Definition

What is breast pain?

Breast pain (mastalgia) can include breast tenderness, sharp burning pain or tightness in your breast tissue. The pain may be constant or it may occur only occasionally.

Breast pain can range from mild to severe. It may occur:

  • Just a few days a month, in the two to three days leading up to your period. This normal, mild-to-moderate pain affects both breasts.
  • A week or longer each month, starting before your period and sometimes continuing through your menstrual cycle. The pain may be moderate or severe, and affects both breasts.
  • Throughout the month, not related to your menstrual cycle.

Postmenopausal women sometimes have breast pain, but breast pain is more common in younger women who haven’t completed menopause.

Most times, breast pain signals a noncancerous (benign) breast condition and rarely indicates breast cancer. Still, unexplained breast pain that doesn’t go away after one or two menstrual cycles or that persists after menopause needs to be evaluated by your doctor.

How common is breast pain?

Breast pain is extremely common. It can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of breast pain?

Most cases of breast pain are classified as either cyclic or noncyclic. Each type of breast pain has distinct characteristics:

Cyclic breast pain:

  • Clearly related to the menstrual cycle
  • Described as dull, heavy or aching
  • Often accompanied by breast swelling or lumpiness
  • Usually affects both breasts, particularly the upper, outer portions, and can radiate to the underarm
  • Intensifies during the two weeks leading up to the start of your period, then eases up afterward
  • More likely to affect women in their 20s and 30s before menopause as well as women in their 40s who are transitioning to menopause

Noncyclic breast pain:

  • Unrelated to the menstrual cycle
  • Described as tight, burning or sore
  • Constant or intermittent
  • Usually affects one breast, in a localized area, but may spread more diffusely across the breast
  • Most likely to affect women after menopause

Extramammary breast pain: The term “extramammary” means “outside the breast.” Extramammary breast pain feels like it starts in the breast tissue, but its source is actually somewhere else. Pulling a muscle in your chest, for example, can cause pain in your chest wall or rib cage that spreads (radiates) to your breast.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

Continues daily for more than a couple of weeks

  • Occurs in one specific area of your breast
  • Seems to be getting worse over time
  • Interferes with daily activities

Although breast cancer risk is low in women whose main symptom is breast pain, if your doctor recommends an evaluation, it’s important to follow through.

Causes

What causes breast pain?

Sometimes, it’s not possible to identify the exact cause of breast pain. Contributing factors may include one or more of the following:

  • Reproductive hormones. Cyclic breast pain appears to have a strong link to hormones and your menstrual cycle. Cyclic breast pain often decreases or disappears with pregnancy or menopause.
  • Breast structure. Noncyclic breast pain often results from changes that occur in the milk ducts or milk glands. This can result in the development of breast cysts. Breast trauma, prior breast surgery or other factors localized to the breast can lead to breast pain. Breast pain may also start outside the breast — in the chest wall, muscles, joints or heart, for example — and radiate to the breast.
  • Fatty acid imbalance. An imbalance of fatty acids within the cells may affect the sensitivity of breast tissue to circulating hormones.
  • Medication use. Certain hormonal medications, including some infertility treatments and oral birth control pills, may be associated with breast pain. Also, breast tenderness is a possible side effect of estrogen and progesterone hormone therapies that are used after menopause. Breast pain may be associated with certain antidepressants, including selective serotonin reuptake inhibitor (SSRI) antidepressants.
  • Breast size. Women with large breasts may have noncyclic breast pain related to the size of their breasts. Neck, shoulder and back pain may accompany breast pain due to large breasts.
  • Breast surgery. Breast pain associated with breast surgery and scar formation can sometimes linger after incisions have healed.

Risk factors

What increases my risk for breast pain?

There are many risk factors for breast pain , such as:

  • Hormone changes during your period
  • Water retention, which may happen during your period
  • Injury to your breast
  • Pregnancy
  • Breastfeeding (nursing)
  • An infection in the breast

Breast cancer (not a usual cause of breast pain)

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is breast pain diagnosed?

Tests to evaluate your condition may include:

  • Clinical breast exam. Your doctor checks for changes in your breasts, examining your breasts and the lymph nodes in your lower neck and underarm. Your doctor will likely listen to your heart and lungs and check your chest and abdomen to determine whether the pain could be related to another condition. If your medical history and the breast and physical exam reveal nothing unusual, you may not need additional tests.
  • If your doctor feels a breast lump or unusual thickening, or detects a focused area of pain in your breast tissue, you’ll need an X-ray exam of your breast that evaluates the area of concern found during the breast exam (diagnostic mammogram).
  • An ultrasound exam uses sound waves to produce images of your breasts, and it’s often done along with a mammogram. You might need an ultrasound to evaluate a focused area of pain even if the mammogram appears normal.
  • Breast biopsy. Suspicious breast lumps, areas of thickening or unusual areas seen during imaging exams may require a biopsy before your doctor can make a diagnosis. During a biopsy, your doctor obtains a small sample of breast tissue from the area in question and sends it for lab analysis.

How is breast pain treated?

For many women, breast pain resolves on its own over time. You may not need any treatment.

If you do require 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 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 breast pain and tenderness. However, danazol carries the risk of potentially severe side effects, such as acne, weight gain and voice changes, which limit its use. Tamoxifen, a prescription medication for breast cancer treatment and prevention, may be recommended for some women, but this drug also carries the potential for side effects that may be more bothersome than the breast pain itself.

Lifestyle changes & Home remedies

What are some lifestyle changes or home remedies that can help me manage breast pain ?

The following lifestyles and home remedies might help you cope with breast pain:

  • Evening primrose oil. This supplement may change the balance of fatty acids in your cells, which may reduce breast pain.
  • Vitamin E. Early studies showed a possible beneficial effect of vitamin E on breast pain in premenstrual women who experience breast pain that fluctuates during the menstrual cycle.

Vitamins and dietary supplements may lessen breast pain symptoms and severity for some women. Ask your doctor if it can help you — and ask about doses and any possible side effects.

If you try a supplement for breast pain, stop taking it if you don’t notice any improvement in your breast pain after a few months. Try just one supplement at a time so that you can clearly determine which one helps alleviate the pain — or not.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: June 22, 2017 | Last Modified: June 22, 2017

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