Why Do I Have Breast Pain? Causes, Diagnosis, and Treatment

Breast pain can be uncomfortable and frustrating, but if you’re experiencing it, you’re not alone.

Also called mastalgia, breast pain is very common – in fact, about 70% of women in the U.S. have it at some point in their lives. 

Usually, it is caused by hormonal changes, and it often resolves on its own.

You can manage it at home with over-the-counter (OTC) pain relievers, dietary changes, and wearing a well-fitting bra.

Although breast pain can be worrying, it is important to know that it is unlikely to be a symptom of breast cancer.

However, you should contact a healthcare provider if your breast pain doesn’t go away or gets worse.

In this article, I’ll talk about the different causes of breast pain, diagnosis, treatment options, and how to manage breast pain at home.

I’ll also discuss the signs that it’s time to talk to your healthcare provider.

Types of Breast Pain

There are two main types of breast pain: cyclical and non-cyclical. 

Cyclical breast pain is the most common and is usually caused by hormonal changes.

In people who menstruate, the luteal phase of the menstrual cycle is a common culprit.

Many people experience sore, swollen breasts during this time, and it goes away once their period starts.

Hormonal changes do not cause non-cyclical pain, which is much less common than cyclical pain.

It isn’t related to menstrual periods or hormones–instead, it can be caused by an acute injury, pulled muscle, bruise, or inflammation.

Generally, you’ll feel pain in one specific spot, and it might hurt to press on it.

Symptoms Associated with Breast Pain

Breast pain symptoms vary from person to person. You might experience symptoms like:

• Swelling
• A feeling of fullness
• Soreness
• Tenderness
• Discomfort
• Aching
• Redness
• Lump(s)

Causes

There are a variety of breast pain causes.

Some of these, like hormonal breast pain, come and go over time. 

Non-hormonal causes include medication side effects, scar tissue, and muscle sprains.

In very rare cases, breast pain can signify breast cancer.

Hormonal changes

Hormonal changes affect everyone, and in some people, they can cause breast pain. Causes of hormonal changes include:

• Puberty
• Menstruation
• Pregnancy
• Menopause

If you have breast pain related to your monthly menstrual cycles, you’ll probably have it every month. It’s relatively common, and it should go away once your period starts. 

This breast pain happens because of increased estrogen levels before your period.

The milk glands and ducts swell up, making the breasts retain fluid. 

However, unlike menstrual cycles, hormonal changes due to puberty, pregnancy, and menopause all last for certain periods of time and do not recur monthly.

If your breast pain is caused by one of these, it should go away.

Some people have breast pain after pregnancy due to their breasts being swollen and full of milk.

If you experience pain and redness, it’s best to see a medical professional, as this can be a sign of an infection, such as a breast abscess. 

Bra fit

Wearing a bra is a personal choice, but wearing a bra that doesn’t fit properly can cause breast pain.

This is particularly true for people with larger breasts.

If your bra isn’t supporting you properly, you can have pain in your breasts, back, shoulders, and neck.

It is important to find a bra that is both comfortable and supportive.

Your bra should fit snugly around the ribcage without digging in, and the shoulder straps should be snug but not restrictive. 

If your bra is uncomfortable, scratchy, hurts, or causes breast pain, you are probably wearing the wrong bra.

Visiting a local store for a professional bra fitting can help you find the correct size and style.

Fibrocystic breast changes

Fibrocystic breast tissue is breast tissue that has benign, or harmless lumps and cysts.

Although breast lumps often make people think of breast cancer, lumps related to fibrocystic changes are not dangerous. 

With fibrocystic breast changes, thick breast tissue and fluid-filled cysts form in the breasts.

Fibrocystic tissue may make your breasts feel sore and swollen during your menstrual cycle. Like the hormonal changes discussed in the previous section, this breast pain will come and go each month.

Fibrocystic breast tissue can cause:

• Pain that comes and goes with your period
• Swollen, heavy breasts
• Lumps that may get bigger before your period
• Pain in the underarms

Mastitis

There are two types of mastitis: lactational and non-lactational. 

Lactational is the most common, and it happens during breastfeeding.

The milk ducts are continually swollen, and bacteria can enter through small breaks in the skin, causing infection. This can make your breasts sore, engorged, and red. 

It’s most common during the first six weeks, but it can happen at any point during breastfeeding.

In many cases, it will go away on its own, and you can manage it at home with warm compresses and pain relievers.

Your healthcare provider can prescribe antibiotics and other medications if it does not resolve.

Medication side effects

Almost all medications come with some side effects. Certain medications can cause sore breasts as a side effect.

They include:

• Chlorpromazine
• Digitalis preparations
• Diuretics
• Methyldopa
• Oxymetholone
• Spironolactone

Scar tissue

If you’ve had breast or chest surgery in the past, you may have remaining scar tissue on the chest wall.

This can cause breast pain. While this should get better with time, contact a healthcare provider if it’s causing problems. 

Back, neck, or shoulder sprains

Spraining or straining a muscle in your chest, back, neck, or shoulder can cause breast pain.

This pain is non-cyclic, so it is usually localized and will go away once the injury heals. 

Although sprains can be sore and uncomfortable, they are considered minor injuries.

You can treat them at home with rest, ice, and OTC pain medication.

Costochondritis and Chest wall pain

In some people, chest wall pain can cause pain in one or both breasts.

The pain can be due to various physical structures that make up the chest wall, such as muscle and bone.

Sometimes the pain is due to inflammation of the cartilage in the chest wall (costochondritis).

Usually, it will hurt if you press on one specific spot. It may come on or get worse with activity.

In most cases, you can manage it at home with rest and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen (Aleve).

Breast cysts

Breast cysts may sound scary, but they are relatively common and are frequently benign. They are the most prevalent type of breast mass.

For some people, these cysts cause no symptoms, and you may never even know you have them.

However, in others, they can cause symptoms like pain, swelling, and nipple pain or discharge. 

If you have symptoms that concern you, it’s a good idea to talk with your healthcare provider, but know that breast lumps are not always breast cancer. 

Breast cancer

It is unlikely that your breast pain is caused by breast cancer—in fact, only 0.5–2% of people diagnosed with breast cancer have breast pain as a symptom. 

The symptoms of breast cancer vary greatly from person to person, and some people have none at all. Some signs to look out for include:

• Irritated, dimpled skin
• A new lump
• Redness or flakiness
• Nipple discharge
• Swelling or thickening
• Size or shape changes
• Pain

Diagnosis 

If you have breast pain, your healthcare provider will evaluate your symptoms to determine its cause.

They will ask about your personal medical history, family history, and symptoms.

They’ll want to know if you’ve felt lumps in your breasts, had any size or shape changes, experienced nipple discharge, and more.

Additionally, they will likely evaluate your breasts by gently palpating the areas causing you pain. They will aim to rule out hormonal causes, like pregnancy, and check for common causes, like mastitis.

The main focus is usually to check for any signs of breast cancer. They will refer you to a specialist if they think this may be the case.

Treatment

Cyclical breast pain usually resolves on its own, so it does not need any specific treatment.

For up to 60% of people with this, the pain returns every month and then resolves, usually relating to their menstrual cycles.

If home remedies and OTC medication do not help your pain, your healthcare provider may recommend certain medications.

NSAIDs are usually used as a first-line treatment, but if these don’t work, they can prescribe other drugs.

However, most of these come with significant side effects, so they are generally used after you’ve tried several other treatments. 

These medications include:

• Danazol: This medication affects your hormones and can help reduce breast pain. It is commonly used to treat endometriosis. While it may help your symptoms, it can cause side effects like weight gain, muscle cramps, and heavy menstrual periods.

• Gonadorelin analogs: These injections can reduce breast pain, but they can cause side effects, including vaginal dryness, oily skin and hair, lower libido, mood changes, and hot flashes. It’s usually used in severe cases and only administered for six months.

• Tamoxifen: Commonly used to treat breast cancer, tamoxifen can help relieve breast pain. Side effects include hot flashes, digestive issues, and an increased risk of venous thromboembolism (VTE). It is not approved to treat breast pain in the U.S.

Managing Breast Pain

If you have breast pain, you can take some simple steps at home to manage it. You can try:

• Wearing a supportive bra
• Taking NSAID medications
• Consuming less sodium
• Avoiding caffeine and alcohol

When To Seek Medical Attention

Usually, breast pain is not a sign of a serious underlying condition, and it doesn’t require a visit to the doctor. However, it’s a good idea to contact your provider if you have:

• Nipple discharge
• A new lump
• Swollen, hard breasts after giving birth
• Persistent pain
• Pain that gets worse
• Redness and inflammation
• Fever
• Chest pain

Additionally, if your breast pain is impacting your daily life, you may want to contact your doctor.

They can determine the cause of your pain and recommend an appropriate course of treatment.

How K Health Can Help

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