Breast pain

Causes of breast pain 

Breast pain may be felt as heaviness or soreness, or a stabbing or burning sensation. It can be felt in any part of the breast and may spread to nearby areas too.

Many women worry that breast pain may be a sign of a serious condition such as breast cancer. However, pain by itself is rarely a sign of cancer.

Causes of breast pain include:

• period-related hormone changes 
• pregnancy
• breast lumps
• mastitis
• an abscess / infection
• an injury
• breastfeeding problems
• medication
• breast cancer (although pain by itself is rare)

When to see your GP 

It's a good idea to see your GP for advice if:

• the pain is particularly severe and stops you from doing your normal activities
• the pain gets worse or doesn't go away
• you have symptoms of an infection, such as swelling, redness or warmth in your breast, or a fever
• you have symptoms of breast cancer

Your GP will examine your breasts and ask about your symptoms. This is to try to find out what’s causing your pain.

If they're not sure about the cause, they may refer you to a breast clinic for tests such as an X-ray or ultrasound scan.

Being referred for further tests can be scary. However, this is routinely done and it doesn't necessarily mean your GP thinks you have breast cancer. Most women who have these tests don't have cancer.

Period-related breast pain (cyclical breast pain) 

Breast pain is commonly caused by changes in hormone levels that occur during the menstrual cycle. This is known as cyclical breast pain.

Hormone changes may be the cause of your pain if:

• you still have periods (you haven't yet reached the menopause) or are having hormone replacement therapy (HRT)
• the pain starts around the same time every month (usually in the two weeks before the start of your period) and improves at the end of your period
• both breasts are affected (although occasionally only one may be)

Wearing a supportive bra during the day, at night and while exercising can help reduce the pain. Over-the-counter painkillers such as paracetamol or ibuprofen, and nonsteroidal anti-inflammatory gels that you rub into your skin can also help reduce the pain.

You should speak to your pharmacist for more advice.

See your GP if the pain is difficult to control. They may refer you to a specialist who can prescribe medication to control your hormone levels.

Pregnancy 

Sore, tender breasts are sometimes an early sign of pregnancy.

This may be the cause of your pain if you also have other signs of pregnancy, such as:

• missing your last period 
• feeling sick and tired
• needing to pee more often than usual
• strange tastes, smells and cravings

You can do a home pregnancy test if you think there's a chance you might be pregnant.

Breast lumps 

There are many types of breast lump, some of which may be painful.

These include:

• a fibroadenoma – a smooth, firm lump that can move around the breast; these are particularly common in young women
• a breast cyst – a fluid-filled sac that develops in the breast tissue; these are most common in women over 35
• mastitis and breast abscesses

Most breast lumps are harmless. However, they should all be checked by a GP just in case they're a sign of something serious, such as cancer.

It is common for most women to be referred by their GP for further investigation.

This is routinely done and it doesn't necessarily mean your GP thinks you have breast cancer. Most women who have these tests don't have cancer.

Treatment depends on the type of lump you have. Some lumps may not need any treatment.

Mastitis 

Mastitis is where the breast tissue becomes inflamed (red and swollen) and painful. It can be caused by a bacterial infection or breastfeeding.

As well as breast pain, mastitis can cause:

• a red, swollen area on your breast that may feel hot to touch
• breast tenderness
• a lump or area of hardness on your breast
• nipple discharge
• flu-like symptoms, such as aches, a high temperature (fever) and chills

See your GP if you think you might have mastitis, as it could lead to an abscess if not treated. Your GP may prescribe antibiotics to treat any infection.

An abscess 

A breast abscess is a collection of pus in the breast. It's usually caused by a bacterial infection such as mastitis.

Breast abscesses are painful, swollen lumps that may also:

• be red and feel hot
• cause the surrounding skin to swell
• cause a fever

See your GP if you think you have a breast abscess. You may need antibiotics to treat the infection and a minor procedure to drain the pus.

An injury 

Breast pain can be caused by an injury to nearby muscles, joints or bones. Sometimes pain can spread along the nerves in your chest so that it feels like it's in your breast.

For example, breast pain can be caused by:

• a pulled muscle in your chest
• a neck, shoulder or back injury
• costochondritis – inflammation of the area where your ribs join to your breastbone
• previous breast surgery

An injury may be the cause of your pain if it's only felt in one spot and it gets worse when you move around.

Wearing a supportive bra and taking painkillers can help relieve the pain while the injury heals. Occasionally, injections of steroid medication and local anaesthetic may be needed if the pain persists.

Breastfeeding problems 

If you're breastfeeding, your pain may be the result of:

• breast engorgement – where your breasts become overly full
• a blocked milk duct
• mastitis – pain and swelling caused by blocked milk duct, which may become infected with bacteria
• a breast abscess – a painful build-up of pus that can occur if mastitis isn't treated
• thrush – a fungal infection that can occur if your nipples are cracked or damaged

Speak to your midwife or health visitor if you think your pain could be related to breastfeeding. They can check your feeding technique and recommend ways to reduce the pain.

Medication 

Occasionally, breast pain can be a side effect of a medication.

Medicines that can cause breast pain include some types of:

• contraceptives – most hormonal contraceptives can cause breast tenderness, including contraceptive pills, patches, injections and the intrauterine system (IUS)
• antidepressants
• antipsychotics (used to treat some mental health conditions)

Check the leaflet that comes with any medication you're taking to see if breast pain or tenderness is listed as a possible side effect.

Contact your GP if the pain is particularly troublesome, as you may need to switch medicine.

Breast cancer 

Pain by itself is rarely a sign of breast cancer.

It's more likely to be a sign of cancer if you also have other symptoms of breast cancer, such as:

• a hard lump in your breast that doesn't move around
• a change in the size or shape of one or both breasts
• nipple discharge, which may be streaked with blood
• dimpling on the skin of your breasts
• a rash on or around your nipple
• your nipple becoming sunken into your breast

See your GP if you're worried you could have breast cancer. They will examine your breasts and may refer you for further tests.

More useful links

• How to use your health services
• Breast screening
• Breastfeeding