Breast Pain: 12 Reasons Your Breasts Hurt

Aching breasts are often nothing to worry about. Everything from your period to your workouts to the medications you are on could be causing your pain. Here's what you should know–and when to talk to a healthcare provider.

If your breasts hurt, your mind may immediately jump to the "C" word, cancer. But the chances are slim that breast pain is breast cancer.

"Breast pain alone is rarely, rarely associated with cancer," Monique Swain, MD, an obstetrician and gynecologist in the breast division at Henry Ford Health System in Detroit, said.

There are two types of breast pain:

• Cyclical pain is associated with your period and most often affects both breasts, although it may affect only one.
• Noncyclical pain is due to any other reason and doesn't follow a monthly pattern—it may always be present. It can affect one or both breasts, all of the breasts, or part of it, and is often felt in a specific location.

However, it's also important to talk to a healthcare provider to rule out possible serious reasons for breast pain.

You should also contact a healthcare provider if you have other symptoms, including a lump unrelated to your period, discharge from your nipple, or signs of infection like redness, swelling, and warmth.

Period-caused Breast Pain

"Hormonal breast pain can happen to any woman that is menstruating," Dr. Swain said. "It doesn't matter if they're 14 or 44; as long as they're still menstruating, they have the risk of having cyclic breast pain."

According to Johns Hopkins Health, cyclical breast pain, or period-related breast soreness, is the most common reason for breast pain. The pain may be barely noticeable or so severe that bras and tighter clothing become bothersome.

For some individuals, it's enough to know that the pain will go away, usually in a week to 10 days. Other individuals may seek relief through over-the-counter or prescription pain medications.

For example, there is a Food and Drug Administration (FDA) approved prescription drug for breast pain called danazol, but it can have serious side effects.

A study published in the journal BMJ Clinical Evidence reviewed numerous interventions for breast pain, including the prescription medications danazol, tamoxifen, and goserelin injections. However, all of these medications may cause significant side effects.

The study also explained that topical non-steroidal anti-inflammatory drugs (NSAIDs) should be the first line of medical treatment. This is due to a better benefit versus risk ratio than the other medications available to treat cyclical breast pain.

Tweaking your diet may also limit menstrual breast pain: Eating more flaxseed might help, as can sticking to a low-fat diet that's rich in complex carbs, Dr. Swain said.

Breast Pain During Pregnancy

The first trimester of pregnancy brings a swirl of hormones that can cause mood changes, food cravings, fatigue, nausea, vomiting, and breast pain.

Breast tissue grows, milk ducts fill, and nipples become sensitive, Jennifer Wu, MD, an obstetrician and gynecologist at Women's Health of Manhattan in New York City, said.

The pain is due to "acute hormonal changes," Dr. Wu said, including human chorionic gonadotropin (HCG). "You're going from zero HCG hormone all the way up."

Also, breast pain may vary and change throughout pregnancy. For example, during the second trimester, there may be less or no breast pain. However, breast pain may return in the third trimester.

You're Nursing

Your baby's mouth at your breast is natural but can also cause discomfort and pain. For example, you may feel pain when the baby first latches onto your nipple or if their mouth isn't positioned correctly.

Many individuals who choose to nurse experience challenges. One of these challenges is pain, especially nipple pain. Your breasts might also hurt when you're nursing if you have blocked milk ducts. If you do, "the milk ducts are very swollen," Dr. Wu said. "They may get clogged and backed up."

You may also have pain if you develop mastitis. Mastitis is an infection in the breast and one of the most common complications in nursing females, per ACOG.

ACOG explained other common symptoms of mastitis include a swollen and painful area of the breast along with a fever, chills, and aching.

Contact a healthcare provider if the pain in your breast, while you're nursing, lasts more than a couple of days, or sooner if you're concerned.

Most hospitals and healthcare groups also offer lactation services to help you get your baby latched appropriately and evaluate the causes of breast and nipple pain.

You Take Certain Meds

Medications that affect your hormones may be one culprit of breast pain. For example, according to the Office on Women's Health, one of the side effects of birth control is breast tenderness.

But other types of medications can cause breast pain as a side effect too. Medline Plus lists many of these medications, including but not limited to:

• Diuretics (also known as water pills)
• Chlorpromazine (used to treat mental illness, among other indications)
• A heart medication called digitalis

The bottom line—talk to a healthcare provider if you think medication may be causing your breast pain. There could be a substitute treatment for you to try instead.

Breast Cyst and Breast Pain

According to Johns Hopkins Medicine, breast cysts are most common in females between the ages of 35 and 50.

"A cyst is a plugged or obstructed breast gland with fluid accumulation behind the obstruction," Therese Bevers, MD, medical director of the Cancer Prevention Center at the University of Texas MD Anderson Cancer Center in Houston, said.

Cysts are generally harmless, but they can be painful. "If [the fluid] is distending the walls of that duct, stretching the tissue, it can become sensitive and very painful," Dr. Bevers said.

Treatment depends on your age, how big the breast cysts are, and if they hurt or not. You may decide to do nothing, or a healthcare provider may drain the fluid to ease the pain.

You Had Surgery

Any trauma to the breast can cause pain, including surgery, a biopsy, an elbow to the chest, or a seatbelt injury. These are all forms of noncyclical pain.

You'd probably know why you hurt immediately if you sustained an injury. But, hopefully, it's not so severe that the pain sticks around.

After the fact, sometimes, as long as two years later, an injury can cause fat necrosis, which appears as a thickening or lumpiness in the breast.

According to a systematic review published in 2019 in the journal Lipids in Health and Disease, fat necrosis of the breast can be caused either by previous trauma or an unknown cause. Fat necrosis of the breast can also cause pain.

By the time fat necrosis develops, you may not remember the original injury. Fat necrosis isn't dangerous and doesn't need to be treated. However, according to the study, it can appear similar to breast cancer.

Reach out to a healthcare provider for further advice if you notice a lump or changes to your breasts.

You Have Shingles

Shingles is a later-in-life manifestation of the same virus that causes chickenpox. Anyone who had chickenpox when they were younger can develop shingles.

According to Harvard Health Publishing, your breasts may hurt if the rash caused by the infection develops on the breast.

"I'll find a rash on the side of the breast, and sometimes the patient didn't even know it was there," Dr. Swain said. The rash can be painful, with itchy blisters that burst. You might also have a fever, headache, and sensitivity to light.

The CDC explained shingles usually last from two to four weeks, and there's no cure (there is a shingles vaccine).

However, antiviral medications can help you get better faster. Your healthcare provider may also prescribe painkillers to help with the pain.

You Strained a Muscle

A strain to your chest muscles after a challenging workout might feel like breast pain even though the injury is elsewhere.

According to Johns Hopkins Medicine, over-the-counter pain relievers may be enough to ease muscular pain. A healthcare provider may recommend something stronger if the pain is more severe.

Muscle problems are just one type of "extramammary" pain or pain that originates outside of the breast tissue but is felt in the breast. Other causes of extramammary pain include stomach and gallbladder disease.

Of course, don't overlook any chest pain (including in your breasts) that could signify a heart attack. Heart attack symptoms may include:

• Chest pain
• Feeling lightheaded or weak
• Pain in your neck, jaw, or back
• Pain in your arms or shoulders
• Shortness of breath

Other symptoms, more likely in females, include tiredness, nausea, and vomiting.

Call 911 right away if you think you're having a heart attack.

You Have Big Breasts

Large breasts can cause enough strain that they stretch breast ligaments and tissues. This can cause pain in your breasts and possibly in your back, neck, and shoulders.

"Women with larger breasts can have breast pain, but typically those women will come in with other concerns too, like back pain and shoulder pain," Dr. Swain said. Finding the right, supportive bra may help alleviate this type of pain. You can also try over-the-counter painkillers. For intense pain, a healthcare provider may prescribe you medication to help.

In extreme cases, some females opt for breast reduction surgery.

You're Wearing the Wrong Bra

An ill-fitting bra can cause pain even if you don't have big breasts. "The majority of the time, women are wearing bras that are too big," Dr. Swain said, and a too-big bra isn't going to support you very well.

A too-small bra isn't much better since it might feel restrictive and uncomfortable. If underwire makes your breast pain worse, pick one with more cushioning at the base of the breast, Dr. Swain said.

Dr. Swain also recommended getting fitted at a department or specialty store where you can buy a well-made bra. "Specific brands are more supportive than others," Dr. Swain said.

You're Nearing Menopause

Females approaching menopause might experience a painful widening and thickening of the milk duct called duct ectasia. While it is most common in individuals nearing menopause, it can also happen at other ages.

Duct ectasia can cause fluid buildup from the duct being blocked. "It can cause pain in the nipple and areola," Dr. Swain said.

Per the ACS, other symptoms, while less common, can include a sticky and thick discharge from the nipple, a nipple that is turned inward, or a lump. And some females have no symptoms of duct ectasia.

If you have any of these symptoms, it is important to talk to your healthcare provider to rule out other, more serious causes.

The condition usually takes care of itself over time (warm compresses can help in the meantime) and doesn't change your risk of breast cancer. However, if the pain doesn't go away, a healthcare provider may recommend removing the duct with surgery.

You Could Have Inflammatory Breast Cancer

This is one of the few times breast cancer may involve pain. Inflammatory breast cancer is a rare and aggressive form of the disease that accounts for about 1% to 5% of all breast cancers.

In people with inflammatory breast cancer, the cancer cells obstruct the lymph vessels in the skin of the breast, causing redness, swelling, and inflammation over about a third or more of the breast.

The skin may also look pitted due to the buildup of lymph fluid. Sometimes you might feel a lump, but usually, not.

The ACS notes that inflammatory breast cancer is more common in younger females, Black females, and females who have clinical obesity—and it's usually treated with surgery, chemo, and/or radiation. In addition, targeted therapies are sometimes used.

Many of these symptoms could also be from an infection or injury. Try not to panic, but do get checked out by a healthcare provider.