Most women experience some form of breast pain at one time or another. Breast pain is typically easy to treat, but it can be a sign of something more serious on rare occasions. Breast pain is common, but when should you see a doctor? Should you be worried or take it as a sign of your period approaching? Knowing the warning signs of breast issues can help you stay on top of your health. Let’s find out instances of when to worry about breast pain and what we should do once you feel any chest discomfort.
Overview of breast pain
Breast pain (mastalgia) can be described as tenderness, throbbing, sharp, stabbing, burning pain or tightness in the breast tissue. The pain may be constant or occur only occasionally, and it can occur in men, women and transgender people.
Breast pain can range from mild to severe. It may occur:
- Just a few days a month, in the two to three days leading up to a menstrual period. This normal, mild-to-moderate pain affects both breasts.
- A week or longer each month, starting before a period and sometimes continuing through the menstrual cycle. The pain may be moderate or severe and affects both breasts.
- Throughout the month, they are not related to a menstrual cycle.
In men, breast pain is most commonly caused by gynecomastia. This refers to an increase in the amount of breast gland tissue caused by an imbalance of estrogen and testosterone hormones. Gynecomastia can affect one or both breasts, sometimes unevenly.
In transgender women, hormone therapy may cause breast pain. In transgender men, breast pain may be caused by the minimal amount of breast tissue remaining after a mastectomy.
Most times, breast pain signals a noncancerous (benign) breast condition and rarely indicates breast cancer. Unexplained breast pain that doesn’t go away after one or two menstrual cycles, or that persists after menopause, or breast pain that doesn’t seem to be related to hormone changes needs to be evaluated.
Breast pain is more common among people who haven’t completed menopause, although it may occur after menopause. Breast pain can also occur in men who have gynecomastia and in transgender people who are undergoing gender reassignment.
Other factors that may increase the risk of breast pain include:
- Breast size. People who have large breasts may experience noncyclic breast pain related to the size of their breasts. Neck, shoulder, and back pain may accompany breast pain caused by large breasts.
- Breast surgery. Breast pain associated with breast surgery and scar formation can sometimes linger after incisions have healed.
- 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 infertility treatments and oral birth control pills, may be associated with breast pain. Breast tenderness is a possible side effect of estrogen and progesterone hormone therapies used after menopause. Breast pain may be associated with certain antidepressants, including selective serotonin reuptake inhibitor (SSRI) antidepressants. Other medicines that can cause breast pain include those used to treat high blood pressure and some antibiotics.
- Excessive caffeine use. Although more research is needed, some people notice improved breast pain when they reduce or eliminate caffeine.
Common causes of breast discomfort and other issues
Hormones are making your breasts sore.
Hormonal fluctuations are the number one reason women have breast pain. Breasts become sore three to five days prior to the beginning of a menstrual period and stop hurting after it starts. This is due to a rise in estrogen and progesterone before your period. These hormones cause your breasts to swell and can lead to tenderness. It’s normal to have breast tenderness that comes and goes around the time of your period. It’s nothing to worry about.
If you become pregnant, your breasts may remain sore during the first trimester as hormone production ramps up. Breast tenderness is one of the earliest signs of pregnancy for many women.
Steps you can take to minimize sore breasts include:
- Eliminate caffeine
- Eat a low-fat diet
- Reduce salt intake
- Avoid smoking
- Take an over-the-counter pain reliever
- Ask your doctor if switching birth control pills or hormone replacement therapy medications may help
You have a breast injury.
Like any part of your body, breasts can be injured. This can happen because of an accident while playing sports or from breast surgery. You may feel a sharp, shooting pain at the time of injury. Tenderness can linger for a few days up to several weeks after trauma to the breast. See your doctor if the pain doesn’t improve, or you notice any of these signs:
- Severe swelling
- A lump in the breast
- Redness and warmth, which could indicate an infection
- A bruise on your breast that doesn’t go away
Your breasts hurt due to an unsupportive bra.
Without proper support, the ligaments that connect breasts to the chest wall can become overstretched and painful by the end of the day. The result is achy, sore breasts. This may be especially noticeable during exercise. Make sure your bra is the correct size and provides good support.
Breast pain is really coming from your chest wall.
What feels like breast pain may actually be coming from your chest wall. This is the area of muscle, tissue and bone that surrounds and protects your heart and lungs. Common causes of chest wall pain include:
- A pulled muscle
- Inflammation around the ribs
- Trauma to the chest wall (getting hit in the chest)
- Bone fracture
Breastfeeding is causing breast tenderness.
Breastfeeding can sometimes be the source of breast pain. Some of the things you can experience while nursing include:
- Painful nipples from an improper latch (the way a baby latches on to suck)
- Tingling sensation during letdown (when the milk starts to flow to the baby)
- Nipple soreness due to being bitten or having dry, cracked skin or an infection
If you have pain while breastfeeding, it’s best to talk to your doctor or a lactation consultant. They can help you troubleshoot the problem while maintaining your milk supply.
You have a breast infection.
Breastfeeding women are most likely to get breast infections (mastitis), but they occasionally occur in other women, too. If you have a breast infection, you may have a fever and symptoms in one breast, including:
If you think you may have a breast infection, it’s important to see a doctor. Treatment typically includes antibiotics and pain relievers.
Breast pain could be a medication side effect.
Some medications may cause breast pain as a side effect. Talk to your doctor about the medications you’re on and if this could be the case for you. Some drugs with this known side effect include:
- Oxymetholone (used to treat some forms of anemia)
- Chlorpromazine (used to treat various mental health conditions)
- Water pills (diuretic drugs that increase urination and are used to treat kidney and heart disease and high blood pressure)
- Hormone therapies (birth control pills, hormone replacement, or infertility treatments)
- Digitalis (prescribed for heart failure)
- Methyldopa (used to treat high blood pressure)
You have a painful breast cyst.
If a tender lump suddenly appears in your breast, you may have a cyst. These fluid-filled lumps aren’t dangerous and often don’t need to be treated as they may resolve on their own. But it’s important to get any lump in your breast evaluated by a doctor.
To diagnose a cyst, your doctor may recommend a mammogram, ultrasound or aspiration (drawing fluid from the lump). Draining fluid from the cyst is also a form of treatment. If the cyst isn’t bothersome, you may not need any treatment at all.
You’re experiencing painful complications from breast implants.
Some women have complications with breast implants, whether made of silicone or saline. One of the most common causes of pain after breast augmentation surgery is capsular contracture, when scar tissue forms too tightly around implants. Breast pain can also be an indication that one of your implants has ruptured. Talk to your doctor about any pain you have to determine if it could be related to the breast implants.
Breast pain can sometimes be a sign of breast cancer.
It’s unusual for breast cancer to cause pain, says Wright, but not impossible. Inflammatory breast cancer often causes pain, but it’s rare, accounting for 1% to 5% of breast cancer cases in the United States.
Symptoms of this aggressive disease often come on suddenly and progress rapidly. Inflammatory breast cancer may cause the breast to become:
- Red or discolored
- Swollen or heavy
The skin on the breast may also thicken or dimple. If you’re concerned about inflammatory breast cancer, see your doctor immediately.
When to Worry and Contact a Medical Professional
If you have any type of breast pain, it’s always best to have it checked out by your doctor, whether you think it’s breast cancer or not. If you have any of the following signs or symptoms, make an appointment to see your doctor:
- Bloody or clear discharge from your nipple
- Given birth within the last week and your breasts are swollen or hard
- Noticed a new lump that does not go away after your menstrual period
- Persistent, unexplained breast pain
- Signs of a breast infection, including redness, pus, or fever
And while breast pain is not a common symptom of breast cancer, nor is breast cancer the most common cause of breast pain, it’s important to know what the signs and symptoms of breast cancer are so you know what to look for.