Breast Pain

Symptoms

Symptoms of breast pain can vary from person to person, even if it is caused by the same thing. The type of pain you have may be a sign of what type of breast pain you have. Cyclic breast pain, for example, is often described as dull, heavy, or aching. It tends to be in the upper and outer areas of the breasts. You may also have breast swelling, fullness or lumpiness. Non-cyclic breast pain, on the other hand, is often described as a tight, burning, stabbing, or aching sensation.

Common breast pain sensations include:

• Tenderness
• Dullness
• Heaviness
• Aching
• Throbbing
• Sharpness
• Stabbing
• Tightness
• Burning

When to worry about breast pain

Signs you should contact your doctor about your breast pain include:

• A breast lump that does not go away after your period
• Signs of infection like redness, swelling, or drainage
• Nipple discharge
• Breast pain that is not related to your period and lasts more than a couple of weeks
• Pain that is located in just one spot of the breast rather than the whole breast
• Pain that is severe or getting worse, is interfering with your life, or wakes you up from sleep
• Skin changes on the breast, such as a dimple
• Changes in the size of the breast or the shape of the nipple

Causes

Cyclic breast pain

This is the most common type of breast pain. It’s related to natural changes in levels of estrogen and progesterone that occur during the menstrual cycle. The breasts are very sensitive to these changes.

Cyclic breast pain usually affects both breasts. The pain usually starts 3–5 days before your period begins and then starts to lessen when you get your period. Cyclic breast pain is more likely to affect people in their 20s and 30s, and people in their upper 40s to lower 50s as they transition into menopause.

Non-cyclic breast pain

This type of breast pain is not related to the menstrual cycle. It may be constant or happen occasionally. Non-cyclic pain is usually located in one specific area of one breast. It’s most common after menopause.

There are a number of causes of non-cyclic breast pain. They include:

• Having large breasts, which can stretch the ligaments that support them
• Wearing a bra that doesn’t fit properly
• Getting pregnant. Breast pain is often one of the first signs of pregnancy.
• Breastfeeding
• Diet and lifestyle. While not confirmed, some research suggests that eating a high-fat diet, smoking, and having caffeine may contribute to breast pain.
• Hormone replacement therapy and hormonal birth control.
• Breast cysts, which can be painful when they develop suddenly or grow quickly.
• Mammary duct ectasia, a widening of one or more milk ducts beneath the breast. Other symptoms may include fever, acute pain, or tenderness.
• Mastitis, an infection of the breast tissue that most often occurs with breastfeeding.
• Inflammatory breast cancer, a rare form of the disease that often makes the breast look red and swollen.
• Hidradenitis suppurativa, an inflammatory skin disease that can affect the breasts and causes pimple-like bumps.
• In boys and men, gynecomastia, which is an increase in breast gland tissue. Causes include hormonal changes, certain medications (antidepressants, heart medications), illegal drug use, and certain conditions such as obesity, testicular cancer, and liver disease.
• Other less common causes of non-cyclic breast pain include trauma to the breast, prior breast surgery, and taking certain medications like certain antidepressants or those for heart conditions (digoxin, etc.)

Extramammary pain

This is pain that feels like it started in the breasts but began somewhere else and spread to the breasts. Examples include:

• Chest wall pain. This is the area of muscle, tissue, and bone that surrounds your heart and lungs. It may be caused by injuries that develop due to repetitive activities like rowing or shoveling. Chest wall pain can also be caused by costochondritis, rib injury, or rheumatoid arthritis.
• Pain caused by spinal disorders, such as cervical (neck) arthritis, muscle spasms, and pinched nerves.
• Trauma to the breast or the chest wall.
• Gallbladder disease or heart disease can cause pain in the chest.

Treatment

You can often treat breast pain with a combination of at-home approaches and treatments recommended by a healthcare provider. Learn about home strategies (from OTC drugs to coaching to helpful apps) and when you may need to see a provider.

• Pain Relievers: OTC pain medications like ibuprofen or acetaminophen can help reduce breast pain and inflammation. These are commonly available and provide quick relief.
• Topical Pain Relief: Creams and gels containing diclofenac or other anti-inflammatory ingredients can be applied directly to the affected area to provide localized relief.
• Supportive Bras: Wearing a well-fitted, supportive bra can reduce breast movement and alleviate pain. Look for bras specifically designed to provide extra support.
• Evening Primrose Oil: Some studies suggest that evening primrose oil supplements can help reduce breast pain by balancing fatty acids in your body.

Preventative tips

• Avoid or reduce the dose of hormone therapy (either birth control or hormone replacement therapy).
• Get fitted so that you’re wearing the right-sized bra and sports bra.
• Try relaxation therapies like yoga and meditation, which may help reduce anxiety that sometimes plays a role in breast pain.
• Avoid caffeine.
• Limit your salt intake.
• Lose weight. This decreases the amount of estrogen in your body which can lead to breast pain.
• Avoid high-fat foods.
• Avoid excessive weight-lifting.
• Try taking OTC pain relievers a few days before your period starts.
• Take vitamins and dietary supplements like evening primrose oil, vitamin E, and vitamin B6.