Breast pain, or mastalgia, is very common. It has many possible causes, including hormonal changes, an incorrect bra fit, and infections. In some cases, it is due to referred pain that comes from other areas of the body, such as the back or neck.
Pain in the breast affects approximately
Breast pain is not commonly a symptom of breast cancer, but if a person has pain alongside other breast changes, such as a lump or discharge, they should speak with a doctor.
Keep reading to learn more about some of the possible causes of breast pain and get tips on how to manage this symptom.
Tender or swollen breasts are usually related to the hormonal changes that take place before a period. This type of breast pain usually causes tenderness in both breasts, and it may extend to the armpit.
When breast pain is related to the menstrual cycle, it is known as cyclic breast pain. Cyclic breast pain can be part of a set of symptoms that occur before a period, known as premenstrual syndrome (PMS), or it may occur on its own.
Other symptoms of PMS
PMS is temporary, and it usually goes away several days after a period begins. In the meantime, people can treat the symptoms by taking over-the-counter (OTC) pain relievers, wearing a comfortable and supportive bra, and using gentle heat to soothe the pain.
Breast pain can also occur due to other hormonal changes, such as those that take place during pregnancy or in the first stage of menopause.
Bras can cause breast pain if they are too tight or they contain an underwire that digs into the skin or breast tissue. If a person gets cyclic breast pain, they may also find that at certain times in their menstrual cycle, their usual bras feel too small or are uncomfortable.
People can get a bra fitting for free at many department stores to find the right size for them. They may wish to purchase non-wired, supportive, and comfortable bras if they experience soreness before their period.
Supportive bras can also help when exercising. According to a 2021 article,
Fibrocystic breast changes are harmless but potentially uncomfortable symptoms that cause the breasts to feel lumpy or otherwise different in texture due to hormonal fluctuations. Fibrocystic breast disease is the
The symptoms may include:
- breasts that feel firmer or thicker than usual
- tenderness
- lumps or cysts
- sensitive nipples
- itchiness
The symptoms may get worse before a period, and they will usually stop after menopause.
The treatment or management of fibrocystic breasts may involve:
- taking OTC pain medication, such as acetaminophen (Tylenol) or ibuprofen (Advil)
- applying cool or warm compresses when the breasts are more painful
- avoiding a large intake of salt, caffeine, or fat in the diet
- starting or stopping birth control pills
If fibrocystic breast changes may be related to a new contraceptive, it is important to speak with a doctor before making any changes to the dosage.
Mastitis is the term for inflammation or swelling in the breasts. The
The symptoms of mastitis include:
The treatment for an infection is antibiotics. A person who is breastfeeding will also need to empty the breasts of milk. If an abscess is present, doctors will drain the pus surgically or remove it with a needle.
Some medications can contribute to the development of breast pain. These include:
- digitalis preparations, such as digoxin (Digox), which treat congestive heart failure and abnormal heart rhythm
- chlorpromazine (Thorazine), a medication for mental health disorders
- certain potassium-sparing diuretics, such as eplerenone (Inspra) or spironolactone (Aldactone)
- oxymetholone (Anadrol), which treats low red blood cell count
- methyldopa (Aldomet), which is a treatment for high blood pressure
People with breast pain should speak with a doctor to find out whether any of their medications could be causing their symptoms.
Both surgery and radiation therapy for breast cancer can cause scar tissue formation. This can result in:
- numbness or pain, if the scar tissue develops around nerves
- an increase in firmness or a rounder appearance of the breast
- formation of a lump if the scar forms around a surgical stitch
Treatment options include:
- physical therapy, if the scar tissue causes pain, stiffness, and pressure
- surgical removal of scar tissue, if it is very painful
- use of creams and ointments to lessen the appearance of scars, if a person finds them bothersome
Breast pain can originate from outside the breast, rather than within it. For example, sprains or injuries in the back, neck, or shoulder might cause pain that a person feels in the breast.
A 2020 study notes that cervical root disorders, which people sometimes refer to as a pinched nerve, can cause breast pain. These disorders involve damage to or inflammation of a nerve root in the neck.
When people perceive pain in a broader area than the site where it originates, this is known as referred pain. The treatment relies on finding the underlying problem. For example, if a person with breast pain has a pinched nerve, physical therapy or spinal surgery for the pinched nerve may improve the breast pain.
Costochondritis is inflammation of the costal cartilage, which connects the ribs to the breastbone. The condition can cause sharp chest pain and tenderness, and it may have a gradual or sudden onset.
The following factors may worsen the pain:
- pressure on the chest, such as when wearing a seat belt
- physical activity
- sitting or lying in particular positions
- deep breathing, sneezing, or coughing
Treatment may include:
- avoiding activities that worsen the pain
- applying heat to the area
- taking one of the following medications:
- Tylenol
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil
- aspirin, if older than 16 years
- corticosteroid injections, such as triamcinolone (Kenalog)
- undergoing transcutaneous electrical nerve stimulation (TENS), a procedure that applies an electric current to an area to reduce pain
A range of conditions can cause pain in the wall of the chest. This pain can sometimes feel as though it is coming from the breast, even though it is not.
The pain can vary in extent, ranging from one specific area to a wide area of the breast. A person may experience:
- burning or sharp pain
- pain that spreads down the arm
- pain that occurs when someone applies pressure to the chest wall
- pain that worsens upon movement
Possible causes include:
- bruising
- fractured ribs
- gallstones
- angina
- autoimmune diseases, such as rheumatoid arthritis
The treatment will vary based on the cause, but it may involve pain management and avoiding movements that make the pain worse until the root cause has improved.
Breast cysts are fluid-filled sacs. They are noncancerous, relatively soft, and more common in premenopausal females. Some cysts
Unless the cysts are particularly large or painful, they do not need treatment. If treatment is necessary, it involves draining the fluid out with a needle.
Breast cancer occurs when cells in the breast mutate and begin growing uncontrollably. Pain in the breast is not usually due to cancer, but this is a possible cause. Other symptoms may
- a lump in the breast
- pain in any part of the breast
- any nipple discharge — bloody, clear, or otherwise
- dimpling or irritation of breast skin
- pulling in at the nipple or pain in the nipple
- flaky, inflamed skin in the nipple area
- thickening or swelling of part of the breast
- change in the shape or size of the breast
- a painful, tender, or itchy breast
- pink, red, or purple discoloration that covers at least one-third of the breast
- swelling of the skin, making one breast look larger than the other
- pitting of the skin, similar to that of orange peel
- a retracted or inverted nipple
The treatment options for breast cancer include surgery, chemotherapy, hormone therapy, radiation therapy, and biologic therapy. People will
Cyclic pain, which is related to the menstrual cycle, and noncyclic pain have some key differences. The following table compares and contrasts the two types of pain:
| Cyclic pain | Noncyclic pain |
|---|---|
| varies with hormones in the menstrual cycle | does not vary with the menstrual cycle |
| common among females in their 20s, 30s, and 40s | more common after menopause |
| generally affects both breasts equally | tends to affect one or more localized areas of one breast |
| may occur alongside tenderness, swelling, or lumpiness | pain often feels sharp and burning |
If a person has cyclic pain, but the pain is worse in one breast than the other, hormones may not be the only cause.
It can help to keep a symptom diary to determine whether pain is cyclic. Alternatively, people can use apps that track menstruation and its associated symptoms to see whether there is a pattern.
In a symptom diary, it can be helpful to assign a numerical value to the pain intensity every day throughout one or more menstrual cycles. If the pain occurs or increases at the same times during each cycle, it may be cyclic. People can share this information with a doctor during an appointment.
People can take
- wearing a supportive bra that fits well
- taking OTC pain medications
- limiting the intake of chocolate, coffee, tea, and soft drinks
- applying hot or cold compresses to the breasts
- getting regular exercise
- engaging in relaxation methods to reduce stress, anxiety, and tension
It is advisable to speak with a healthcare professional before trying self-care techniques to ensure that they are appropriate. In certain circumstances, medical intervention may be necessary.
There are multiple possible causes of breast pain, or mastalgia. This symptom may be cyclic or noncyclic. If the pain is cyclic, it is related to the fluctuating hormones of the menstrual cycle.
Noncyclic breast pain can be due to PMS, fibrocystic breast changes, injuries and sprains, or inflammation around the ribs. Sometimes, cysts or infections are responsible for this symptom.
Although breast cancer is not usually a cause of breast pain, anyone with this symptom should consult a doctor to rule out this condition.