New Research Links Exercise to Breast Pain

More than 400 women who took part in the London Marathon last year reported experiencing breast pain when exercising, according to new research. The large-scale study of 1,285 female marathon runners found that a third of women (411 in total) experienced breast pain, with more than half describing the pain they felt as discomforting.  A further 21 per cent said the pain caused them distress, was horrible or was excruciating. It is the first piece of research to establish the link between breast pain and breast size, identifying that pain increases with breast size. The research was led by Dr Nicola Brown at St Mary’s University College, Twickenham with colleagues at the University of Portsmouth’s Research Group in Breast Health of which Dr Brown is also a member. Earlier studies by Dr Joanna Scurr, at the University of Portsmouth, have found when running, women’s breasts move up to 21cm. In the current study more than 200 women said that breast pain was severe enough to affect their exercise behaviour and 61 women reported the use of medication to relieve symptoms. Worryingly, the study showed that 44 per cent of respondents hadn’t done anything to relieve their symptoms, suggesting that women may accept pain as part of exercise. It highlights the lack of effective treatment methods available and the need for more research on breast pain treatment to allow women to exercise in greater comfort and without pain. Those taking part weighed, on average, 62.7kg, were 1.65m tall and had a body mass index of 22.9, well within the ideal healthy range. The women wore 56 different bra sizes ranging from an AA cup to an H cup, and under-band measurements ranged from 28-40 inches. The most common bra size was 34B. Those who had never had children were more likely to experience pain (35 per cent), than those who had given birth (28 per cent). Of those who experienced pain, more women experienced pain when participating in vigorous physical activity (64 per cent), compared to moderate physical activity (54 per cent). Dr Brown said, “This is the first time a scientific study of breast pain in women marathon runners has been done and the results were shocking." “The link between breast pain and exercise has not been formally established, but given so many women in this survey identified exercise as the most likely cause of their pain, this does have implications for breast pain management. It demonstrates the need for more research to be conducted to investigate this important issue, allowing women to exercise in greater comfort.” Dr Scurr leads the University of Portsmouth’s Breast Health Research Group whose work has helped inform sports bra design for the past five years. She said, “We know from extensive testing in the lab over the past five years that some bras work better than others and provide more support to women of all cup sizes. But these results show more bra manufacturers need to do more research and work closely with scientists and women to design bras which allow women of all shapes and sizes to lead active and healthy lives.” There are four types of breast pain, also known as mastalgia, which can interfere with a women’s social, physical, sexual and work-related activities: Pain that is constant or intermittent but not related to the menstrual cycle; pain that is directly related to the menstrual cycle; extra-mammary pain that is felt in the breast but originates in the chest or elsewhere; and pain due to excessive breast motion during exercise. Dr Brown said, “The results point clearly towards the need for women to be educated about managing breast pain and for health practitioners to manage the symptoms. “Supportive, well-designed bras are highly recommended because the breast itself has limited support of its own and running produces much more strain on the breast than walking.” The research has been published in the British Journal of Sports Medicine. Brown N, White J, Brasher A, Scurr, J. The experience of breast pain (mastalgia) in female runners of the 2012 London Marathon and its effect on exercise behaviour. British Journal of Sports Medicine Online First April 20 2013 doi 10.1136/bjsports-2013-0192175