What is breast pain?
Breast pain includes any type of pain or discomfort that occurs in your breasts, including the nipples and areolas. It can occur in both breasts at the same time or as right or left breast pain alone. Breast pain can affect women and men in any age group or population. The medical term for it is mastalgia.
Breast pain can vary in character and intensity depending on the underlying cause and individual factors. You may experience sharp breast pain, tenderness, aching or burning. It can be constant or occur only when you examine or massage your breast. It can gradually build over weeks or months if a painful lump forms slowly, or it can appear suddenly, such as with mastitis or injury to the breast.
Your breasts will undergo normal changes in size, shape, consistency and appearance over the course of your life. Hormonal changes are a common cause of female breast pain and other breast symptoms. Hormonal changes can occur at the onset of puberty; during menstrual cycles, pregnancy, breastfeeding, perimenopause and menopause; and with the use of hormone medications.
Breast pain can also be caused by physical changes, such as weight fluctuations, or other causes, such as breast injury and breast surgery. Female and male breast pain causes can also include cancer and other diseases, disorders and conditions, such as breast infections, breast adenosis, and cysts.
Seek prompt medical care if you have unexplained breast pain or changes in one or both breasts. Left undetected and untreated, some underlying causes of breast pain, such as mastitis (inflammation or infection) and breast cancer, can be fatal or lead to serious complications. Seeking regular medical care throughout your life improves your chances of discovering serious diseases at their earliest, most curable stages.
What other symptoms might occur with breast pain?
Breast pain may occur by itself or with other symptoms. Some signs of breast problems may only be evident through medical testing and imaging, so seek regular medical care if you have breast pain or changes in your breasts. Symptoms that may occur along with breast pain include:
- Breast swelling or lumpiness due to hormonal changes during puberty, menstrual cycles, pregnancy, or menopause
- Irritability and mood swings, which can be due to premenstrual syndrome, perimenopause, or menopause
Symptoms that might indicate a serious or life-threatening condition
In some cases, breast pain can be caused by or indicate a serious underlying condition, such as breast cancer. Seek prompt medical care if you have unexplained breast pain which may or may not occur with other symptoms, such as:
- Breast deformity or misshapen breast
- Change in the look and feel of the skin of the breast, such as dimpling or puckering
- Change in the size, shape or appearance of the breast
- New onset of inverted nipple
- Nipple discharge or tenderness
- Rash or sore on the breast or nipple
- Redness or inflammation of the breast
- Swelling of one arm, which may be associated with breast cancer
- Swelling of underarm lymph nodes, which may be associated with breast cancer
- Weight loss, which may be associated with cancer
Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms:
What causes breast pain?
Breast pain may be caused by a variety of diseases, disorders and conditions. Sometimes breast pain is caused by a benign condition that is not generally harmful, such as pregnancy and other conditions that cause hormonal changes. In fact, over the course of your life, your breasts will undergo normal changes in size, shape, consistency and appearance.
However, because breast pain and breast changes may indicate a serious condition, such as breast cancer or infection, it is important to seek prompt medical care if you experience unexplained breast pain or other breast symptoms.
Hormonal causes of breast pain
Many different types of hormonal changes can cause breast pain including:
- Menopause and perimenopause
- Menstrual cycle
- Use of hormone medications such as birth control pills
- Hormone imbalance
Breastfeeding-related causes of breast pain
Breast pain can also be caused by breastfeeding (nursing) and conditions often associated with breastfeeding including:
- Mastitis (bacterial infection of the breast ducts)
- Milk engorgement, when the milk initially comes in after birth or if the breasts have not adequately been relieved of milk
- Plugged milk ducts (tender or painful lumps radiating from the areola)
Types of cancer that can cause breast pain
Breast pain is generally not a common symptom of breast cancer; but metastatic cancer that has spread from another body region to the breast can cause pain.
Disorders, diseases and conditions that can cause breast pain
Female and male breast pain are more commonly caused by disorders, diseases and conditions, such as:
- Adenosis (noncancerous lumps caused by enlarged breast lobules)
- Cyst (benign, noncancerous sac that contains fluid, air or other materials)
- Diabetic mastopathy (small, hard lumps in the ducts or the lobules of premenopausal women with type 1 diabetes)
- Duct ectasia (widened breast ducts that become filled with fluid and hardened; duct ectasia most often occurs in middle age)
- Fat necrosis (scarred fatty breast tissue)
- Fibroadenomas (lumps made of glandular and connective breast tissue; occurs more often in younger women)
- Fibrocystic breasts (common enlargement or lumpiness of the fibrous breast tissue)
- Gynecomastia (swelling of male breast tissue)
- Hyperplasia (enlargement of the cells lining the breast ducts or breast lobules)
- Intraductal papillomas (lumps in the breast ducts)
- Phyllodes tumors (rare breast tumors made of an enlargement of connective tissue combined with glandular tissue; some phyllodes tumors are malignant but most are benign)
- Radial scars (benign breast lesions that look like cancer on mammograms)
Other causes of breast pain
Breast pain can also be caused by lifestyle, dietary or physical factors, such as:
- Breast surgery
- Diet containing high levels of caffeine, fat and salt
- Injury to the breast or to an area near the breast, such as a chest muscle
- Wearing a bra with a poor fit or insufficient support
- Weight fluctuations
When should you see a doctor for breast pain?
In most cases, mild breast pain or tenderness from time to time is normal. It often resolves on its own. However, there are times when seeing a doctor is the safest option.
Make an appointment to see your doctor when breast pain:
Affects one specific area
Interferes with your sleep or activities
Lasts more than a couple of weeks or is worsening
See a doctor promptly for breast pain when:
You also have a clear or bloody discharge from the nipple.
You have a lump that is not related to your menstrual period.
You have recently given birth and you have a hard or swollen breast or breasts.
- You have other signs of a possible breast infection, including fever, pus, redness, swelling or warmth.
How do doctors diagnose the cause of breast pain?
To diagnose the cause of breast pain, your doctor will take a medical history, perform an exam, and perhaps order testing. Questions your doctor may ask about your medical history and breast pain include:
Is the pain in one or both breasts? Is it all over or in one spot?
How would you describe the pain, such as sharp, achy or burning?
How long has your breast been painful?
On a scale of 1 to 10 with 10 being the worst pain ever, how would you rate your breast pain?
Is the pain constant or does it come and go?
What, if anything, seems to make your breast pain better or worse?
Are you experiencing any other symptoms, such as nipple discharge, skin changes, or a lump?
When was your last menstrual period?
Have you ever had a mammogram?
Do you have a family history of breast disease or breast cancer?
- Are you taking hormone medications?
Your doctor will also perform a physical exam, including a clinical breast exam. You may need to raise your arms, press your hands against your hips, or change posture while your doctor examines your breasts. This can help reveal changes in your breasts that are not apparent lying down.
Depending on what your doctor finds or learns from the exam and medical history, testing may be necessary including:
Mammogram, which is an X-ray exam of your breasts
Ultrasound, which is an imaging exam that uses soundwaves instead of radiation. It can give your doctor a different view of breast tissue than a mammogram.
Breast biopsy, which is a procedure to take a sample of tissue from a lump or other suspicious area
It is not always possible to diagnose an underlying cause or condition. If the problem persists and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.
How do you treat breast pain?
Since breast pain is a symptom, treating it depends on the underlying condition that is causing it. If a physical or hormonal problem is causing the pain, the goal will be to correct it if possible. Otherwise, treatment may focus on symptom relief.
Possible treatments may include:
Antibiotics to treat mastitis and other infections
Lowering the dose of hormone replacement therapy or stopping it
Medications to treat fibrocystic breasts
Over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) to relieve pain and swelling
Starting or adjusting hormonal birth control or changing to a different form of birth control
Surgery to drain cysts or remove lumps or cysts
Home remedies for breast pain
There are several strategies you can use at home to relieve breast pain including:
Applying heat or cold therapy to your breasts
Limiting caffeine and eating a low-fat diet with more complex carbohydrates and fewer simple sugars
Taking acetaminophen (Tylenol) or over-the-counter NSAIDs, such as ibuprofen (Advil, Motrin)
- Wearing a supportive bra, such as a sports bra or nursing bra
Alternative treatments for breast pain
Several supplements are available that may help with breast pain. Some women find that these products reduce the symptoms of breast problems. However, studies on the effectiveness of herbal products are usually limited. Herbal supplements can also interfere with traditional medicine and may not be safe for some women. Talk with your doctor before starting a supplement.
Supplements that may work to improve breast pain include:
Citrus sinensis essential oil
Evening primrose oil
- Wheat germ
What are the potential complications of breast pain?
In some cases, breast pain can be due to an underlying condition that can result in serious or life-threatening complications. You can minimize the risk of serious complications by following the treatment plan you and your healthcare professional design specifically for you.
Complications of underlying causes of breast pain can include:
- Bone pain from bone metastases of breast cancer
- Breast abscess (collection of pus in the breast tissue)
- Chronic breast pain
- Secondary cancer (metastatic cancer), such as brain or lung cancer that has spread from the breast
- Sepsis (life-threatening bacterial blood infection) caused by spread of a breast infection or abscess