Ouch, what is that?

You're cruising along in your day, enjoying the sunshine, and suddenly, out of nowhere, you feel a sharp, stabbing pain in your breast.

First thought: ouch! Next thoughts: heart attack? Breast cancer? What is that?

Deekshita Damidi, MD, family physician with Baptist Primary Care, said, "Random pain like this is common, and your first thoughts shouldn't immediately go to the worst-case scenario. There are many possible causes."

Dr. Damidi separated possible causes of breast pain into the following three categories:

Cyclical breast pain

Cyclical pain varies throughout the menstrual cycle with hormonal fluctuations in the body, which can be triggered naturally or with certain medications. This breast pain typically develops around a week before a period and can last throughout the course of your menstrual cycle. People using birth control can also experience these symptoms. 

Non-cyclical breast pain

Non-cyclical pain in the breast/chest area is sporadic, intermittent pain that comes and goes. This could be caused by fat necrosis, a benign condition that most commonly results from a past injury or from previous surgery in the area. In addition, Dr. Damidi explained, "There is research coming out about the role diet and lifestyle may play in breast pain. We recommend eating a low-fat diet, quitting smoking, and decreasing caffeine consumption to see if that eases the pain."

Extramammary pain

Extramammary pain feels like it is in or around the breast, but may actually originate from other lung or muscle-skeletal issues. There are four common examples of this type of pain:

• Stretched ligaments: Females with large breasts may experience pain due to stretching of Cooper's ligaments (the connective tissues that help give breasts their shape). They may also have associated neck, back and shoulder pain.

• Costochondritis: Inflammation in the cartilage where the rib and breastbone connect. This pain can be localized to the half of the chest closest to breastbone, and may feel tender when pressure is applied, the rib cage moves, or a person takes a deep breath. It can often occur after heavy lifting or activities that stretch the upper body.

• Mastitis: This is inflammation of breast tissue sometimes accompanied by infection, causing pain, red skin patches, swelling and tenderness. It's more common in lactating mothers but can also occur in non-lactating women.

• Pleurisy: The two large, thin tissues that separate the lungs from the chest wall (pleura) swell and become inflamed, causing them to rub against each other. This causes pain as you inhale and exhale.

Just glitches

In most cases, these quick stabs of pain are just "glitches" that come and go, lasting only one or two breaths. If the pain is ongoing or becomes more frequent, it's worth a call to your primary care physician (PCP). Be prepared to tell him or her:

• When the pain began
• How long it lasted
• How it felt
• What, if any, other symptoms you had
• How often symptoms occur

In addition to discussing your experiences, your doctor may listen to your heart and lungs, and check your blood pressure and pulse. If your physician thinks your heart may be the problem, he or she may order more testing.

Breast cancer concerns

For many, the first thought that comes to mind when one of these pains occurs is, "Do I have breast cancer?" Fortunately, pain isn't a common indication of breast cancer. However, if it's accompanied by other symptoms, you should contact your primary care physician to get it checked out.

Common symptoms of breast cancer include:

• Lumps or bumps in the breast or surrounding lymph nodes
• Inflammation of the breast, armpits or collarbone
• Changes in nipple appearance or structure, such as nipples that have turned inward
• Skin dimpling or thickening, possibly resembling an orange peel
• Nipple discharge
• Breast or nipple redness, flaking, thickening or dryness

Doctors recommend doing monthly self-exams and getting routine mammograms to help catch potential cancer early.

This story was originally published in October 2021.