bubble_chart Concept

Breast distending pain refers to the condition of breast swelling and pain.

This entry only discusses simple breast distending pain; distending pain caused by other conditions such as subcutaneous nodules in the breast, breast sores and ulcers, etc., are not within the scope of this discussion.

bubble_chart Pattern Analysis

1. Phlegm and Qi Stagnation︰It is commonly seen in lactating women with obesity. Difficulty in milk secretion, distending and sagging pain in the breasts, discomfort and distension in the epigastrium and abdomen, acid swallow and belching, greasy tongue coating, and slippery pulse. $Phlegm-qi obstruction causing breast distending pain, liver depression and qi stagnation causing breast distending pain, and qi-blood deficiency causing breast distending pain! The disease causes of these three syndromes all originate from qi. Phlegm-qi obstruction causing breast distending pain is due to excessive dampness generating phlegm, with phlegm congealing and qi obstructing. Key points for pattern identification: difficulty in milk secretion, distending and sagging pain in the breasts, often accompanied by epigastric and abdominal distension and discomfort, acid swallow and belching, greasy tongue coating, and slippery pulse. Treatment should harmonize the stomach and regulate qi, promote lactation, and relieve pain. Depression-Resolving Pill with modifications can be used.

   Liver depression and qi stagnation causing breast distending pain is due to emotional depression and constrained liver qi. Key points for pattern identification: cyclical breast distending pain, chest distension, slight abdominal distension and fullness with pain, thin yellow or white tongue coating, and wiry pulse. Treatment should soothe the liver and regulate qi. The formula for soothing the liver and relieving depression or Bupleurum Liver-Soothing Powder can be used.

   Qi-blood deficiency causing breast distending pain is due to insufficient qi and blood, disharmony of the liver and stomach, and impeded qi movement. Key points for pattern identification: frequent breast distension and pain without clear regularity, pale complexion, dizziness and palpitations, shortness of breath and lack of strength, tender and pale tongue texture, and thin weak pulse. Treatment should tonify and nourish qi and blood. Eight Precious Ingredients Decoction can be used.

2. Liver Qi Depression︰Monthly cyclical breast distending pain, which may occur on one or both sides, with the outer side being more noticeable; the distending pain is pronounced before menstruation and alleviates or disappears after menstruation. There is chest and diaphragm stuffiness and fullness, pain in both flanks and lower abdominal distension and fullness. Lactating women may experience inhibited lactation and breast enlargement, with a thin yellow or white tongue coating and a wiry pulse. $Phlegm-qi obstruction breast distending pain, liver depression qi stagnation breast distending pain, and qi-blood deficiency breast distending pain! The disease causes of these three patterns all originate from qi. Phlegm-qi obstruction breast distending pain is caused by excessive dampness generating phlegm, with phlegm congealing and qi obstructing. Key points for pattern differentiation: difficulty in lactation, distending and sagging pain in the breasts, often accompanied by epigastric and abdominal stuffiness and distension, acid regurgitation and belching, a greasy tongue coating, and a slippery pulse. Treatment should harmonize the stomach and regulate qi, promote lactation and relieve pain, and may use the Depression-Resolving Pill with modifications.

   Liver depression qi stagnation breast distending pain is caused by emotional depression and constrained liver qi. Key points for pattern differentiation: cyclical breast distending pain, chest distension, lower abdominal distension and fullness with pain, a thin yellow or white tongue coating, and a wiry pulse. Treatment should soothe the liver and regulate qi, and may use a liver-soothing and depression-relieving formula, or Bupleurum Liver-Soothing Powder.

   Qi-blood deficiency breast distending pain is caused by insufficiency of qi and blood, disharmony of the liver and stomach, and inhibited qi movement. Key points for pattern differentiation: frequent breast distension and pain without clear regularity, pale complexion, dizziness and palpitations, shortness of breath and lack of strength, a tender and pale tongue texture, and a thin and weak pulse. Treatment should supplement and nourish qi and blood, and may use Eight Precious Ingredients Decoction.

3. Deficiency of Both Qi and Blood︰The breasts frequently experience distension and pain without a clear pattern. The complexion is pale, with dizziness, palpitations, shortness of breath, and lack of strength. The tongue texture is tender and pale, and the pulse is thin and weak. **Phlegm-qi obstruction causing breast distending pain**, **liver depression qi stagnation causing breast distending pain**, and **qi-blood deficiency causing breast distending pain**—all three syndromes originate from qi. 1. **Phlegm-qi obstruction causing breast distending pain** arises from excessive dampness producing phlegm, which then congeals and obstructs qi. Key diagnostic points: difficulty in milk flow, distending and sagging pain in the breasts, often accompanied by epigastric and abdominal stuffiness, acid regurgitation, belching, a greasy tongue coating, and a slippery pulse. Treatment should focus on harmonizing the stomach and regulating qi, promoting lactation, and relieving pain. The Depression-Resolving Pill can be modified for use. 2. **Liver depression qi stagnation causing breast distending pain** results from emotional depression and constrained liver qi. Key diagnostic points: cyclical breast distending pain, chest distension, lower abdominal distension and fullness with pain, a thin yellow or white tongue coating, and a wiry pulse. Treatment should focus on soothing the liver and regulating qi. The soothing liver and relieving depression formula or the Bupleurum Liver-Soothing Powder can be used. 3. **Qi-blood deficiency causing breast distending pain** arises from insufficient qi and blood, disharmony between the liver and stomach, and impaired qi movement. Key diagnostic points: frequent breast distension and pain without a clear pattern, pale complexion, dizziness, palpitations, shortness of breath, lack of strength, a tender and pale tongue texture, and a thin, weak pulse. Treatment should focus on tonifying and nourishing qi and blood. The Eight Precious Ingredients Decoction can be used.

Clinically, it is also observed that lactating women may experience breast distension and pain due to abundant milk production that the infant cannot fully consume, leading to residual milk accumulation. Alternatively, during the process of terminating lactation, they may experience breast distending pain that radiates to the chest and ribs, but without other discomforts. In such cases, it is advisable to reduce milk production and use charred germinated barley, charred hawthorn fruit, or the terminating lactationFour Ingredients Decoction.

bubble_chart Documentation

1. Leizheng Zhicai．Breast Diseases: "Breast diseases are mostly related to the liver, stomach, heart, and spleen, as the nipple belongs to the liver meridian, and the breast belongs to the stomach meridian. ... Breast milk is transformed from qi and blood, and its source is the stomach, being the essence of water and grain.
2. Zabing Yuanliu Xizhu．Source and Flow of Chest, Diaphragm, Back, and Breast Diseases: "However, among breast diseases in women, the most severe is mastoptosis. Due to static blood attacking upwards after childbirth, suddenly both breasts elongate, becoming as thin as intestines and hanging down, passing directly over the lower abdomen, causing unbearable pain. This is a critical condition and also a rare one. After extensive research of ancient methods, it is urgent to use Sichuan Lovage Rhizome and Chinese Angelica, each one catty, to make a strong decoction, and take it warm frequently. ..."