How can I effectively counsel patients about the potential causes of breast pain and the importance of follow-up?

Counseling patients about breast pain involves explaining the common potential causes, reassuring them, and emphasizing the importance of follow-up.

• Potential causes: Breast pain can be cyclical, related to hormonal changes during the menstrual cycle, or non-cyclical, caused by other factors such as infections, trauma, or rarely malignancy.

  Reassure patients that cyclical breast pain is common and usually not associated with serious pathology.

• Management advice: Suggest wearing a well-fitted supportive bra, especially during exercise and at night, as this can reduce pain.

  Offer simple analgesia such as paracetamol or ibuprofen as first-line treatment for pain relief.

  Encourage keeping a pain diary to track severity, timing, and response to treatment, which aids diagnosis and management decisions.

• When to seek further care: Advise patients to follow up if pain is severe, affects quality of life or sleep, or does not improve after 3 months of first-line treatment, as specialist referral may be needed.

  Explain that persistent breast masses or other concerning symptoms require prompt evaluation to exclude serious causes such as breast cancer.

• Importance of follow-up: Emphasize that follow-up allows monitoring of symptoms, reassessment of diagnosis, and timely referral if needed.

  Provide written patient information, such as NHS resources on breast pain, to support understanding and self-management.