hi. noted history of nipple itchiness, breast pain and intake of premarin for years. how old are you now? do you have any history of breast cancer or concerns in your family? it is best if you consult a doctor, preferably a general surgeon, for physical examination and clinical evaluation. you may have fibrocystic changes in your breast, hence, you experience pain which usually occurs before and during menses and/or during hormonal changes in the body. these breast lesions are benign but monitoring is necessary. other lesion types must also be ruled-out. diagnostics such as combined studies of breast ultrasound and mammography will be of help. management (medical and/or surgical) will be directed accordingly. hope this helps. good day!! ~dr.kaye