Breast Pain: When to Worry

Breast pain is very common and usually not associated with an underlying problem—in other words, pain in breasts is rarely associated with cancer. Breast pain can be associated with something as simple as a poorly fitting bra or from a more serious concern. In this article, we will discuss breast pain causes and when pain in the breast requires a visit to a doctor.

Breast pain is typically categorized as cyclical and non-cyclical.

What is Cyclical Breast Pain?

Cyclical breast pain is caused by the menstrual cycle. It usually appears a few days or one week before the menstrual cycle begins and may last the duration of menstruation. Typically, it involves either the whole breast or the upper outer portions, sometimes radiating to the arm.

The exact mechanism of this breast pain is uncertain, though it is incredibly common. More than two-thirds of women will complain of breast pain, most commonly between the ages of 20 and 40. The pain is classically described as dull and aching.

What is Non-Cyclical Breast Pain?

Non-cyclical breast pain—that is, pain that does not occur solely during a menstrual cycle—can have a variety of causes. Most commonly, this is caused by an improperly fitting bra. However, non-cyclical pain in the breast can also be caused by fibrocystic changes such as:

● cysts or fibroadenomas

● complications from breast implants

● musculoskeletal pain

● trauma

It is important to differentiate breast pain from underlying chest wall or musculoskeletal pain. Chest wall pain is more typically sharp or burning, more focal, and can often be experienced by “pushing on the area.” Pain in the breast tissue can be constant or intermittent without pressure on the area.

Other breast pain causes include medicines such as:

● infertility treatments

● birth control pills

● post-menopausal hormonal supplements

● digitalis

● some antidepressants

● blood pressure pills

Smoking or excessive caffeine intake can also cause breast pain.

Breast pain is rarely caused by breast cancer. However, breast swelling, skin changes, and redness may be either a sign of mastitis (breast infection) or inflammatory cancer and should prompt a visit to your physician.

When Should I Worry About Breast Pain?

Most of the time, breast pain is not a cause for alarm. However, there are times when you should worry about breast pain. Pain that is non-cyclical and persistent or worsening should be addressed with a doctor’s visit.

At this visit, your doctor will take a short history, followed by breast imaging such as a mammography or ultrasound. Often, imaging will be normal with no underlying cause identified. This should be regarded as expected and be a cause for relief.

Sometimes, however, structural abnormalities such as cysts will be found. Cysts are very common and usually require no intervention or treatment. Sometimes, if they are particularly painful, the cysts will be drained using a small needle under local anesthetic. A biopsy can be performed in the rare instance that a suspicious solid nodule is detected.

How is Breast Pain Treated?

Breast pain with normal imaging findings is treated symptomatically, often with analgesics.

Other treatments may include heat or ice, decreasing caffeine intake, ceasing to smoke, and lower fat diets.

Herbal medicines are sometimes helpful. These nontraditional medicines include primrose oil, turmeric, ginger, castor oil, and vitamins B and E. Some women have found relief by means of meditation and stress reduction techniques as well as acupuncture. These methods have served to eliminate or reduce pain in some women.

The Bottom Line

Breast pain that presents without any other symptoms is usually no cause for worry. Many times, a well-fitting bra may be all that is needed to find relief. Check with your local clothing store to get measured with the right size. The importance of a well-fitting bra is not to be underestimated!

If your only symptom is breast pain, your breast cancer risk is very low. However, you should schedule a doctor’s visit if you experience:

● Pain that is not related to a period

● Pain that is persistent or worsening

● Breast swelling

● Skin changes

● Redness

These may be symptoms of a more serious infection or cause for worry.

Regardless of your symptoms, it is always better to get peace of mind early! Schedule an appointment with your doctor or local breast imaging center to lay concerns to rest.