Breast pain (mastalgia) — a common complaint among women — can include breast tenderness, sharp burning pain or tightness in your breast tissue. The pain may be constant or it may occur only occasionally.
Breast pain can range from mild to severe. It may occur:
Just a few days a month, in the two to three days leading up to your period. This normal, mild-to-moderate pain affects both breasts.
A week or longer each month, starting before your period and sometimes continuing through your menstrual cycle. The pain may be moderate or severe, and affects both breasts.
Throughout the month, not related to your menstrual cycle.
Postmenopausal women sometimes have breast pain, but breast pain is more common in younger women who haven’t completed menopause.
Most times, breast pain signals a noncancerous (benign) breast condition and rarely indicates breast cancer. Still, unexplained breast pain that doesn’t go away after one or two menstrual cycles or that persists after menopause needs to be evaluated by your doctor.
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Most cases of breast pain are classified as either cyclic or noncyclic. Each type of breast pain has distinct characteristics.
Breast pain characteristics
Cyclic breast pain Noncyclic breast pain
Clearly related to the menstrual cycle Unrelated to the menstrual cycle
Described as dull, heavy or aching Described as tight, burning or sore
Often accompanied by breast swelling or lumpiness Constant or intermittent
Usually affects both breasts, particularly the upper, outer portions, and can radiate to the underarm Usually affects one breast, in a localized area, but may spread more diffusely across the breast
Intensifies during the two weeks leading up to the start of your period, then eases up afterward Most likely to affect women after menopause
More likely to affect women in their 20s and 30s before menopause as well as women in their 40s who are transitioning to menopause
Extramammary breast pain
The term “extramammary” means “outside the breast.” Extramammary breast pain feels like it starts in the breast tissue, but its source is actually somewhere else. Pulling a muscle in your chest, for example, can cause pain in your chest wall or rib cage that spreads (radiates) to your breast.
When to see a doctor
Make an appointment with your doctor if breast pain:
Continues daily for more than a couple of weeks
Occurs in one specific area of your breast
Seems to be getting worse over time
Interferes with daily activities
Although breast cancer risk is low in women whose main symptom is breast pain, if your doctor recommends an evaluation, it’s important to follow through.
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Sometimes, it’s not possible to identify the exact cause of breast pain. Contributing factors may include one or more of the following:
Reproductive hormones. Cyclic breast pain appears to have a strong link to hormones and your menstrual cycle. Cyclic breast pain often decreases or disappears with pregnancy or menopause.
Breast structure. Noncyclic breast pain often results from changes that occur in the milk ducts or milk glands. This can result in the development of breast cysts. Breast trauma, prior breast surgery or other factors localized to the breast can lead to breast pain. Breast pain may also start outside the breast — in the chest wall, muscles, joints or heart, for example — and radiate to the breast.
Fatty acid imbalance. An imbalance of fatty acids within the cells may affect the sensitivity of breast tissue to circulating hormones.
Medication use. Certain hormonal medications, including some infertility treatments and oral birth control pills, may be associated with breast pain. Also, breast tenderness is a possible side effect of estrogen and progesterone hormone therapies that are used after menopause. Breast pain may be associated with certain antidepressants, including selective serotonin reuptake inhibitor (SSRI) antidepressants.
Breast size. Women with large breasts may have noncyclic breast pain related to the size of their breasts. Neck, shoulder and back pain may accompany breast pain due to large breasts.
Breast surgery. Breast pain associated with breast surgery and scar formation can sometimes linger after incisions have healed.