Women of all ages report having breast pain, also known as mastalgia. Pain can occur both before and after the menopause. However, breast pain is most common during the reproductive years.
The severity and location of breast pain can vary. Pain can occur in both breasts, one breast, or in the underarm. Severity can range from mild to severe and is typically described as tenderness, sharp burning, or tightening of the breast tissue.
Hormonal changes due to events such as menstruation, pregnancy, lactation, and menopause can also have an effect on the type of breast pain experienced.
The following are ten common causes of breast pain.
1. Breast cysts
Some women have a higher risk of developing painful breast conditions than others. At times, milk duct or gland changes may result in the formation of breast cysts.
Breast cysts can feel like a lump in the breast. They are fluid-filled sacs that can be soft or firm.
They may or may not cause pain. These cysts typically enlarge during the menstrual cycle and go away once menopause is reached.
Most breast cysts consist of fluid rather than cells. A cyst is different from a tumor, and it is not cancerous.
Certain medications can contribute to the development of breast pain.
Medications that are linked to an increase in breast pain include:
- drugs that affect the reproductive hormones
- some treatments for mental health conditions
- some cardiovascular treatments
Examples of these types of drugs are:
- oral hormonal contraceptives
- postmenopausal estrogen and progesterone preparations
- antidepressants, such as selective serotonin reuptake inhibitor (SSRI)
- antipsychotic, such as Haloperidol
- digitalis preparations, for example, digoxin
- Methyldopa (Aldomet)
- Spironolactone (Aldactone)
Others that can have this effect include:
- some diuretics
- anadrol, a steroid
- infertility treatments
People with breast pain should speak to their healthcare provider to see if any of their medications are having an effect.
3. Breast surgery
Undergoing breast surgery and the formation of scar tissue can lead to breast pain.
The severity and type of pain vary between individuals and ranges from no pain to severe pain. It can result from nerve damage or inflammation. Pain may affect the surface of the breast, or it may be deep.
The amount and type of pain may change over time.
Soon after surgery, pain may be severe.
Long-term effects may include:
- increased sensitivity
- pain on touching the area
- reduced sensitivity and possible numbness
- inability to raise the arm over the head
- difficulty driving, doing handicrafts, and other regular activities
Some of these may last 6 months or longer.
One study that followed up women who had undergone breast surgery over 6 months found that overall, mild pain tends to persist over time, moderate pain may increase, and severe pain will likely decrease.
Costochondritis, or costosternal syndrome, is an inflammation of the cartilage that connects the ribs and breastbone.
It can occur with arthritis. Arthritis in the neck or upper back can also lead to pain or numbness in the chest. It can also occur with an injury or physical strain.
Sometimes, there may be swelling.
It is not related to the breast, but it causes a burning pain that can be confused with breast pain.
This condition most often affects women and people over 40 years of age.
5. Fibrocystic breast changes
Fibrocystic breast changes can cause one or both breasts to become lumpy, tender, and swollen. This is due to a buildup of fluid-filled cysts and fibrous tissue. There may also be nipple discharge.
This harmless condition is not uncommon in women aged between their 20s and 50s. It is not linked to a higher risk of breast cancer.
Some changes that might help reduce discomfort include:
- following a low-salt diet
- using mild pain-relief medication
At least one study has suggested that vitamin E and B6 supplements may help with cyclic mastalgia, and especially fibrocystic changes.
However, a systematic review concluded that vitamins make no difference.
Caffeine reduction and evening primrose oil are often recommended, but one systematic review has concluded that these are not effective in treating breast pain.
Mastitis is a painful infection of the breast.
It is most common during breast-feeding, due to a clogged milk duct. However, it can happen at other times.
Symptoms may include:
7. A poorly fitted bra
Breast pain can result from an improperly fitted bra. A bra that is too tight or too loose can compress the breasts or leave them improperly supported, resulting in discomfort.
To check if a bra fits properly, ask yourself:
- Is the bra riding up at the back?
- Are the straps or underwire digging in or the breasts bulging out?
- Does the center fit close to the breastbone and can you pass a finger easily under the band below the cups?
Many department stores offer a bra-fitting service.
Wearing a sports bra during exercise can also be beneficial.
8. Breast cancer
Most breast cancers do not cause pain. However, inflammatory breast cancer and some tumors can lead to breast discomfort.
People should contact their doctor if they experience:
- a lump or other area of concern in the breast
- pain or a lump that does not go away after menstruation
- any nipple discharge, bloody, clear, or otherwise
- breast pain without a known cause or that does not go away
- symptoms consistent with a breast infection such as redness, pus, or fever
9. Back, neck, or shoulder sprains
Sprains in these parts of the body might end up causing painful sensations in the breasts.
This might occur due to the distribution of nerves in the upper torso.
10. Chest wall pain
A range of conditions can cause pain in the wall of the chest. This can sometimes feel as if it is coming from the breast, even though it is not.
Common causes of chest wall pain include:
- a pulled muscle in the chest
- inflammation of the tissue that surrounds the ribs due to costochondritis or Tietze's syndrome
This type of pain might seem to spread down the arm on moving and intensifies under pressure.
Cyclic pain varies with hormonal fluctuations. Symptoms depend on factors such as the menstrual cycle.
It accounts for 75 percent of breast pain.
Cyclic breast pain often occurs with fibrocystic changes, including lumpiness and thickened areas of breast tissue.
Cyclic swelling, pain, breast aching, heaviness, and lumpiness tend to resolve after menstruation.
Hormonal changes during pregnancy and breast-feeding can also lead to breast changes, including pain.
Noncyclic pain is unrelated to the menstrual cycle. It can affect one or both breasts, and it does not vary as hormones change.
There may be constant or intermittent tightening, burning, or soreness. Pain tends to remain in one area of the breast. It can stem from trauma or a previous biopsy.
Some breast pain is not related to the breast but to underlying structures.
A healthcare provider can help determine the cause of breast pain and decide on any treatment, if necessary.
Self-care suggestions include:
- wearing a supportive bra throughout the day, a sports bra during exercise, and possibly sleeping in a bra
- limiting intake of caffeine and sodium, such as chocolate, coffee, tea, and soft drinks, although research has not confirmed this
- applying hot or cold compresses to the breasts
- consuming a low-fat diet, increasing dietary fruits, vegetables, and grains
- keeping a healthy weight
- taking vitamins, which are available to buy online, such as Vitamin B6, Vitamin B1, and Vitamin E
- using over-the-counter medications such as aspirin, acetaminophen, or ibuprofen
- trying relaxation methods to reduce stress, anxiety, and tension
- considering cyst aspiration or drainage, if recommended
- keeping a symptom journal to identify whether the pain is cyclic or noncyclic
People should speak with their healthcare provider before trying self-care techniques, to see if they are appropriate.
In certain circumstances, people may require medical intervention for their breast pain.