9 causes of breast pain and when you should be concerned

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9 causes of breast pain and when you should be concerned
Breast pain can be caused by hormonal changes, cysts, or breastfeeding.Sakan Piriyapongsak / EyeEm/Getty Images
  • Breast pain is often normal and part of the menstrual cycle, occurring during your period.
  • It can also happen due to breastfeeding, benign cysts, exercise, and cancer.
  • If you have a lump in your breast that doesn't go away, see a doctor immediately.
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Breast pain, also known as mastalgia, can occur in people of every gender and may feel like a sharp stabbing, throbbing, burning, or soreness.

Some of the most common reasons for breast pain include hormonal changes, breastfeeding, trauma from an injury, taking certain medications (such as oral birth control pills and certain diuretics), an infection, or a benign cyst.

"Occasional breast pains are normal, especially if a woman is ovulating or if she is on her period," says Jaydeep Tripathy, MBBS, a primary care doctor at Doctor Spring. "Another commonly overlooked reason is using a poor-fitting bra."

Related Article Module: Follow this 5-step guide to check for breast cancer at home

According to the National Breast Cancer Foundation (NBCF), breast pain is not usually a symptom of cancer. However, the NBCF recommends making an appointment to see your doctor if your breast pain gets worse over time, persists for more than a couple of weeks, or is accompanied by a rash, nipple discharge, or a new lump that doesn't go away after your period ends.

Here are some of the most common causes of breast pain, and when they might be cause for concern.

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1. Hormone changes

Breast pain that happens at the same or similar times in your menstrual cycle is called cyclic breast pain and is caused by changes in your hormone levels.

According to Johns Hopkins Medicine, hormonal fluctuations are the leading cause of breast pain. When hormonal changes are the culprit, Chauhdry says the pain will usually occur in both breasts.

2. Your period

If you're about to get your period, breast pain is often a result of a rise in estrogen and progesterone. In this case, the breasts may feel swollen, tender, and sore. If you're menstruating, the pain typically appears three to five days before your period and may subside right after it starts or continue to the end of your cycle.

3. Ovulation

Some women also experience breast pain around the time they're ovulating, and it will typically go away at the start of the menstrual cycle. Johns Hopkins Medicine reports that the pain may feel like a radiating sensation in the underarm and can range from barely noticeable to severe.

4. Menopause

Many women who experience non-cyclical breast pain are peri-menopausal and between ages 40-50. This pain may be described as soreness, tightness, or a burning sensation.

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Harvard Health reports that the pain may be the worst during perimenopause, when hormones often rise and drop erratically, and then continue into menopause, particularly in women undergoing hormone therapy or taking hormonal birth control.

5. Pregnancy

If you're pregnant, your breasts may feel sore, swollen, and even tingly as early as one to two weeks after conception. According to Mayo Clinic, this discomfort may lessen as your body adjusts to the hormonal changes about three or four weeks into the pregnancy and then return late in the third trimester as the breasts are preparing for milk production.

To manage the pain, Tripathy recommends wearing loose-fitting clothing and comfortable, supportive bras like comfortable sports bras. He also advises checking with your doctor first before taking any medication for the pain.

6. Cysts

According to Tahir Chauhdry, a board-certified OB-GYN and medical advisor at Sesame, cysts tend to cause intense pain in a particular area. Cysts usually feel like soft lumps roughly the size of a grape and are most common in premenopausal women.

Most benign cysts feel like a small smooth and easily movable water-filled balloon, whereas a malignant tumor may feel harder and thicker. Unlike cysts, the majority of malignant tumors will also be painless and irregularly shaped.

7. Exercise

If your breast pain is caused by exercise, Chauhdry says it will typically feel like muscular aching in the chest. This may happen when you pull or strain a chest muscle while strength training, or when you engage in high-impact exercises (like running and jumping) that put stress on the ligaments in your chest.

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Tripathy says the latter often happens if your breasts are moving around a lot during exercise - which is why it's important to wear a supportive sports bra.

"It usually subsides after your physical activity," he tells Insider.

8. Blocked milk ducts during breastfeeding

Mastitis, which happens most often but not always in breastfeeding women, is an infection in the breast tissue caused by a blocked milk duct or bacteria that's entered the milk duct. Common signs of mastitis include fever, thickening of the breast tissue, redness in a wedge-shaped pattern on the breast, and a continuous burning sensation, especially while breastfeeding. The breasts may also feel warm to the touch.

"This occurs when the milk duct gets clogged or infected, often causing swelling, redness, and pain," says Tripathy. "To avoid it, pump breastmilk and take adequate fluids. You may also be prescribed antibiotics or other anti-inflammatory medicines."

According to a 2015 study, mastitis occurs in about 20% of breastfeeding women.

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9. Excess milk during breastfeeding

Engorgement is a painful condition that occurs when the breasts are filled with excess milk.

"This is common during the first week after giving birth and can make your breasts feel swollen and tender," Tripathy tells Insider. "You can use a warm compress before breastfeeding your baby and massage your breasts while feeding to relieve the pain. Pumping will also help you to avoid milk build-up."

If you choose not to breast feed, you will most likely be advised to wear a supportive sports bra and to wait until your brain signals your body to stop milk production. This may take a week or so. In this situation, you should not pump or express milk as that will send a message to your body to continue milk production.

When is breast pain a cause for concern?

According to Tripathy, if you experience a sharp pain, it's not always necessarily a cause for concern. It can be, however, if it happens persistently, the area around it looks infected, or you have other accompanying symptoms. Also, keep in mind that a lump isn't always an indicator of breast cancer, even if it causes discomfort.

"Benign cysts can also sometimes be painful," says Tripathy. "But if you feel a lump that is painful, consult your doctor to find out if it needs to be treated."

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Signs of breast cancer

  • Lymph node enlargement in the armpit area
  • Changes in breast symmetry
  • Skin dimpling or redness
  • Nipple discharge.

Since breast pain isn't one of the more common signs of breast cancer, Chauhdry says it's best to talk with your doctor, who can make a diagnosis by doing an ultrasound, a diagnostic mammogram (a detailed X-ray), an MRI scan, or a biopsy (looking at breast tissue or fluid under a microscope).

Early detection of breast cancer is key. Since there is no designated age to begin screening for breast cancer, Mayo Clinic advises talking with your doctor about your risk factors before deciding on a mammography schedule that's right for you. While it's generally recommended to begin mammograms around age 40, you may benefit from starting to get mammograms earlier than that if you have a high risk of breast cancer.

Recommendations vary among experts about when to start getting mammograms which can be confusing. Its is best to make your decision based on which guideline is best for you

Insider's takeaway

Breast pain is not a common sign of breast cancer and usually more likely the result of normal hormonal shifts, benign cysts, or exercise.

However, it's important to monitor the pain, and talk to your doctor if it's accompanied by a lump or other symptoms like fever, skin changes, or bloody nipple discharge.

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"Breast pain is concerning when it's persistent, sharp, intense, or affects your quality of daily living," says Tripathy.

When in doubt about the cause of your breast pain, especially if it's only in one breast and one specific spot, you should always discuss it with your doctor.

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