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 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 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 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.
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.
For many, the first thought that comes to mind when one of these pains occurs is, "Do I have breast cancer?"
"Pain is not a common indication of breast cancer. It's very rare," said Jennifer Crozier, MD, medical oncologist with Baptist MD Anderson Cancer Center. "However, if the pain is accompanied by additional symptoms, you should contact your PCP or OB/GYN, who may order more tests."
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
"I encourage my patients to do their own breast exams on a monthly basis, and keep their breast imaging up to date with annual mammograms starting at age 40. If you are concerned, contact your doctor," said Dr. Crozier.
"The most common first-line treatment for breast pain is conservative and includes physical support, over-the-counter pain relievers such as ibuprofen or acetaminophen, and manipulation of hormone-based medications for those who take them," said Dr. Damidi. "But if the pain becomes more frequent, is ongoing, or is accompanied by other symptoms, call your doctor. If the pain is accompanied by lightheadedness, nausea, severe headache or difficulty breathing, call 911."