Causes – Changing hormone levels can cause changes in the milk ducts or milk glands. These changes in the ducts and glands can cause breast cysts, which can be painful and are a common cause of cyclic breast pain. Noncyclic breast pain may be caused by trauma, prior breast surgery or other factors.
- 1 What is the main cause of breast pain?
- 2 What does cancerous breast pain feel like?
- 3 Does stress cause breast pain?
- 4 How do you know if you have breast cyst?
- 5 What is a breast infection called?
What is the main cause of breast pain?
Most women experience some form of breast pain at one time or another. Breast pain is typically easy to treat, but on rarer occasions it can be a sign of something more serious. Medical director of the Suburban Hospital Breast Center Pamela Wright, M.D,, discusses the most common causes of breast pain (mastalgia), their treatments and when to see a doctor:
- Hormones are making your breasts sore. Hormonal fluctuations are the number one reason women have breast pain. Breasts become sore three to five days prior to the beginning of a menstrual period and stop hurting after it starts. This is due to a rise in estrogen and progesterone right before your period. These hormones cause your breasts to swell and can lead to tenderness. “It’s normal to have breast tenderness that comes and goes around the time of your period,” says Wright. “It’s nothing to worry about.” If you become pregnant, your breasts may remain sore during the first trimester as hormone production ramps up. Breast tenderness is one of the earliest signs of pregnancy for many women. Steps you can take to minimize sore breasts include:
- Eliminate caffeine
- Eat a low-fat diet
- Reduce salt intake
- Avoid smoking
- Take an over-the-counter pain reliever
- Ask your doctor if switching birth control pills or hormone replacement therapy medications may help
- You have a breast injury. Like any part of your body, breasts can be injured. This can happen because of an accident, while playing sports or from breast surgery. You may feel a sharp, shooting pain at the time of injury. Tenderness can linger for a few days up to several weeks after trauma to the breast. See your doctor if the pain doesn’t improve or you notice any of these signs:
- Severe swelling
- A lump in the breast
- Redness and warmth, which could indicate an infection
- A bruise on your breast that doesn’t go away
- Your breasts hurt due to an unsupportive bra. Without proper support, the ligaments that connect breasts to the chest wall can become overstretched and painful by the end of the day. The result is achy, sore breasts. This may be especially noticeable during exercise. Make sure your bra is the correct size and provides good support.
- Breast pain is really coming from your chest wall. What feels like breast pain may actually be coming from your chest wall. This is the area of muscle, tissue and bone that surrounds and protects your heart and lungs. Common causes of chest wall pain include:
- A pulled muscle
- Inflammation around the ribs
- Trauma to the chest wall (getting hit in the chest)
- Bone fracture
- Breastfeeding is causing breast tenderness. Breastfeeding can sometimes be the source of breast pain. Some of the things you can experience while nursing include:
- Painful nipples from an improper latch (the way a baby latches on to suck)
- Tingling sensation during letdown (when the milk starts to flow to the baby)
- Nipple soreness due to being bitten or having dry, cracked skin or an infection
If you have pain while breastfeeding, it’s best to talk to your doctor or a lactation consultant. They can help you troubleshoot the problem while maintaining your milk supply.
- You have a breast infection. Breastfeeding women are most likely to get breast infections (mastitis), but they occasionally occur in other women, too. If you have a breast infection, you may have a fever and symptoms in one breast, including:
If you think you may have a breast infection, it’s important to see a doctor. Treatment typically includes antibiotics and pain relievers.
- Breast pain could be a medication side effect. Some medications may cause breast pain as a side effect. Talk to your doctor about the medications you’re on and if this could be the case for you. Some drugs with this known side effect include:
- Oxymethone, used to treat some forms of anemia
- Chlorpromazine, used to treat various mental health conditions
- Water pills (diuretics), drugs that increase urination and are used to treat kidney and heart disease and high blood pressure
- Hormone therapies (birth control pills, hormone replacement or infertility treatments)
- Digitalis, prescribed for heart failure
- Methyldopa, used to treat high blood pressure
- You have a painful breast cyst. If a tender lump suddenly appears in your breast, you may have a cyst, says Wright. “These fluid-filled lumps aren’t dangerous and often don’t need to be treated as they may resolve on their own. But it’s important to get any lump in your breast evaluated by a doctor.” To diagnose a cyst, your doctor may recommend a mammogram, ultrasound or aspiration (drawing fluid from the lump). Draining fluid from the cyst is also a form of treatment. If the cyst isn’t bothersome, you may not need any treatment at all. Learn more about breast cysts and other noncancerous breast lumps,
- You’re experiencing painful complications from breast implants. Some women have complications with breast implants, whether made of silicone or saline. One of the most common causes of pain after breast augmentation surgery is capsular contracture, when scar tissue forms too tightly around implants. Breast pain can also be an indication that one of your implants has ruptured. Talk to your doctor about any pain you’re having to determine if it could be related to the breast implants.
- Breast pain can sometimes be a sign of breast cancer. It’s unusual for breast cancer to cause pain, says Wright, but not impossible. Inflammatory breast cancer often causes pain but it’s rare, accounting for 1% to 5% of breast cancer cases in the United States. Symptoms of this aggressive disease often come on suddenly and progress rapidly. Inflammatory breast cancer may cause the breast to become:
- Red or discolored
- Swollen or heavy
Skin on the breast may also thicken or dimple. If you’re concerned about inflammatory breast cancer, see your doctor immediately.
When should I worry about breast pain?
By: Michelle Lee, MD, and Wendi Owen, MD If you have breast pain, you are not alone. Breast pain, also known as mastalgia, is common and accounts for 45-70% of breast-related health care visits. The good news is that most causes of breast pain are benign (non-cancerous) and usually related to hormonal changes in your body or something as simple as a poor fitting bra.
- Breast pain varies a lot from person to person and may feel like a dull ache, tenderness, burning sensation, sharp pain or just a sense of uncomfortable fullness.
- To understand what causes breast pain and what to do about it, it is important to understand a little bit about the different types of breast pain.
Types of breast pain There are two main types of breast pain. The first type is cyclical and changes with hormonal changes in your body. Cyclical breast pain typically involves both breasts, involves either the entire breast or the upper outer portion, and may radiate to the armpit.
- Most importantly, it varies with your menstrual cycle.
- Cyclical breast pain is usually worse during the week before you start your period.
- The pain usually subsides or improves after your period.
- With cyclic breast pain, it is also common to feel like your breasts are lumpier during the week before your period.
Cyclical breast pain is the most common type of breast pain and usually does not require any treatment or medical evaluation. The second main type of breast pain is noncyclic breast pain. Noncyclic breast pain usually involves only one breast and is not related to your menstrual cycle.
- It can be constant or intermittent, just not associated with any particular pattern.
- The cause of noncyclical breast pain is often harder to determine.
- Just like with cyclical breast pain, most causes of noncyclical breast pain are benign.
- The most common cause is a poor-fitting bra.
- Other causes include pregnancy, trauma, muscle strain and prior surgery.
Although breast cancer is usually not painful, when it does cause pain, the pain tends to be noncyclical and usually just in one focal spot. Because of this, noncyclical breast pain may require a little more evaluation to determine the cause. When should I talk to my doctor?
You have a lump in the area of pain that does not go away after your period. You have redness, swelling or drainage from the area (signs of infection). You have nipple discharge. Your breast pain is not clearly associated with your menstrual cycle or lasts more than two weeks. Your breast pain is just in one spot and does not involve the whole breast. Your breast pain keeps getting worse. The pain is affecting your life and limiting what you can do.
Even if you do not fit into any of these categories, if you are worried, it is always a safe bet to talk to your doctor about your symptoms. What will my doctor do? Your doctor will probably ask you questions about your breast pain. These may include: How long has it been there? Is the pain associated with any other changes in your lifestyle or body? Have you noticed a lump or any other changes to your breast? How bad is the pain? What does the pain feels like? Do you have any family history of breast cancer? Your doctor will likely examine your breasts for lumps, skin changes, focal tenderness or nipple discharge.
- Depending on the exam and your answers to the questions, your doctor may order imaging tests.
- What types of imaging tests will my doctor order? Mammogram Your doctor may order a mammogram, which is an x-ray of your breast.
- A technologist will take at least two x-rays of your breast while your breast is compressed.
If you have not had a screening mammogram in over a year, they may take x-rays of your non-painful breast, too. A breast radiologist will look at your x-rays while you wait and determine if you need any additional x-rays or a breast ultrasound. Breast Ultrasound If you are younger than 40, lactating or pregnant, your doctor may order an ultrasound of your breast instead of a mammogram.
- During the breast ultrasound, a technologist or breast radiology will put ultrasound gel on your breast and scan the area of pain with a hand-held ultrasound probe.
- The breast radiologist may decide to perform a mammogram as well to evaluate your area of pain.
- Either a technologist or a breast radiologist will discuss the results of your imaging with you before you leave and a report will be sent to your doctor.
What kinds of things might the radiologist see? In 75-88% of women who have imaging for breast pain, the mammogram and/or ultrasound are completely normal. In around 10% of women, the radiologist will find a benign cause for the pain. The most common benign cause of pain is a breast cyst.
- Breasts cysts are sacs of fluid in the breast and many women have them and never know it.
- They can become painful with changes in your body’s hormones or when they increase in size.
- One-to-two percent of women may need further evaluation with a breast biopsy because the radiologist sees something on the images and cannot tell exactly what it is.
A breast biopsy is an outpatient procedure where a small piece of tissue is removed from your breast to be evaluated under a microscope. Very few women with breast pain have breast cancer and some studies show that your chance of having breast cancer is the same whether you have breast pain or not.
Wear a properly fitted bra without underwire. Wear a sports bra while exercising. Some changes in diet have been shown to reduce symptoms of breast pain, such as decreasing your intake of fatty foods and caffeine. Some over-the-counter, herbal and prescription medications have been shown to help. Ask your doctor about these options and if any are right for you. Some women find that ice packs or heating pads help their pain, and you can try these to see if one works for you. Stress reducing and relaxation techniques may also help alleviate symptoms of breast pain.
The bottom line Breast pain is common and usually not associated with anything bad. Cyclical breast pain comes and goes with your menstrual cycle and is related to hormonal changes in your body. Non-cyclical breast pain has a wide variety of causes and the cause is harder to determine but also usually related to benign processes in the breast.
Talk to your doctor about your breast pain if you are worried, particularly, if you have a lump in the area of pain that does not go away after your period, redness, swelling, drainage from the area (signs of infection), nipple discharge, or if your breast pain is not clearly associated with your menstrual cycle, lasts more than two weeks, is just in one spot, keeps getting worse or is affecting your life and limiting what you can do.
Your doctor may order imaging tests to evaluate your breast pain. Although these are usually normal, they may help find a cause for the pain or identify something that needs to be biopsied. There are several treatments for breast pain, but there is not a single one that works for everyone, and you should talk to your doctor about any that may be right for you.
What does cancerous breast pain feel like?
Knowing how your breasts normally look and feel is an important part of your breast health. Although having regular screening tests for breast cancer is important, mammograms do not find every breast cancer. This means it’s also important for you to know what your breasts normally look and feel like, so you’ll be aware of any changes in your breasts.
Swelling of all or part of a breast (even if no lump is felt) Skin dimpling (sometimes looking like an orange peel) Breast or nipple pain Nipple retraction (turning inward) Nipple or breast skin that is red, dry, flaking, or thickened Nipple discharge (other than breast milk) Swollen lymph nodes under the arm or near the collar bone (Sometimes this can be a sign of breast cancer spread even before the original tumor in the breast is large enough to be felt.)
Many of these symptoms can also be caused by benign (non-cancerous) breast conditions, Still, it’s important to have any new breast mass, lump, or other change checked by an experienced health care professional so the cause can be found and treated, if needed.
Written by References
Henry NL, Shah PD, Haider I, et al. Chapter 88: Cancer of the Breast. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology,6th ed. Philadelphia, Pa: Elsevier; 2020. Morrow M. Chapter 3: Physical Exam of the Breast.
- In: Harris JR, Lippman ME, Morrow M, Osborne CK, eds.
- Diseases of the Breast,5th ed.
- Philadelphia: Wolters Kluwer Health; 2014.
- National Cancer Institute.
- Physician Data Query (PDQ).
- Breast Cancer Treatment (Adult) – Patient Version.2021.
- Accessed at https://www.cancer.gov/types/breast/patient/breast-treatment-pdq on October 13, 2021.
Sabel MS. Clinical manifestations, differential diagnosis, and clinical evaluation of a palpable breast mass. UpToDate.2021. Accessed at https://www.uptodate.com/contents/clinical-manifestations-differential-diagnosis-and-clinical-evaluation-of-a-palpable-breast-mass on October 13, 2021.
References Henry NL, Shah PD, Haider I, et al. Chapter 88: Cancer of the Breast. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology,6th ed. Philadelphia, Pa: Elsevier; 2020. Morrow M. Chapter 3: Physical Exam of the Breast. In: Harris JR, Lippman ME, Morrow M, Osborne CK, eds.
Diseases of the Breast,5th ed. Philadelphia: Wolters Kluwer Health; 2014. National Cancer Institute. Physician Data Query (PDQ). Breast Cancer Treatment (Adult) – Patient Version.2021. Accessed at https://www.cancer.gov/types/breast/patient/breast-treatment-pdq on October 13, 2021.
Sabel MS. Clinical manifestations, differential diagnosis, and clinical evaluation of a palpable breast mass. UpToDate.2021. Accessed at https://www.uptodate.com/contents/clinical-manifestations-differential-diagnosis-and-clinical-evaluation-of-a-palpable-breast-mass on October 13, 2021. Last Revised: January 14, 2022 American Cancer Society medical information is copyrighted material.
For reprint requests, please see our Content Usage Policy,
Is breast pain normal when not on period?
What is noncyclic breast pain? – Noncyclic breast pain is fairly uncommon, feels different than cyclical mastalgia, and does not vary with the menstrual cycle. Generally, the pain is present all the time and is in only 1 specific location. One cause of noncyclic breast pain is trauma, or a blow to the breast.
Does stress cause breast pain?
3. Breast pain not linked to periods (non-cyclical breast pain) – It’s often unclear what causes non-cyclical breast pain. It can be related to:
a benign (not cancer) breast condition previous surgery to the breast injury to the breast having larger breasts a side effect from a drug treatment, such as certain antidepressant drugs and some herbal remedies such as ginseng
Stress and anxiety can also be linked to breast pain. Non-cyclical breast pain may be continuous or it may come and go. It can affect women before and after the menopause. The pain can be in one or both breasts and can affect the whole breast or a specific area.
How do you know if you have breast cyst?
Symptoms – Breast cysts may be found in one or both breasts. Signs and symptoms of a breast cyst include:
- A smooth, easily movable round or oval lump that may have smooth edges — which typically, though not always, indicates it’s benign
- Nipple discharge that may be clear, yellow, straw colored or dark brown
- Breast pain or tenderness in the area of the breast lump
- An increase in breast lump size and breast tenderness just before your period
- A decrease in breast lump size and resolution of other symptoms after your period
Having breast cysts doesn’t increase your risk of breast cancer. But having cysts may make it harder to find new breast lumps or other changes that might need evaluation by your doctor. Your breasts may feel lumpy and painful when you’re menstruating, so it’s important to be familiar with how your breasts feel throughout your menstrual cycle so that you’ll know if something changes.
What is a breast infection called?
Overview – Mastitis is an inflammation of breast tissue that sometimes involves an infection. The inflammation results in breast pain, swelling, warmth and redness. You might also have fever and chills. Mastitis most commonly affects women who are breast-feeding (lactation mastitis).
What kind of breast pain indicates pregnancy?
Breast changes In the early stages of pregnancy, your breasts may feel more tingly, full and sore and your bra may not fit quite like it used to. Because this is linked to hormone changes in your body, it could also mean you are about to start your period.
How soon in pregnancy does breast pain start?
– Breast pain is often the first symptom of pregnancy, occurring as early as one to two weeks after conception — technically, weeks three and four of pregnancy. That sore boob sensation peaks in the first trimester because your body is flooding with hormones.
- These hormones have an important job, preparing your body to grow a tiny human — a hungry little human.
- To feed that hunger, hormones work quickly to prepare your breasts for breastfeeding,
- Blood flow to the area increases and your boobs grow larger.
- The cleavage may be pretty great — but this growth can also be painful, even causing skin irritation and itching.
Ouch! The milk ducts in your breasts also grow to prepare for breastfeeding. And hormones stimulate the growth of milk-producing glands. Basically, your boobs go through a massive growth spurt.
Will breast pain go away on its own?
Treatment – For many people, breast pain resolves on its own over time. You may not need any treatment. If you do need help managing your pain or if you need treatment, your doctor might recommend that you:
- Eliminate an underlying cause or aggravating factor. This may involve a simple adjustment, such as wearing a bra with extra support.
- Use a topical nonsteroidal anti-inflammatory (NSAID) medication. You may need to use NSAIDs when your pain is intense. Your doctor may recommend that you apply an NSAID cream directly to the area where you feel pain.
- Adjust birth control pills. If you take birth control pills, skipping the pill-free week or switching birth control methods may help breast pain symptoms. But don’t try this without your doctor’s advice.
- Reduce the dose of menopausal hormone therapy. You might consider lowering the dose of menopausal hormone therapy or stopping it entirely.
- Take a prescription medication. Danazol is the only prescription medication approved by the Food and Drug Administration for treating fibrocystic breasts. However, danazol carries the risk of potentially severe side effects, such as heart and liver problems, as well as weight gain and voice changes. Tamoxifen, a prescription medication for breast cancer treatment and prevention, may help, but this drug also carries the potential for side effects that may be more bothersome than the breast pain itself.