Breast pain is one of the most common breast problems. Pain can range from mild to severe, and sometimes requires treatment. It may affect one or both breasts, or can radiate into the armpit. In general, breast pain is not a sign of cancer.

Types of breast pain

There are 3 types of breast pain: pain related to the menstrual cycle, pain not affected by the menstrual cycle, and pain originating in the chest that feels as though it is in the breast.

Breast pain related to the menstrual cycle: This pattern of pain seems to be related to changes in hormone levels. Women usually feel increased breast pain before their menstrual period and a reduction in pain afterwards. Pain can be present with or without accompanying lumpiness of the breast due to a fibrocystic condition. Because stress can also affect hormone levels, this may influence breast pain.

Breast pain not affected by the menstrual cycle: This type of breast pain can show up in either premenopausal or postmenopausal women. It may be felt in one specific area of the breast and is sometimes called "target zone" breast pain. It may occur in one or both breasts. In some women it lasts for as long as one or 2 years, then disappears.

Sometimes this pain is caused by trauma to the breast, or it will center on the site of a previous breast biopsy. In most cases, doctors don't know the cause of this continuous type of pain. Although breast cancer is very rare in women with this form of pain, it still must be ruled out with tests.

Breast pain originating in the chest: This category is not really a form of breast pain, but is actually a type of chest pain that feels as though it is coming from the breast. This type of arthritic pain originates in the middle of the chest and is called costochondritis. It occurs where the ribs and breastbone connect. Poor posture and the aging process can contribute to increased stress on these joints, resulting in pain. This pain does not change with the menstrual cycle.

Evaluating breast pain

Physicians evaluate breast pain by identifying its location and assessing its pattern, including its strength and how long the pain lasts. It is also important to know how much the pain interferes with your daily activities. A doctor's assessment will include your medical history, physical exam, and, in some cases, a mammogram (X-ray of the breast) if you're over 50 years old (or younger if you have an increased risk of breast cancer) or an ultrasound exam. Surgical biopsy is not usually recommended. For most women with breast pain, the most important reason for a careful evaluation is to gain reassurance that the pain is not due to breast cancer.

Treating breast pain

Treatment can include medication, lifestyle changes, and diet changes.

Medication: Medication for pain relief is generally needed only in cases of severe, disabling pain. If you have costochondritis, acetylsalicylic acid (ASA) or anti-inflammatory medications may be prescribed. Since pain relief medication can have unwanted side effects, it's a good idea to incorporate various lifestyle changes that can help reduce or eliminate the pain experienced by many women.

Lifestyle changes: Wearing a good, supportive bra reduces excess movement of the breasts, which can contribute to the pain. Also, learning how to relax the body fully can reduce stress-related hormones, which may affect the breasts. Many women have found meditation and visualization helpful in quieting the mind. An exercise program may be beneficial, as well.

Diet changes: Although evidence of reduced breast pain from dietary change is not conclusive, many women have found it helpful to:

  • eliminate caffeine (found in coffee, tea, cola drinks, and chocolate)
  • reduce dietary fat by reducing intake of baked goods, meat, and high-fat dairy products and increasing fruit, vegetables, and grains
  • reduce salt intake
  • take vitamin supplements - talk to your doctor or a nutritionist about recommended doses (vitamin E, vitamin B6, and evening primrose oil)
Urve Kuusk, MD 
in association with the MediResource Clinical Team