What is breast pain?

Breast pain includes any type of pain or discomfort that occurs in your breasts, including the nipples and areolas. Breast pain can affect women and men in any age group or population. Breast pain may be described in a variety of ways, such as tenderness, aching or burning. Breast pain can occur in one or both breasts at the same time.

Breast Problems Spotlight

Breast Pain? Join the Discussion

Breast pain can vary in character and intensity depending on the underlying cause and individual factors. It can be constant or may be felt only when you examine or massage your breast. Breast pain can gradually build over weeks or months if a painful lump forms slowly, or it can appear suddenly, such as can occur with mastitis or injury to the breast. Your breasts will undergo normal changes over the course of your life in size, shape, consistency and appearance. Hormonal changes are a common cause of breast pain and other breast symptoms. Hormonal changes can occur at the onset of puberty; during menstrual cycles, pregnancy, breastfeeding, perimenopause and menopause; and with the use of hormone medications. Breast pain can also be caused by physical changes, such as weight fluctuations, or other causes, such as breast injury and breast surgery. Breast pain can also occur due to cancer and other diseases, disorders and conditions, such as breast infections, breast adenosis, and cysts. Seek prompt medical care if you have unexplained breast pain or changes in one or both breasts. Left undetected and untreated, some underlying causes of breast pain, such as mastitis and breast cancer, can lead to life-threatening complications. Seeking regular medical care throughout your life improves your chances of discovering serious diseases at their earliest, most curable stages. SYMPTOMS

What other symptoms might occur with breast pain?

Breast pain may occur by itself or with other symptoms. Some signs of breast problems may only be evident through medical testing, so seek regular medical care if you have breast pain or changes in your breasts. Symptoms that may occur along with breast pain include:... Read more about breast pain symptoms CAUSES

What causes breast pain?

Breast pain may be caused by a variety of diseases, disorders and conditions. Sometimes breast pain is caused by a benign condition that is not generally harmful, such as pregnancy and other conditions that cause hormonal changes. In fact, over the course of your life, your breasts will undergo normal changes in size, shape, consistency and appearance. However, because breast pain and breast changes may indicate a serious condition, such as breast cancer, it is important to seek prompt medical care if you experience unexplained breast pain or other breast symptoms...

What other symptoms might occur with breast pain?

Breast pain may occur by itself or with other symptoms. Some signs of breast problems may only be evident through medical testing, so seek regular medical care if you have breast pain or changes in your breasts. Symptoms that may occur along with breast pain include:

Breast swelling or lumpiness due to hormonal changes during puberty, menstrual cycles, pregnancy, or menopause Fever Irritability and mood swings, which can be due to premenstrual syndrome, perimenopause, or menopause

Symptoms that might indicate a serious or life-threatening condition

In some cases, breast pain can be caused by or indicate a serious underlying condition, such as breast cancer. Seek prompt medical care if you have unexplained breast pain which may or may not occur with other symptoms, such as:

Breast deformity or misshapen breast Change in the look and feel of the skin of the breast, such as dimpling or puckering Change in the size, shape or appearance of the breast New onset of inverted nipple Nipple discharge or tenderness Rash or sore on the breast or nipple Redness or inflammation of the breast Swelling of one arm, which may be associated with breast cancer Swelling of underarm lymph nodes, which may be associated with breast cancer Weight loss, which may be associated with cancer Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms: Change in level of consciousness or alertness, such as lethargy, passing out, or unresponsiveness Dizziness or feeling faint High fever (higher than 101 degrees Fahrenheit)

What causes breast pain?

Breast pain may be caused by a variety of diseases, disorders and conditions. Sometimes breast pain is caused by a benign condition that is not generally harmful, such as pregnancy and other conditions that cause hormonal changes. In fact, over the course of your life, your breasts will undergo normal changes in size, shape, consistency and appearance. However, because breast pain and breast changes may indicate a serious condition, such as breast cancer, it is important to seek prompt medical care if you experience unexplained breast pain or other breast symptoms.

Hormonal causes of breast pain

Many different types of hormonal changes can cause breast pain including:

Menopause and perimenopause Menstrual cycle Pregnancy Puberty Use of hormone medications such as birth control pills

Breastfeeding-related causes of breast pain

Breast pain can also be caused by breastfeeding (nursing) and conditions often associated with breastfeeding including:

Mastitis (bacterial infection of the breast ducts) Milk engorgement, such as when the milk initially comes in after birth or if the breasts have not adequately been relieved of milk Plugged milk ducts (tender or painful lumps radiating from the areola)

Types of cancer that can cause breast pain

Breast pain is generally not a common symptom of breast cancer, but different types of cancers may cause breast pain including:

Breast cancer (also known as primary breast cancer, which begins in the breast) Metastatic cancer that has spread from another body region to the breast

Disorders, diseases and conditions that can cause breast pain

Breast pain is more commonly caused by disorders, diseases and conditions, such as:

Adenosis (noncancerous lumps caused by enlarged breast lobules) Cyst (benign, noncancerous sac that contains fluid, air or other materials) Diabetic mastopathy (small, hard lumps in the ducts or the lobules of premenopausal women with type 1 diabetes) Duct ectasia (widened breast ducts that become filled with fluid and hardened; duct ectasia most often occurs in middle age)

Fat necrosis (scarred fatty breast tissue) Fibroadenomas (lumps made of glandular and connective breast tissue that occur more often in younger women) Fibrocystic breasts (common enlargement or lumpiness of the fibrous breast tissue) Gynecomastia (swelling of male breast tissue) Hyperplasia (enlargement of the cells lining the breast ducts or breast lobules) Intraductal papillomas (lumps in the breast ducts) Phyllodes tumors (rare breast tumors made of an enlargement of connective tissue combined with glandular tissue; some Phyllodes tumors are malignant but most are benign) Radial scars (benign breast lesions that look like cancer on mammograms)

Other causes of breast pain

Breast pain can also be caused by lifestyle, dietary or physical factors, such as:

Breast surgery Diet containing high levels of caffeine, fat and salt Injury to the breast or to an area near the breast such as a chest muscle Wearing a bra with a poor fit or insufficient support Weight fluctuations

What are the potential complications of breast pain?

In some cases, breast pain can be due to an underlying condition that can result in serious or life-threatening complications. You can minimize the risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of underlying causes of breast pain can include:

Bone pain from bone metastases of breast cancer Breast abscess (collection of pus in the breast tissue) Chronic breast pain Secondary cancer (metastatic cancer), such as brain or lung cancer that has spread from the breast Sepsis (life-threatening bacterial blood infection) caused by spread of a breast infection or abscess

Definition
By Mayo Clinic staff

Breast pain (mastalgia) is a common complaint among women. You might describe your breast pain as chronic tenderness, sharp burning or tightness in your breast tissue. The pain may be constant or it may occur only occasionally. Some women have severe breast pain, occurring more than five days a month, Severe breast pain may even persist throughout the menstrual cycle. Postmenopausal women sometimes have breast pain, but the symptom is more common in younger, premenopausal women and perimenopausal women. Most times, breast pain signals a noncancerous (benign) breast condition and rarely signifies breast cancer. Still, unexplained breast pain that doesn't go away after your next menstrual cycle or that persists after menopause needs to be evaluated by your doctor.

Symptoms
By Mayo Clinic staff

Most cases of breast pain are classified as either cyclic or noncyclic. Each type of breast pain has distinct characteristics.
Breast pain characteristics Cyclic breast pain

Noncyclic breast pain

Clearly related to the menstrual cycle Described as dull, heavy or aching Often accompanied by breast swelling or lumpiness Usually affects both breasts, particularly the upper, outer portions, and can radiate to the underarm Intensifies during the two weeks leading up to the start of your period, then eases up afterward Usually affects premenopausal

Unrelated to the menstrual cycle Described as tight, burning or sore Constant or intermittent Usually affects one breast, in a localized area, but may spread more diffusely across the breast Usually affects postmenopausal women

women in their 20s and 30s and perimenopausal women in their 40s

Extramammary breast pain Extramammary breast pain feels like it originates in the breast, but its source is actually somewhere else. Pulling a muscle in your chest, for example, can cause pain in your chest wall or rib cage. When to see a doctor Make an appointment with your doctor if:

You have breast pain that persists daily for more than a couple of weeks Your breast pain is localized to one specific area of your breast Your breast pain seems to be getting worse over time Your breast pain interferes with daily activities

Although it's not a common symptom of breast cancer, localized breast pain is associated with breast cancer in a small percentage of women.

Causes
By Mayo Clinic staff

Most of the time, it's not possible to identify the exact cause of breast pain. Likely contributors are:

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 so experts theorize that hormones play a role. However, no studies have identified a particular hormonal abnormality as a contributor to cyclic breast pain. Anatomical factors. The cause of noncyclic breast pain is likely to be anatomical rather than hormonal, triggered by breast cysts, breast trauma, prior breast surgery or other factors localized to the breast. Noncyclic breast pain may also originate 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. This theory provides the rationale for taking evening primrose oil capsules as a remedy for breast pain. Evening primrose oil contains gamma-linolenic acid (GLA), a type of fatty acid. GLA is thought to restore the fatty acid balance and decrease the sensitivity of breast tissue to circulating hormone levels.

Medication use. Certain hormonal medications, including some infertility treatments and oral contraceptives, may be associated with breast pain. Also, breast tenderness is a possible side effect of estrogen and progesterone hormone therapy, which could explain why some women continue to have breast pain even after menopause. There have also been reports of breast pain associated with prescribed antidepressants, including selective serotonin reuptake inhibitor (SSRI) antidepressants, such as fluoxetine (Prozac) and sertraline (Zoloft). Breast size. Women with large breasts may have noncyclic breast pain related primarily to the size of their breasts. This type of breast discomfort is typically accompanied by neck, shoulder and back pain. Some studies have shown that breast reduction surgery sometimes reduces these symptoms. Breast surgery itself, however, also causes pain, which may linger after the incisions have healed.

Preparing for your appointment

By Mayo Clinic staff

You're likely to start by seeing your family doctor, a general practitioner or other care provider. However, in some cases when you call to set up an appointment, you may be referred immediately to a breast health specialist. What you can do The initial evaluation of your breast pain focuses on your medical history. You'll discuss with your doctor the location of the breast pain, its relation to your menstrual cycle and any other relevant breast history that might explain the cause of your pain. You can facilitate this discussion by preparing ahead of time:

Take note of all your symptoms, even if they seem unrelated to the reason for which you scheduled the appointment. Review key personal information, including major stresses or recent life changes. Make a list of all medications, vitamins and supplements that you regularly take. Write down questions to ask your doctor. List your questions from most important to least important in case time runs out.

What to expect from your doctor Your doctor may ask you questions about:

How long you've experienced the breast pain The severity of your pain on a 10-point scale Whether the pain occurs in one or both breasts When you had your last mammogram Whether you have other signs or symptoms, such as a breast lump, area of thickening or nipple discharge If you have skin changes, such as redness or a rash

Your doctor also may assess your personal risk of breast cancer, based on factors such as your age, family medical history and prior history of precancerous breast lesions.

Tests and diagnosis

By Mayo Clinic staff

Tests to evaluate your condition may include:

Clinical breast exam and physical exam. During this exam, your doctor checks for changes in your breasts, visually and manually examining your breasts and the lymph nodes located in your lower neck and underarm area. Your doctor will probably listen to your heart and lungs and check your chest wall and abdomen to be certain the pain originates from your breast and isn't related to some other condition. If your medical history and the breast and physical exam reveal nothing unusual, you may not need additional tests. Mammography. If your doctor detects a breast lump, unusual thickening in your breast tissue, or focused area of pain, you need to undergo mammography an Xray exam of your breast tissue. Even if your breast exam is normal, your doctor may recommend diagnostic mammography if you're age 30 or older and you're experiencing a new onset of breast pain. Diagnostic mammography focuses in on suspicious areas in your breast to double-check for lesions that may be too small to feel. Ultrasound. An ultrasound exam uses sound waves to produce images of your breasts and is often performed in conjunction with mammography. You might undergo ultrasound to evaluate a focused area of pain even if the mammogram appears normal. Breast biopsy. Suspicious breast lumps, areas of thickening or unusual areas seen during imaging exams may require a biopsy before your doctor can make a diagnosis. During a biopsy, your doctor (radiologist) obtains a small sample of breast tissue from the suspicious area and sends it for microscopic analysis.

Treatments and drugs

By Mayo Clinic staff

Often, breast pain resolves on its own within a few months. Very few women require specific treatment. To treat breast pain, your doctor might recommend that you:

Eliminate an underlying cause or aggravating factor. This may involve a simple adjustment, such as wearing a bra with extra support, or a significant change, such as switching birth control methods.

Use a topical nonsteroidal anti-inflammatory medication. You apply the medication directly to the area affected by noncyclic breast pain. Take an oral contraceptive. If you already take an oral contraceptive, you may need a dose adjustment. Reduce the dose of menopausal hormone therapy. You might also consider stopping menopausal hormone therapy entirely. Take a prescription medication. Danazol is the only prescription medication approved by the Food and Drug Administration for treating breast pain and tenderness, but it comes with the risk of potentially severe androgenic side effects, such as acne, weight gain and voice changes, that limit its use. Tamoxifen, a prescription medication for breast cancer treatment and prevention, may be recommended for some women, but this drug also carries the potential for side effects that may be more bothersome than the breast pain itself.

Breast pain can be due to many possible causes. Most likely breast pain is from hormonal fluctuations from menstruation, pregnancy, puberty, menopause, and breastfeeding. Breast pain can also be associated with fibrocystic breast disease, but it is a very unusual symptom of breast cancer