk residue in the ducts, causing purulent discharge. In this case, local heat application followed by massage and milk expulsion performed by a professional lactation masseuse can cure the condition. Regular follow-up with ultrasound and mammography of the breast is needed in the future. (Medications should be used under the guidance of a physician.)