Breast pain

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

Some women who have pain in one or both breasts may fear breast cancer. However, breast pain is not a common symptom of cancer.

Some breast tenderness is normal. The discomfort may be caused by hormone changes from:

• 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
• Puberty in both girls and boys

Soon after having a baby, a woman's 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 a common cause of breast pain. Fibrocystic breast tissue contains lumps or cysts that tend to be more tender just before your menstrual period.

Certain medicines may also cause breast pain, including:

• Oxymetholone
• Chlorpromazine
• Water pills (diuretics)
• Digitalis preparations
• Methyldopa
• Spironolactone

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

If you have painful breasts, the following may help:

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

There is no good evidence to show that reducing the amount of fat, caffeine, or chocolate in your diet helps reduce breast pain. Vitamin E, thiamine, magnesium, and evening primrose oil are not harmful, but most studies have not shown any benefit. Talk to your provider before starting any medicine or supplement.

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

Call your 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 pain that does not go away after your menstrual period
• Persistent, unexplained breast pain
• Signs of a breast infection, including redness, pus, or fever

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

Your provider may arrange a follow-up visit if your symptoms have not gone away in a given period of time. You may be referred to a specialist.

Hunt KK, Mittendorf EA. Diseases of the breast. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 34.

Jacobs L, Hardin R. Management of benign breast disease. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 11th ed. Philadelphia, PA: Elsevier Saunders; 2014:565-567.

Olawaiye AB, Alvero R. Mastodynia. In: Ferri FF, ed. Ferri's Clinical Advisor 2017. Philadelphia, PA: Elsevier; 2017:767-767.

Sandadi S, Rock DT, Orr JW, Valea FA. Breast diseases: detection, management, and surveillance of breast disease. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 15.