Breast pain

Overview

Breast pain, also called mastalgia, may be a feeling of aching, tenderness or throbbing in the breast. Or it may feel like stabbing or burning pain. The pain may be there all the time, it may last for just a short time, or it may come and go. Anyone can have breast pain.

Breast pain can be cyclic and noncyclic. Cyclic breast pain happens in a regular pattern. It's linked to menstrual cycles and changing hormone levels in people who menstruate. Noncyclic pain doesn't have a regular pattern and isn't linked to menstrual cycles.

In men, breast pain often can be caused by a condition called gynecomastia (guy-nuh-koh-MAS-tee-uh). In transgender men, pain may happen due to chest binding. Pain also might affect breast tissue that's left behind after gender-affirming chest surgery. In transgender women, gender-affirming hormone therapy might cause breast pain.

Typically, breast pain is due to a condition that is not cancer. It's not common for breast pain to be a symptom of breast cancer.

Symptoms

Cyclic and noncyclic are two types of breast pain that appear differently.

Cyclic breast pain

• Linked to menstrual cycles and changing hormone levels during menstruation.
• Often described as a dull, aching or burning pain or as a heaviness in the breast.
• Often happens along with breast swelling, fullness or lumpiness.
• Usually affects both breasts, especially the upper, outer part of the breast, and the pain may go into the underarm.
• Typically gets worse during the week before a menstrual period starts, then gets better after that.
• More likely to affect people in their 20s and 30s. It's less common after menopause.

Noncyclic breast pain

• Not linked to menstrual cycles.
• Often described as tight, burning, stabbing or aching pain.
• Can come and go or may be there all the time.
• Usually affects one breast in a specific area but may spread across the breast.

When to see a doctor

Make an appointment with your healthcare professional if breast pain:

• Goes on every day for more than two weeks.
• Happens in one specific area of the breast.
• Seems to get worse over time.
• Makes it hard for you to do your daily activities.
• Wakens you from sleep.

Breast cancer risk is low in people whose main symptom is breast pain. But if your healthcare professional suggests that you have tests to check for breast cancer, it's important to get those tests.

Causes

Breast pain is common and can happen for many reasons, from normal hormone changes to conditions affecting the breast or nearby areas of the body.

Menstrual cycle

Changing hormones that happen during a menstrual cycle often cause cyclic breast pain. The pain typically starts during the week before the beginning of a period and goes away when the period starts.

Pregnancy

Breast tenderness and pain are common in the early stages of pregnancy.

Breast cysts

Changing hormone levels can cause changes in the milk ducts or milk glands within the breast. Those changes can cause breast cysts. Cysts are a common cause of cyclic breast pain. But sometimes, a cyst also may cause noncyclic breast pain.

Infection

An infection within the breast can lead to breast pain. A common type of breast infection is called mastitis. It often happens in people who are breastfeeding.

Breast injury

Some types of breast pain may be caused by trauma or other injury to the breast.

Medicines

Breast pain may be a side effect of some medicines, including:

• Birth control pills.
• Hormone therapies used for menopause and perimenopause.
• Gender-affirming hormone therapy.
• Selective serotonin reuptake inhibitor (SSRI) antidepressants.
• Some medicines used to treat high blood pressure.
• Some types of antibiotics.

Duct ectasia

This condition affects the milk ducts in the breast. It happens when one or more milk ducts beneath the nipple widen, thicken and fill with fluid. This can cause the ducts to become blocked or clogged and may lead to breast tenderness and pain.

Fatty acids

When the level of fatty acids in the body's cells is out of balance, that may affect the sensitivity of breast tissue to hormones and lead to breast pain.

Activity

Doing a lot of activity and movement without proper breast support can stretch the ligaments, called Cooper ligaments, that hold breast tissue in place. That can lead to deep, sharp, stabbing pain that may last for a short time and then go away.

Cancer

Although it's rare for cancer to cause breast pain, a type of cancer called inflammatory breast cancer may cause pain and tenderness throughout the breast.

Gynecomastia

In men, breast pain can be caused by gynecomastia. This condition causes a rise in the amount of breast gland tissue due to the hormones estrogen and testosterone being out of balance in the body. Gynecomastia can affect one or both breasts.

Chest binding

In transgender men, pain may happen due to chest binding.

A health concern in another part of the body

In some situations, pain in the breast is due to a health issue that happens in another part of the body. This is called extramammary breast pain. For example, pulling a muscle in the chest can cause pain in the chest wall or rib cage that spreads to the breast. Arthritis that affects the cartilage in the chest, a condition called costochondritis, also can lead to breast pain. Other examples of conditions that could lead to breast pain include shingles and a pinched nerve in the neck.

Risk factors

Factors that may raise the risk of breast pain include:

• Breast size. People who have large breasts are at higher risk of breast pain. Neck, shoulder and back pain may happen along with breast pain that's due to large breasts.
• Breast surgery. Breast pain caused by breast surgery and scars sometimes can last after surgical wounds have healed.
• Smoking. Some research has shown that people who smoke are at higher risk of breast pain.

Prevention

Because breast pain has many possible causes, it isn't always possible to prevent it. But the following steps might help.

• Wear a properly fitted bra, and wear a sports bra during exercise.
• Don't lift large amounts of weight on a regular basis for a long time without using proper techniques and taking safety steps.
• Don't smoke. If you need help stopping smoking, talk with your healthcare professional.
• Eat a low-fat diet that includes complex carbohydrates. Some research has shown that a diet that's high in fat may be linked to breast pain.
• Limit caffeine. Some people find that having less caffeine is helpful in avoiding breast pain. But studies of caffeine's effect on breast pain have not shown clear results.