Breast Pain

Breast Pain (Mastalgia)

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Updated on October 20, 2024
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Breast pain (mastalgia) is any pain or discomfort that occurs in one or both breasts. Most commonly, breast pain is caused by fluctuating levels of hormones, particularly in the days leading up to menstruation. Only rarely is breast pain a sign of breast cancer.

Overview

What Is Breast Pain?

Breast pain is any pain that occurs in the breast tissue. The discomfort can be mild to severe, and can range from feelings of tightness or tenderness to a throbbing, stabbing, or burning sensation.

 Breast pain is particularly common in women between ages 15 and 40.

In most cases, breast pain is caused by a benign condition, such as changing hormone levels around the time of menstruation, or lifestyle habits such as wearing a poor-fitting bra. Only rarely is breast pain a sign of breast cancer.

Types of Breast Pain

There are two types of breast pain:

  • Cyclic Breast Pain Cyclic breast pain occurs on a regular cycle, most commonly in premenopausal women between 20 and 50 years old. It’s usually caused by hormonal fluctuations, with some people experiencing pain at the start of ovulation, which then continues until a day or two after menstruation occurs. Cyclic breast pain usually affects both breasts.

  • Noncyclic Breast Pain Noncyclic breast pain isn’t caused by hormonal fluctuations, so it doesn’t follow a regular pattern. The pain can be constant or sporadic, and can be caused by injuries, infections, or other conditions like breast cysts. Noncyclic breast pain usually affects one breast.

Signs and Symptoms of Breast Pain

The signs and symptoms of breast pain can vary based on whether the pain is cyclic or noncyclic.

Cyclic Breast Pain
Noncyclic Breast Pain
Dull, heavy, or aching feeling, usually in both breasts; can also be accompanied by breast swelling, fullness, or lumpiness
Tight, burning, stabbing, or aching feeling, usually in one breast
Affects the upper, outer breasts and can radiate to the underarm
Can affect one particular area of the breast or radiate across the breast
Intensifies in the weeks leading up to the start of the menstrual cycle, then subsides after the first day of menstruation
Doesn’t follow a regular pattern, but can be constant or sporadic
Usually occurs before menopause
Often occurs after menopause

Causes and Risk Factors of Breast Pain

Cyclic breast pain is related to hormonal changes and usually occurs in the week or two before a person gets their period, when the levels of the hormones estrogen and progesterone are on the rise. After menstruation, the pain tends to decline.

The causes of noncyclic breast pain are more varied, and can include:

  • Pregnancy
  • Infections such as mastitis (inflammation of the breast, often caused by infection related to overproduction of milk during lactation
  • Breast cysts
  • Fibroadenomas (a type of benign breast lump)
  • Fibrocystic breast changes (common and benign changes that create lumpy or ropelike nodes in the breast)
  • Trauma or injury
  • Wearing a poor-fitting bra
  • Breast surgery
  • Antidepressant medications like SSRIs (selective serotonin reuptake inhibitors)
  • Hormone therapy, such as to treat symptoms of menopause
In men or people assigned male at birth, breast pain is usually caused by a condition called gynecomastia, which occurs from an imbalance of testosterone and estrogen.

How Is Breast Pain Diagnosed?

To diagnose breast pain, a doctor will likely start by taking a detailed medical history and performing a physical exam, paying close attention to its location and severity, as well as when it appears. In some cases, breast pain can be “referred” — meaning, the pain may feel as if it’s in the breast, but may actually be starting in a different location, like the chest.

If a physical exam turns up something abnormal, doctors can order additional testing, including a mammogram or breast ultrasound. These tests are used to take images of the breast tissue and can rule out more serious causes of breast pain, such as breast cancer. If a lump is detected during a physical exam, a doctor can also order a breast biopsy.

Treatment and Medication Options for Breast Pain 

Treatment will depend on what’s causing breast pain and how severe symptoms are. Mild cases of breast pain may not require any treatment, but medications — both over-the-counter and prescription — are options for people who are experiencing discomfort.

Medication Options

Breast pain can be treated with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve). Acetaminophen (Tylenol) and aspirin are other options.

There are also hormonal prescription medications available to treat more severe cases of breast pain, including danazol and tamoxifen. Danazol is approved by the U.S. Food and Drug Administration to treat mastalgia, while tamoxifen (a breast cancer medication) is given off label to treat breast pain. Both medications come with side effects such as increased risk of blood clots and stroke.

For people who use hormone medications, such as birth control pills, switching or making adjustments to your medication may also help ease breast pain (though you should talk to your doctor before making any changes).

Complementary and Integrative Therapies

  • Primrose Oil and Vitamin E Some research has shown that taking evening primrose oil and vitamin E supplements together was effective in treating pain in women with cyclical breast pain.

  • Flaxseed Oil One study showed that flaxseed oil (as well as vitamin E) may be effective in reducing pain and fibrocystic nodules in women with mastalgia.

  • Acupuncture A review found that acupuncture might provide better pain relief for mastitis than antibiotics, and may be an effective complementary treatment for breast pain.

Prevention of Breast Pain

It’s not always possible to prevent breast pain, especially if it occurs regularly as part of your menstrual cycle, but taking medications (including contraceptives) as well as making certain lifestyle changes can help ease the discomfort.

Lifestyle Changes for Breast Pain

Some lifestyle measures you can try to prevent breast pain include:

Wear a Properly Fitted Bra

Wearing an ill-fitted bra can contribute to breast (and back) pain. Wearing a sports bra during exercise can also give you extra support.

Try Cutting Back on Caffeine

Some people say that reducing their caffeine intake can help improve breast pain symptoms, although the evidence isn’t conclusive.

Avoid Medications or Treatments That Can Cause or Worsen Breast Pain

These can include SSRIs or hormone therapy.

Follow a Low-Fat Diet

Research is also mixed, but some people say that cutting back on fat may ease breast pain and sensitivity.

How Long Does Breast Pain Last?

It can be hard to tell how long breast pain will last, in part because there can be many different underlying causes. In the case of cyclic breast pain, the discomfort may appear regularly throughout each of your menstrual cycles, for either months or years. About 60 percent of people with cyclic breast pain will experience some relief from treatment, with 20 to 30 percent of them showing a complete remission within two years.

For about 50 percent of people with noncyclic breast pain, the discomfort will subside on its own; for the rest, the pain won’t subside until the underlying condition is found and treated.

Complications of Breast Pain

Complications of breast pain can depend on the underlying cause. If breast pain lingers for more than a couple of weeks or seems to be getting worse over time, or you notice symptoms such as a lump, nipple discharge, or skin dimpling, contact your doctor to rule out serious causes such as a disease or an infection that requires treatment.

You may also want to call your doctor if breast pain is causing complications that interfere with your daily activities such as exercise (especially vigorous, high-impact workouts), sleep, and intimacy with your partner.

In addition, the treatments for mastalgia — including danazol and tamoxifen — can cause side effects such as nausea, bloating, headache, vaginal dryness, hot flashes, leg cramps, and more.

Research and Statistics: How Many People Have Breast Pain? 

Breast pain is particularly common among women of reproductive age, with about 2 in 3 experiencing it at some point during their reproductive lives. Sometimes, postmenopausal people can also develop breast pain.

About 1 in 3 women seek medical care for breast pain — of these, many worry that their pain is a symptom of breast cancer. That said, breast pain only occurs in 0.5 to 2 percent of people who are later diagnosed with cancer.

The Takeaway

  • Breast pain is common among women, particularly those of childbearing age.
  • Breast pain can be cyclic (meaning it follows a regular pattern and fluctuates with the menstrual cycle) or noncyclic (without patterns, not linked to the menstrual cycle).
  • Breast pain usually isn’t caused by breast cancer, and can often be treated with NSAIDs such as ibuprofen.

Common Questions & Answers

What are some common causes of breast pain?
Breast pain can be caused by factors such as hormonal changes (such as around menstrual cycles); medications; a bra that isn't fitting properly; or an infection, disease, or other condition in the breast.
If breast pain persists longer than a couple of weeks, isn’t getting any better or is becoming worse, you feel a lump or see nipple discharge or pitting or dimpling of the skin of your breast, contact your doctor.
Mastalgia is rarely linked to breast cancer. But, if you have breast pain that persists longer than a couple of weeks, see your doctor to rule out infection or a disease such as breast cancer.
There are two main types of breast pain: cyclical, which is related to the menstrual cycle and can intensify before the start of a period, and noncyclical, which may be caused by infection, a benign breast condition, or other causes.
Treatment will depend on factors such as the cause of the breast pain, your symptoms, and how severe your pain is. In addition to medication, your doctor may recommend lifestyle measures to prevent and relieve breast pain.

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Lisa D. Curcio, MD, FACS

Medical Reviewer
Lisa Curcio, MD, is a board-certified general surgeon and a fellowship-trained surgical oncologist. She is currently the medical director of breast surgery at Northern Dutchess Hospital in Rhinebeck, New York. Dr. Curcio attended George Washington University Medical School in Washington, D.C., where she also completed a residency in general surgery. She was invited to fellowship training in cancer surgery at City of Hope National Medical Center in Duarte, California. She was the recipient of the competitive U.S. Air Force Health Professions Scholarship Program. During her military commitment, Dr. Curcio served in the military as chief surgical oncologist at Keesler Medical Center in Biloxi, Mississippi. 

From 2003 to 2004, she served as program director for Susan G. Komen in Orange County and remains involved with Komen outreach efforts. She was on the board of Kids Konnected, a nonprofit that helps children of cancer patients deal with the emotional fallout of a cancer diagnosis. Currently, she is on the board at Miles of Hope Breast Cancer Foundation, an organization dedicated to providing support services for people affected by breast cancer in New York's Hudson Valley. Dr. Curcio also has a strong background in breast cancer research, having contributed to dozens of peer-reviewed articles. She is currently a member of the Alpha Investigational Review Board.

Her practice includes benign and malignant breast diagnoses. Dr. Curcio was diagnosed with breast cancer at the age of 37. Although her fellowship training was in surgical oncology, this experience motivated her to provide compassionate, high level breast care and to focus on breast surgery.

Dr. Curcio is passionate about treating the patient and individualizing the care plan to their specific needs. Dr. Curcio strongly believes that cancer care must include lifestyle changes to focus on healthier habits to reduce future events. Her practice also focuses on breast cancer risk reduction, education, and access to genetic testing for patients with a family history of breast cancer.
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Maria Masters

Maria Masters

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Maria Masters is a contributing editor and writer for Everyday Health and What to Expect, and she has held positions at Men's Health and Family Circle. Her work has appeared in Health, on Prevention.com, on MensJournal.com, and in HGTV Magazine, among numerous other print and digital publications.

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Resources
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  5. Kumari J et al. Effectiveness of Evening Primrose and Vitamin E for Cyclical Mastalgia: A Prospective Study. Cureus. April 11, 2024.
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