
By Vicki MacLean, N.P.
Melrose & Wakefield – Women’s Health – Breast Surgery

Breast pain is common in women of all ages.
Tingling, burning, zinging, tender — these are just some of the words my patients use to describe breast pain, a common condition in women of all ages.
By the time they come to see me in my Melrose office, most women have had breast pain for a month or two. They may have seen their primary care doctors and not gotten help for the problem. And they may be concerned that their pain is a sign of something serious, like breast cancer.
This sort of concern is natural, and it’s a sign that you care about your health. But let me reassure you: Breast pain is rarely associated with breast cancer.
It’s still important that you come in and get checked out when you have breast pain, though. Your doctor or a nurse practitioner like me can make sure your pain isn’t a symptom of a serious condition. If it’s not, we’ll work with you to find what else may be causing your breast pain.
Potential reason No. 1 for breast pain: Cyclical breast pain
One of the most common causes of breast pain is changes in your hormone levels. Most hormone-related breast pain is tied to a woman’s menstrual cycle. This is cyclical mastalgia, or cyclical breast pain.
Some of the different hormone-related causes of cyclical breast pain include:
- Menopause
- Pregnancy (especially in the first trimester or in women who are pregnant at a young age)
- Premenstrual syndrome (PMS) and menstrual cycle
- Puberty
Potential reason No. 2 for breast pain: Noncyclical breast pain
Breast pain that’s not related to your hormone levels is noncyclical mastalgia, or noncyclical breast pain. This type of breast pain can be harder to diagnose. It could be related to the structure of your breasts, particularly if you have heavy or large breasts. Traumatic injury to the breasts or a breast cyst also may cause breast pain. An imbalance of fatty acids in your diet can contribute to breast pain, because your breasts are made up of breast tissue and fat.
Sometimes the pain isn’t actually in your breasts — it’s in your chest wall, which protects your heart and lungs. Because your chest wall is so close to your breasts, problems in your chest wall like costochondritis (an infection of the cartilage connecting your ribs to your breastbone) can feel like breast pain.
Breast pain also can be linked to pregnancy, especially in the first trimester or in women who are pregnant at a young age. After birth, women can experience pain if a milk duct doesn’t drain properly and becomes infected. This condition is called breastfeeding mastitis. About 10 percent of U.S. mothers who breastfeed have breastfeeding mastitis at some point, and it can become serious if it’s not treated.
Some medications for other conditions can cause breast pain. These include medications for:
- Anemia
- Birth control
- Glaucoma
- Heart problems
- High blood pressure
- Mental disorders
- Osteoporosis
People used to think breast pain was caused by getting too much caffeine in the food or drinks they had, like coffee, tea, or chocolate. We’ve moved away from that assumption, as it’s never been proven.
Symptoms of other breast problems
Most breast pain is nothing to be worried about. But you should still get checked out by your doctor or another health professional if you have breast pain. We don’t want you to ignore potential signs of breast cancer or another serious problem.
Make sure you perform monthly breast self-exams. These are extremely important to catch breast cancer as early as possible. Pay close attention if you notice any of the following during your exams:
- Any lumps in your breast
- Changes in how your breast’s skin looks or feels
- Changes in the size or shape of your breast
- Clear or bloody nipple discharge
- Lumps or thick areas in or near your breast or underarm
- Tender nipple
Of course, you should get regular mammograms as your doctor recommends. We recommend that all women who are not at high risk for breast cancer start having annual mammograms at age 40. You might need to have mammograms earlier or more often based on your personal and family health history.
Treatment options for breast pain
When women come to see me for breast pain, one of the first things I recommend is to get properly fitted for their bras by a trained expert. Wearing the wrong size supports your breasts less, which can cause pain.
We also can take a look at your medications to see if you’re taking one known to contribute to breast pain. We may need to adjust your dose or have you try a different medication.
Many times, breast pain goes away completely or gets better on its own. If it doesn’t, over-the-counter pain medications can be very effective in treating breast pain. I recommend women take ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs), particularly for cyclical breast pain that only comes around at certain times of the month. Hot or cold compresses can help with the pain as well.
Knowing the facts about breast pain can make a world of difference. We’re here for you with the education and support you need to live an active, healthy life that’s free from breast pain.
Tags: breast cancer, internal medicine, OB/GYN, women's health