Breast pain occurs for a variety of reasons. How do you know if the discomfort is normal or a sign of a more serious condition like breast cancer? Get to know common reasons for breast pain, types of breast pain, symptoms to watch out for, and some pain management techniques.

Top reasons for breast pain

Breast pain is a common occurrence in women and is uncomfortable but usually benign. In most cases, breast pain unaccompanied by other symptoms won’t be cancer. It can be due to:

• Hormonal fluctuation
• Injury
• Unsupportive bras
• Chest pain (from injury, for example)
• Breastfeeding
• Infection
• Certain medications
• Cyst
• Implant complications
• Cancer (a less common cause)

Types of breast pain

Breast pain, or mastalgia, can happen for a number of different reasons.  This pain can often be described in a number of different ways including: dull, heavy, aching, sharp, throbbing, stabbing, or burning. Your breasts might just feel tender or tight. Pain ranges in severity and duration depending on the cause. There are some benign breast conditions, and at times, there are other conditions associated with breast pain that may start off benign, though may increase the risk for breast cancer in the future, but this isn’t always the case. 

Fibrosis

Fibrosis is a thickening of breast tissue that is similar to scarring. Having fiboritic, or more commonly fibrocystic breasts, does not necessarily mean you are at an increased risk for developing cancer.  The most common symptoms associated with fibrosis may include tenderness, pain, swelling, or lumps. Treatment for this condition isn’t necessary, but you can use a heating pad or pain relievers to reduce discomfort. In severe cases, you may need to see your primary doctor for evaluation for next steps. 

Mastitis

Mastitis is when there is an infection to any area of the breast. This also does not cause cancer or increase the risk for cancern. This usually begins as a swelling to the breast that may also be associated withredness, pain, or warmth. This is usually treated with antibiotics, but you could also consider applying a warm compress to the area, and massaging the area.  The condition has similar symptoms to inflammatory breast cancer, so if the antibiotics do not help resolve your symptoms, it will be important that you follow up with your primary care provider in 1-2 weeks. 

Fat necrosis

Fat necrosis of the breast is a benign condiation and does not increase cancer risk or require treatment (in most cases). Fat necrosis is due to damage from injury, surgery, or radiation treatment. It might cause a lump or make the skin around your breast look thicker, red, or bruised. The condition is more common in large-breasted people.

Lobular carcinoma in situ (LCIS)

LCIS itself is not cancer, and is usually something that is diagnosed after having a breast biopsy for a different reason. This usually does not show up on routine mammograms either. Although LCIS often has no physical symptoms and doesn’t usually require treatment, it can increase the risk of breast cancer. After diagnosis, it will be important that you stay up to date with the routine breast cancer screening guidelines. Making lifestyle changes, medication, or surgery may reduce risks. Speak to your primary care provider about your options.

Fibroadenomas

Fibroadenomas (noncancerous tumors) can feel like marble-like lumps but, in some cases, won’t have noticeable symptoms. An imaging test might spot a tumor. Your primary care provider will most likely recommend removing growing fibroadenomas. The tumors might be left in place if there are no signs of growth because removal may also reduce healthy tissue. Your primary care provider will monitor the situation. Breast cancer risks increase slightly with more complex fibroadenomas, so if you suspect you may have a fibroadenoma it will be important for you to follow up with a doctor.  

Signs and symptoms of Breast Cancer

There are a few different signs and symptoms associated with breast cancer including lumps, skin changes, tenderness, or discharge. However, it is important to know that often times people diagnosed with breast cancer, have no signs or symptoms at all. Your primary care provider might order image testing if you’re experiencing any of these symptoms. Other factors that can influence your next steps include how long you’ve had breast pain (or any physical changes to your breast), the intensity and type of pain, and your family history with breast cancer. 

Warning signs

Risk factors associated with breast pain include breast size, certain medications, surgery, or excessive amounts of caffeine. Talk to your primary care provider if:

• You have pain accompanied by a lump that doesn’t disappear after your period
• There are signs of infection like redness, swelling, or discharge
• There’s nipple discharge
• Pain isn’t cyclical
• Pain has a focal point
• Pain continues to grow in intensity and interferes with your lifestyle

How can you tell if breast abnormalities are not cancer?

Breast pain can be cyclical, that is it can be associated with your menstrual cycle because the pain can be a side effect of hormonal changes. There are also a variety of possible causes for non-cyclical breast pain. This type of pain is often due to benign natural processes or a poorly fitting bra. Some breast pain might be managed by:

• Wearing bras without an underwire and that fit properly
• Using sports bras when exercising
• Reducing fatty foods and caffeine in your diet
• Using ice or heat
• Reducing stress
• Avoiding smoking
• Pain medication (only if breast pain is severe)

Diagnosing your condition

You can use the location of your breast pain to help analyze the type of breast pain you’re experiencing and whether it’s an issue that needs treatment. Cyclical pain, also known as non-focal pain, often occurs in both breasts, particularly right before your period. Breast cancer isn’t usually in both breasts. Targeted pain could be more reason for concern, particularly if breast pain is associated with visible changes to your breast. 

Tracking the intensity and duration of breast pain may help you find patterns. Track for at least a few months to get enough data. Your primary care provider may evaluate your condition with tests such as a clinical breast exam, mammogram, ultrasound, or breast biopsy. You might not need additional tests if there’s nothing unusual in your medical history or physical exam.  

Although breast pain can often be due to benign causes, speak with your primary care provider if you’re concerned about pain or physical abnormalities.