Breast pain - What is it?

Breast pain is also called mastalgia. It means that you have pain rather than just tenderness in your breasts. The pain can make you uncomfortable and worried. But it's rarely a sign of a serious problem, such as breast cancer. Many women get breast pain.

It is normal for your breasts to feel tender at certain times, such as just before your period, in early pregnancy and when you are breastfeeding. This tenderness is caused by normal changes in your hormones.[1] You probably won't worry about these normal changes.

But you may worry if your breasts are painful rather than just tender, and the pain is so bad that it interferes with your life.

There are two main types of breast pain:[2]

Cyclical breast pain is linked to your periods (menstrual cycle) and is worst just before your period. It is the commonest type of breast pain.
Non-cyclical breast pain is not linked to your periods. It means that your breasts may feel painful some of the time, a lot of the time or even constantly.

You may be worried that the pain in your breasts is due to cancer. But in fact, pain on its own is not a common symptom of breast cancer. Less than 1 in 10 women with breast cancer have breast pain as their main symptom.[3] A study of women who had a mammogram (an X-ray of the breast) because they had breast pain found that they were no more likely to have cancer than those who didn't have breast pain.[4]

Most women with breast pain never know the cause of their pain. Because cyclical pain is linked with periods, some doctors think hormone imbalances may be to blame. (Hormone imbalances occur when your body produces too much or too little of one or more hormones.) But there is no evidence of this.[2] Other doctors think that cyclical pain is caused by the water retention in the breasts before your period. But again there is no proof for this.[5]

Breast pain that's not linked to periods (non-cyclical breast pain) can be caused by:

Pregnancy
A breast infection that affects breastfeeding mothers (mastitis)
A knock or blow to the breast
A cyst
A tumour
Inflammation of a vein in the breast (thrombophlebitis)
A problem in the muscles, bones or joints in your chest, such as arthritis.[3]

But usually there's no sign that anything's wrong and the cause remains a mystery.[2]

Lots of researchers have looked at whether breast pain is caused by psychological problems, such as depression and anxiety. Some of them found that women with breast pain were more likely to be depressed or anxious. But it could be that the women studied were more depressed because they had breast pain, instead of depression causing the breast pain.[3]

What type of breast pain you get seems to change with age. You are most likely to get cyclical breast pain in your twenties and thirties. Non-cyclical breast pain tends to start later, usually in your thirties or forties. But it can also start after menopause.[2]

References

Medline Plus. Breast pain. Available at http://www.nlm.nih.gov/medlineplus/ency/article/003152.htm (accessed on 3 June 2007).
Morrow M. The evaluation of common breast problems. American Family Physician. 2000; 61: 2371-2377.
Smith RL, Pruthi S, Fitzpatrick LA. Evaluation and management of breast pain. Mayo Clinic Proceedings. 2004; 79: 353-372.
Duijm LE, Guit GL, Hendriks JH, et al. Value of breast imaging in women with painful breasts: observational follow-up study. BMJ. 1998; 317: 1492-1495.
Preece PE, Richards AR, Owen GM, et al. Mastalgia and total body water. BMJ. 1975; 4: 498-500.

Glossary

hormones: Hormones are chemicals that are made in certain parts of the body. They travel through the bloodstream and have an effect on other parts of the body. For example, the female sex hormone is made in a woman's ovaries. Oestrogen has many different effects on a woman's body. For example, it makes the breasts grow at puberty and helps control periods. It is also needed to get pregnant.
menstrual cycle: The menstrual cycle is the regular monthly process that causes an egg to be released from the ovaries so that a woman can get pregnant. The menstrual cycle causes her period, the bleeding that happens if she does not get pregnant.
mammogram: A mammogram is a special kind of X-ray picture of the breast. It is used to screen women for breast cancer, as well as to investigate breast lumps.
X-ray: X-rays are pictures taken of the inside of your body. They are made by passing small amounts of radiation through your body and then onto film.
cysts: A cyst is a sac or cavity that develops under your skin and is filled with fluid. Cysts are benign, which means that they are not cancerous.
inflammation: Inflammation is when your skin or some other part of your body becomes red, swollen, hot and sore. Inflammation happens because your body is trying to protect you from germs, from something that's in your body and could harm you (like a splinter) or from things that cause allergies (these things are called allergens). Inflammation is one of the ways in which your body heals an infection or an injury.
arthritis: Arthritis is when your joints become inflamed, making them stiff and painful. There are different kinds of arthritis. Osteoarthritis is the most common type. It happens when the cartilage at the end of your bones becomes damaged and then starts to grow abnormally. Rheumatoid arthritis happens because your immune system attacks the lining of your joints.
menopause: When a woman stops having periods, it is called the menopause. This usually happens around the age of 50.

This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.