Breast Pain (Mastalgia)

What is breast pain?

Breast pain, also called mastalgia, is a very common condition that can affect anyone. The pain can vary from feeling mildly sore to throbbing or stabbing. Frequent or recurring breast pain can interfere with your life and make it hard to go about your daily activities. Breast pain that doesn’t go away can also point to an underlying condition that needs treatment from a healthcare provider.

Things like hormonal changes (due to medications or menstruation), wearing a poor-fitting bra or infection can cause breast pain in people assigned female at birth (AFAB). In people assigned male at birth (AMAB), a condition called gynecomastia is the most common cause of breast pain. Most cases of breast pain aren’t due to breast cancer.

Types of breast pain

There are two main types of breast pain: cyclic and noncyclic.

Cyclic breast pain

This type of breast pain lines up with your menstrual cycle. It’s most common in people AFAB between 20 and 50. You may have pain in one breast or both, and it typically occurs due to natural hormonal changes. It likely occurs about a week before your period.

Cyclic breast pain goes away naturally once you get your period but returns before your next menstrual cycle. You can also get this type of pain if you take or change hormone medication (like for birth control or hormone replacement therapy). Cyclic breast pain is a predictable pattern. This type of breast pain typically goes away after menopause because you no longer menstruate.

Noncyclic breast pain

This type of breast pain has nothing to do with your menstrual cycle or period. It’s most common if you’re older than 40 and can continue after menopause. Noncyclic breast pain doesn’t follow a predictable pattern. It can come and go or be chronic and constant. This type tends to affect one breast in a specific area. Noncyclic breast pain tends to happen due to injury, breast size or a benign (noncancerous) breast condition.

How common is breast pain?

Breast pain is common. About 70% of people AFAB will have breast pain at least once. Breast pain is more common in people who haven’t reached menopause.

The rate is slightly less in people AMAB with about 50% to 65% experiencing breast pain at some point. It’s worth noting that the majority of causes of breast pain aren’t serious or life-threatening.

What are the symptoms of breast pain?

Your symptoms will differ depending on whether you have cyclic or noncyclic breast pain. During cyclic breast pain, your breasts will likely feel:

• Tender or sore.
• Swollen.
• Heavy.

The severity of the pain can be different for everyone, and for some, it may spread to your armpit and shoulders.

The symptoms of noncyclic breast pain are a little different. They could include:

• Pain in one specific area of just one breast.
• A sharper, more acute pain.
• A burning, stabbing sensation in that one area.

What does cancerous breast pain feel like?

You don’t always have painful breasts with breast cancer. But if you do, your breast may feel sore or throbbing in one specific area. More commonly, breast cancer causes a change in your skin’s texture. It may dimple (like the skin of an orange) or become itchy and warm. You may also have nipple changes like nipple discharge or nipple inversion (nipples turn inward).

What kind of breast pain is alarming?

Breast pain that sticks around for longer than two weeks or pain that’s unpredictable could be a signal that it’s time to contact a healthcare provider. It’s also worth calling your provider if you have painful breasts after menopause.

Is it normal for only one breast to hurt?

Yes. Breast pain can affect one breast or both breasts. Hormonal changes tend to affect both breasts, but that’s not set in stone. Similarly, an infection or underlying disease can affect one breast only. It can also affect both. It’s always best to see a healthcare provider for an accurate diagnosis.

What causes breast pain?

Cyclic breast pain is often triggered by your natural menstrual cycle. Noncyclic breast pain causes may include:

• Birth control pills.
• Pregnancy.
• Infections like mastitis.
• Inflammation.
• Hormone therapy.
• Prior radiation therapy.
• Antidepressant medications like SSRIs (selective serotonin reuptake inhibitors).
• Breast cysts.
• Fibroadenomas (noncancerous lumps).
• Costochondritis (inflammation in the cartilage in your breastbone).
• Surgical scars.
• Trauma or injury.

There are also certain activities that can cause noncyclic breast pain, including:

• Smoking.
• Caffeine consumption.
• Stress.
• Breastfeeding.
• Eating foods high in fat.

Some breast pain is pain in your chest wall. There are layers of muscle and tissue around your heart and lungs that can become inflamed. It’s easy to think this pain is from your breasts when it’s from your chest wall.

In many cases, there’s no clear underlying cause for breast pain.

Is breast pain a sign of breast cancer?

Not usually. People with breast cancer will likely develop lumps in their breast area that can be quite painful. But most sources of breast pain aren’t due to cancerous lumps or tumors. If you have concerns about breast pain (especially if you’re at risk for breast cancer), you should schedule a visit with your healthcare provider for breast examination.

Can stress and anxiety cause breast pain?

Possibly. There are a few studies that show a connection between breast pain and anxiety. It’s always best to consult with your healthcare provider about ways to manage stress and anxiety.

Why do you feel breast pain during pregnancy?

During pregnancy, your body begins producing more hormones than normal, specifically estrogen. This directly affects your breasts, often making both of them painful and tender.

Who is more likely to have breast pain?

You’re more likely to have painful breasts if you:

• Have large breasts. People with large breasts tend to have shoulder, neck and back pain, too.
• Had breast surgery and have scar tissue from it.
• Take medications that affect your hormones. This can include birth control pills, infertility medication, hormone therapy and others.
• Drink lots of caffeine. Research suggests a link between breast pain and drinking lots of caffeinated beverages.

What are the complications of breast pain?

Possible complications of breast pain can vary depending on what’s causing it. If the cause is noncyclic, the complications could include:

• Difficulty sleeping.
• Issues with sexual intimacy.
• Being unable to participate in exercise or high-impact activities.

But some types of breast pain occur due to disease or infection. Leaving these types of conditions untreated can cause more serious complications.

Rarely, cancer can cause breast pain. For this reason, if you experience breast pain for longer than two weeks or have symptoms like a lump, skin dimpling and nipple changes, contact a healthcare provider.

How is breast pain diagnosed?

Before performing a breast exam, your provider will ask you about your symptoms, how long you’ve been experiencing them and the severity and frequency of your pain. During the breast exam, they’ll examine your breasts for any possible lumps. They may ask you to lean forward during the exam to assess whether the pain is coming from your breast or from inside your chest.

Your provider may order a mammogram or an ultrasound, but whether you need either of these imaging tests will depend on a few different factors, including:

• Your specific type of pain.
• The findings from the breast exam.
• Your age.
• The length of time since your last breast-imaging procedure.

How is breast pain treated?

Since cyclic breast pain is a regular part of your menstrual cycle, it doesn’t require as much treatment. There are some pain-relieving medications you can take to help with your symptoms if the pain is becoming unmanageable, including:

• Acetaminophen (Tylenol®).
• Ibuprofen (Advil®, Motrin®).
• Naproxen sodium (Aleve®, Naprosyn®).
• Aspirin (Anacin®, Bayer®).
• Diclofenac (Voltaren®).

If your breast pain is even more severe, your provider may suggest danazol or tamoxifen, which are two prescription medications. But these two medications also have certain side effects, which is why it’s important to talk with your doctor before taking them, to determine whether it’ll be worth it for your specific case.

There are also a few other methods that you can use to help relieve breast pain, including:

• Avoiding, adjusting or stopping hormone medications (like birth control) or medications known to cause breast pain. Don’t do this without talking to your provider.
• Wearing a well-fitting, supportive bra. (Breast size and shape changes over time. So, make sure you’re routinely fitted for the correct bra size.)
• Avoiding tobacco products like cigarettes.
• Eliminating caffeine.
• Applying heat to the most painful area on your breast, being sure to protect your skin.
• Taking vitamin E supplements. Some studies show this can help with breast pain in people who experience breast pain due to menstruation.
• Using evening primrose oil on your breast. Some studies show this can decrease breast pain.
• Taking magnesium supplements. If you take these during your menstrual cycle, roughly two weeks before your period, it can help relieve some of your symptoms.
• Applying over-the-counter (OTC) trolamine salicylate cream to ease aches and pains.
• Engaging in relaxation therapies to reduce stress.

Please note that some of these treatments aren’t well-studied and may not offer relief to everyone. You should talk to your healthcare provider to see if they think you’d benefit from any of the above treatments.

If you have noncyclic breast pain, your healthcare provider may suggest using similar treatment methods as they would for cyclic breast pain. But if they find the underlying cause of your pain is due to things like an infection or a benign cyst, sometimes a more specific treatment is necessary for that cause (like antibiotics or surgery).

Can you prevent breast pain?

Since cyclic breast pain is a regular part of your menstrual cycle, you can’t exactly prevent it. But there are certain lifestyle changes you can make to ensure that your symptoms won’t be as bad. This could include wearing a supportive bra, reducing caffeine intake and quitting smoking.

How long does breast pain last?

Before menopause, you’ll likely experience cyclic breast pain during every menstrual cycle. Though breast pain is a relatively constant issue, the severity of the pain depends on how you decide to treat it — through specific, pain-relieving medications and certain lifestyle changes.

You can also treat noncyclic breast pain with medications and lifestyle changes. With this type of pain, though, your provider may recommend medication or treatment specific to the underlying cause of your pain.

What type of breast pain is normal?

Certain causes of breast pain, like hormonal changes or birth control pills, can be normal. But this doesn’t mean you have to live with pain or not seek treatment. For example, changing birth control could bring you relief.

While occasional breast pain can be normal, it can also be a sign of a problem. It’s always best to see a provider so they can rule out any serious causes and help you find a solution to your pain.

When should I see my healthcare provider about my breast pain?

Contact your healthcare provider if your breast pain:

• Gets worse.
• Doesn’t go away after two weeks.
• Interrupts your daily activities or sleep.

If your pain is accompanied by a lump, nipple discharge or skin changes, contact your provider right away.

A note from Cleveland Clinic

While breast pain can cause significant discomfort, it’s usually not serious. Your healthcare provider can help you manage symptoms with treatments like medication and different self-care practices. Pain that lasts longer than two weeks or becomes severe is always worth a call to your provider. Your provider can order tests and examine your breast to find the underlying cause of your pain.

If you develop other symptoms along with breast pain — such as lumps, changes in skin texture or discharge from your nipples — schedule a consultation with your healthcare provider ASAP.