Breast Pain, Cyclical
Breast pain, also called mastalgia, affects most women at some point.
The 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, but pain by itself is rarely a sign of cancer.
This page summarises some of the possible causes of breast pain and offers advice on when to see your GP.
Causes of breast pain
Causes of breast pain include:
- period-related hormone changes
- breast lumps
- an abscess
- an injury
- breastfeeding problems
- breast cancer (although pain by itself is rare)
Click on these links for more information about these causes.
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 one to three days 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, as can over-the-counter painkillers such as paracetamol or ibuprofen, and gels that you rub into your skin such as ibuprofen or diclofenac.
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, such as danazol, tamoxifen or goserelin.
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.
There are many types of breast lump, some of which may be painful
- 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, but they should be checked by a GP just in case they're a sign of something serious, such as cancer.
Treatment depends on the type of lump you have. Some lumps may not need any treatment. Read more about treatments for breast lumps.
In addition to 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
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 with a needle. Read more about how breast abscesses are treated.
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.
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.
Read more about breast pain and breastfeeding.
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, such as sertraline
- antipsychotics (used to treat some mental health conditions), such as haloperidol
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.
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. Read more about how breast cancer is diagnosed.
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 to try to determine what's causing your pain.
Being referred for further tests can be scary, but 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.