Why Do I Have Breast Pain?

Although breast pain can be worrying as well as uncomfortable, it is not typically a sign of breast cancer. The most common cause of painful breasts is a fluctuation in hormones, but a number of other conditions can also be at the root of the problem. Read on to better understand what may be causing your pain and when to consult your doctor.

Cyclical vs. Non-Cyclical Pain

Cyclical breast pain varies with hormone fluctuations and can also be tied to particular times during a woman’s menstrual cycle, typically getting worse shortly before her period. Hormonal factors can also cause an increase in breast pain during puberty, pregnancy, and menopause. In approximately 75% of cases, breast pain is cyclical.

Causes of Non-Cyclical Breast Pain

Non-cyclical pain can be persistent throughout the menstrual cycle or come and go in patterns unrelated to the menstrual cycle. Non-cyclical pain can have a variety of causes.

Fibrocystic Changes

Fibrocystic breast changes are a common cause of breast pain and swelling. These changes are marked by the development of benign, fluid-filled cysts and fibrous tissue, and nipple discharge may also be present. Symptoms often worsen right before period onset. Although often associated with aging, fibrocystic breasts are not uncommon among women as young as 20. If fibrocystic breast changes cause you pain, consult with your doctor about possible remedies. Different studies suggest certain supplements or lifestyle changes may be helpful, and recommendations vary.

Surgery

Some patients report pain following recovery from breast surgery. This varies greatly among individuals, who can experience no pain at all, severe pain, or anything in between. Pain can be caused by scar tissue, inflammation, or nerve damage and may be felt either at or beneath the breast’s surface. Over time, this pain may increase or decrease. If post-surgery breast pain interferes with your enjoyment of life, talk with your doctor about steps you can take to feel better.

Breastfeeding-Related Causes

It’s common for nursing mothers to struggle with breast pain for a variety of reasons. If the breasts become engorged, as often happens when a woman goes longer than usual between nursing or pumping milk, they can feel heavy, tight, and painful. Nursing or expressing milk will usually alleviate the pain. If pain persists, mastitis (an infection of the breast) may be the cause. Contact your doctor promptly if the breast feels warm or appears red or if you develop a high or persistent fever. If pain is primarily in the nipples, this could be the result of poor latch or a thrush infection.

Irritation of Other Body Parts

Sometimes, pain that is felt in the breast actually originates in a different part of the body, such as the chest, arm, or back muscles. Consider whether you’ve worked these areas of your body harder than usual or they’ve suffered strain or injury.

Substances

Some medications and other substances can contribute to breast pain. These include (but are not limited to)

• Tobacco
• SSRIs
• Antipsychotics
• Oral contraceptives
• Hormone therapies
• Antibiotics
• Diuretics
• Infertility treatments
• Medications prescribed for heart disease

If you suspect your medication is causing breast pain, ask your doctor if an alternative is available.

Inflammatory Breast Cancer

While most breast cancers do not typically cause pain, inflammatory breast cancer is a notable exception. It’s rare, accounting for less than 5% of breast cancer cases, but it’s also a highly aggressive form of breast cancer that can become quite advanced between annual mammography screenings. Consequently, it’s important to take note of symptoms early and seek treatment as soon as possible. In addition to pain, symptoms of inflammatory breast cancer can include

• Reddish or bruised appearance
• Sudden change in the appearance of the breast
• Heaviness, thickness, and an orange-peel appearance (often referred to as peau d’orange)
• Enlarged lymph nodes under the arm or around the collarbone
• Increased warmth in the breast

Breast pain can have many causes. If your pain seems unrelated to your menstrual cycle and you’re not sure what’s causing it, talk with your doctor.

Iowa Radiology provides state-of-the-art breast imaging and biopsy in Central Iowa. We offer 3-D mammography, breast ultrasound and MRI, and imaging-guided biopsy. Feel free to contact us to schedule your annual screening mammogram or ask your doctor to refer you to Iowa Radiology when you need diagnostic imaging.

Sources

"Inflammatory Breast Cancer." Cancer.gov. National Cancer Institute, 23 May 2012. Accessed 13 July 2018.

"Inflammatory Breast Cancer." MayoClinc.org. Mayo Foundation for Medical Education and Research, 6 March 2018. Accessed 13 July 2018.

La Leche League Great Britain. Accessed 13 July 2018.

Smith, Lori. "Eight common causes of breast pain." Medical News Today. Healthline Media UK Ltd., 9 July 2018. Accessed 13 July 2018.

"What Causes Breast Pain?" Healthline.com. Healthline Media, 24 Jan 2017. Accessed 13 July 2018.