Breast pain

Definition

Alternative Names

Pain - breast; Mastalgia; Mastodynia; Breast tenderness

Considerations

There are many possible causes for breast pain. For example, hormone level changes from menstruation or pregnancy often cause breast tenderness. Some amount of swelling and tenderness just before your period is normal.

Although many women who have pain in one or both breasts may fear breast cancer, breast pain is NOT a common symptom of cancer.

Common Causes

Some amount of breast tenderness is normal. The discomfort may be caused by hormonal changes due to:

• Menopause (unless a woman is taking hormone replacement therapy)
• Menstruation and premenstrual syndrome (PMS)
• Pregnancy -- breast tenderness tends to be more common during the first trimester and in women who become pregnant at a young age
• Puberty in both girls and boys

Soon after childbirth, your breasts may become swollen with milk. This can be very painful. If you also have an area of redness, call your health care provider. Breastfeeding itself may also cause breast pain.

Fibrocystic breast changes are also a common cause of breast pain. Fibrocystic breast tissue contains lumps that tend to be more tender just before your menstrual period.

Certain medications may also cause breast pain, including digitalis preparations, methyldopa (Aldomet), spironolactone (Aldactone), certain diuretics, Anadrol, and chlorpromazine.

Shingles can lead to pain in the breast if the painful blistering rash appears on the skin over one of your breasts.

Home Care

If you have painful breasts, the following may help:

• Take medication such as acetaminophen or ibuprofen
• Use heat or ice on the breast
• Wear a well-fitting bra that supports your breasts

Although some women believe that reducing the amount of fat, caffeine, or chocolate in their diet helps with their symptoms, there is no good evidence that this helps. Vitamine E, thiamine, magnesium, and evening primrose oil are not harmful, but in most studies they have not shown any benefit. Before taking any medication or supplement, be sure to talk with your health care provider.

Certain birth control pills may help relieve breast pain. Ask your health care provider if this therapy is right for you.

Call your health care provider if

Call your health care provider if you have:

• Bloody or clear discharge from your nipple
• Given birth within the last week and your breasts are swollen or hard
• Noticed a new lump with the pain that does not go away after your menstrual period
• Persistent, unexplained breast pain
• Signs of a breast infection, including local redness, pus, or fever

What to expect at your health care provider's office

Your health care provider will perform a breast examination and ask questions about your breast pain. You may have amammogram or ultrasound.

Your health care provider may schedule a follow-up visit if your symptoms have not gone away in a given period of time. Your health care provider may recommend that you see a specialist if the symptoms do not go away.

Prevention

There is not really any way to prevent most breast pain, but wearing a well-fitting bra for support may help.

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References

Valea FA, Katz VL. Breast diseases: diagnosis and treatment of benign and malignant disease. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 15.