Mastalgia (breast pain) is widely used and can be localized or diffuse and may occur on one or both sides. Etiology Localized chest pain are usually caused by a focal disease as a mass such. B. breast cysts) or an infection (eg. B. mastitis, abscess) caused. Most breast cancers do not cause pain. Diffuse bilateral pain can breast disease or are rarely caused by diffuse bilateral mastitis. However, diffuse bilateral pain are very common in women without conspicuous Mamma findings. The most common causes are hormonal changes that cause a proliferation of breast tissue (eg., During the luteal phase or early pregnancy in women with estrogen or progestin intake) Large pendulous breasts that stretch the Cooper’sche ligament clarification history, the history the current condition should the temporal occurrence of the pain and its nature (focal or diffuse, one or both sides) taken into account. The relationship between chronic or recurrent pain and the phase of the menstrual cycle should be determined. In reviewing the Organysteme the pregnancy (z. B. enlargement of the abdomen, amenorrhea, morning sickness) or a breast disease (eg. As presence of many lesions) should be looked for symptoms that point. The history should diseases that can cause diffuse pain (eg breast disease.), And the intake of estrogens and progestins consider physical examination: The investigation focuses on the chest and the adjacent regions, for abnormalities such as skin changes, including redness, rash , overemphasis on the normal skin structures and approaches of edema, sometimes referred to as peau d’orange (orange peel) called and wird.Warnzeichen for signs of infection, such as redness, warmth and tenderness, respected the following findings are particularly important: signs of infection interpretation of findings the absence of abnormal findings suggests that the pain is caused by hormonal changes or large, pendulous breasts. Pathological findings can on any other specific disorders hinweisen.Tests For inexplicable and up to several months lasting pain, a pregnancy test should be made, especially if other symptoms or signs of pregnancy are present. Other tests are rarely indicated-only if there is through the physical findings suspected to another disorder that needs to be clarified. Treatment If menstruation dependent mastalgia usually acetaminophen or NSAIDs are effective. For severe pain can be treated with Danazol or tamoxifen briefly. These drugs inhibit estrogen and progesterone. The intake must be stopped if estrogen or a progestin is taken. With pregnancy-related chest pain resistant, supportive bra and / or paracetamol may be helpful. Current evidence suggests that evening primrose oil, vitamin E, or both used together, can reduce the severity of mastalgia. Summary Diffuse sided chest pain can usually be due to hormonal changes or large, sagging breasts and show no abnormal physical findings on.