Breast pain (mastalgia) a common complaint among women can include breast tenderness, sharp burning pain, or tightness in your breast tissue.

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The pain may be constant or it may occur only occasionally.

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Breast pain can range from mild to severe.  

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Most times, breast pain signals a noncancerous (benign) breast condition and rarely indicates breast cancer.  

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Breast pain can be cyclic (related to the menstrual cycle) or non-cyclic (not related to the menstrual cycle).

 

Causes

• 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.

• Fibrocystic breasts: AKA lumpy-bumpy breasts are a combination of fluid-filled cysts (sacs) and fibrous (scar-like) tissue in the breast tissue.

• Fibroadenoma: Noncancerous tumors found in the glands.

• Large breasts: Tend to pull on the ligaments of the breast, and discomfort may involve the neck and shoulder as well.

• Diet: Many patients report that cutting back on caffeine has greatly improved their breast pain. Also, a low-fat, high-complex carbohydrate diet has been shown to be helpful in some small studies.

• Smoking: Smoking might increase breast pain by increasing epinephrine levels in the breast. Epinephrine is involved in the perception of pain.

• Medication: Up to one-third of women taking postmenopausal hormone therapy may experience some degree of noncyclical breast pain. Luckily, this tends to resolve over time. Other medications can also contribute to pain, including some antidepressants, cardiovascular agents, and antibiotics.

• Breast Injury: This is most commonly from irritation of the pectoralis major muscle. Examples of activities that can cause this muscle pain include lifting weights, running, raking, rowing, and shoveling.

• Pregnancy: It is important to consider pregnancy as a common cause of breast pain. Half of the pregnancies are accidental or unintended.

• Breast surgery: Breast pain associated with breast surgery and scar formation can sometimes linger after incisions have healed.

• Breast cancer

• Infection (mastitis): Often caused by a clogged milk duct in lactating women, but it can also occur in non-lactating women. If you experience other symptoms of infection like fever, aches, fatigue, and breast changes (warmth and redness), you may have an infection and a breast abscess. 

• Bras: A poor-fitting bra can aggravate and damage the tissue, leading to breast soreness and heaviness. Wear quality bras and sports bras that fit correctly. Buy bras without underwire, as this wire can dig into the tissue of the breast and cause more pain.  

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Diagnosis

• Clinical breast exam. 

• Mammogram. An X-ray exam of your breast.

• Ultrasound. An ultrasound uses sound waves to produce images of your breasts, and it's often done along with a mammogram. You might need an 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.  

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Treatment

• Wear a firm support bra, fitted by a professional if possible.

• Wear a sports bra during exercise and while sleeping, especially when your breasts may be more sensitive.

• Use a pain reliever (analgesic), such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others), to alleviate breast pain.

• Evening primrose oil. This supplement may change the balance of fatty acids in your cells, which may reduce breast pain. This can be bought from health stores, pharmacies and supermarkets. The correct dose is 1300mg twice a day for 2-3 months. The dose can then gradually be reduced as you choose. If you are pregnant or hoping to become pregnant, or if you are on medication for epilepsy, you must NOT take Evening Primrose oil capsules.

• Vitamin E: In one study, 200 international units (IU) of vitamin E taken twice daily for two months improved symptoms in women with cyclic breast pain.

• Decrease the fat in your diet, which may decrease breast pain or discomfort associated with fibrocystic breasts.

• Use a heating pad or warm water bottle to relieve your discomfort.

• Diclofenac sodium 1% gel (Voltaren Arthritis Pain) - available as an OTC arthritis medication; this can be used on the breast to provide pain relief. 

• Seed cycling may relieve some of your symptoms if a hormonal imbalance is present. Seed cycling is not really new but it is newly trendy.

• Adjust birth control pills. If you take birth control pills, skipping the pill-free week or switching birth control methods may help with breast pain symptoms. But don't try this without your doctor's advice.

• Reduce the dose of menopausal hormone therapy. You might consider lowering the dose of menopausal hormone therapy or stopping it entirely.

• 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.

• Give it time. Most commonly, pain goes away on its own after a few months, without the need for any treatment.

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Related Content: Habits to Lower Breast Cancer Risk.