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 things that affect the structure of the breast, such as breast cysts, breast trauma, prior breast surgery or other factors localized to the breast. 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 therapy. Breast pain may be associated with certain antidepressants, including selective serotonin reuptake inhibitor (SSRI) antidepressants, such as fluoxetine (Prozac, Prozac Weekly, Sarafem) and sertraline (Zoloft).
  • 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 can sometimes linger after incisions have healed.
Jan. 16, 2013