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Updated 11 February 2013

Breast pain

Breast pain (mastalgia) is common, but is not often a sign of serious disease. It is seldom a symptom of breast cancer.

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Breast pain (mastalgia) is common, but is not often a sign of serious disease. It is seldom a symptom of breast cancer.

Causes

  • Cyclic
    Women often experience discomfort or aches in their breasts about a week before or during their menstrual periods which then disappear once the period is over. This is called cyclical breast pain and is due to hormonal changes related to the menstrual period. Some women might also experience this when they first start taking birth control pills or hormone replacement therapy. Cyclical breast pain usually disappears after menopause.

  • Non-cyclic
    Non-cyclic breast pain is less predictable and occurs at any age. The pain can be described as burning or stabbing which comes and goes, and may last for some time before disappearing. The pain is often on one side only, and extends into the armpit. It may be due to heavy breasts, an ill-fitting bra, chest muscle strain, a cyst, certain medications, or stress. A warm, tender breast with redness and swelling is often a sign of mastitis, an infection of the milk ducts. Mastitis is often found with breast-feeding.

  • Other causes of breast pain may include injury or growths. Breast pain not originating in the breast includes such diverse causes as Tietze's syndrome (pain and tenderness over the ribs beneath the breasts, which may be related to excessive muscle strain), cervical radiculopathy, fractured rib, Mondor's disease (pain in the lower breast from an inflammation of a vein crossing within the breast tissue), angina, gall bladder inflammation, hiatus hernia and peptic ulcer disease.

Home Treatment

  • use a heated pad or a hot water bottle to reduce pain

  • take painkillers if necessary

  • eliminate caffeine from your diet and limit salt intake, especially before your menstrual period. Restricting sugar and alcohol intake might also help

  • take Evening Primrose oil for cyclical breast pain

  • massage your breasts with arnica oil
  • always wear a properly fitting bra, especially during exercise. Replace worn bras

  • lose weight if you’re overweight and your breasts are large

When to see a doctor

  • if pain continues for more than two days despite treatment

  • if pain is severe and prevents normal activity

  • if there are other symptoms such as fever, redness of the breast which feels warm, or a pussy discharge from the nipples

Prevention
To prevent and treat monthly breast swelling and discomfort, a change in diet may help. The doctor’s recommendations may include that a healthy weight be maintained and a balanced diet be adopted as preventive measures. Because salt can contribute to fluid retention, salt intake should be restricted close to the menstrual period.

Other substances to consider limiting are sugar and alcohol. Furthermore, doctors may suggest wearing a bra around the clock to reduce movement and lessen discomfort until the tenderness has passed.

Medication
The reassurance that no cancer is present, and pain relief with an analgesic such as aspirin or ibuprofen for periods of intense pain, is usually all the treatment that is necessary. If this is not sufficient, cyclical breast pain (cyclical mastalgia) can be treated with vitamin B6 (pyridoxine) and gamma linolenic acid (Evening Primrose oil).

If this treatment is not effective, the patient should be seen by a specialist at a breast service clinic, as further interventions may be indicated.

Reviewed by Dr Jenny Edge

 
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