Breast Cancer

Diagnosing and Treating Breast Pain

Breast Pain

Breast pain is not uncommon, but when it occurs it can be worrisome. Pain can be experienced in one breast or both breasts, in one part of the breast or the entire breast, as well as in the armpit. It can feel hot, dull, sharp, or shooting. It can be constant or intermittent. 

Breast pain affects about 70 percent of all women at some time during their lifetime; about 15 percent of women need treatment to get pain relief.

The severity of breast pain varies from woman to woman. Breast pain occurs more frequently in younger women, rather than in women that have gone through menopause.

Most of us believe that pain is a signal that something is wrong. Sometimes it is, but sometimes it is a byproduct of a natural function such as having sore or painful breasts before each monthly menstruation.

Breast pain is usually an indication of having a breast condition that is not cancerous.

About 5 percent of breast tumors will cause breast pain in early-stage cancer.

Two Main Types of Breast Pain

  • Cyclical Breast Pain: This pain is about how breast tissue reacts to changes in a woman's estrogen and progesterone hormone levels every month during her menstrual cycle. Some women’s breasts may feel swollen; they can be painful, as well as sore. They may feel lumpy to the touch. If this occurs, it usually happens a few days before a woman begins to menstruate each month and ends after her monthly menstruation. Cyclical breast pain is the most commonly reported breast pain, with 75 percent of women experiencing this kind of pain. While this type of pain is usually connected to a woman’s menstrual cycle, stress has been known to be a factor in affecting hormone levels and impacting breast pain.
  • Non-cyclical Breast Pain: This pain occurs much less often than cyclical breast pain. It is not affected by a woman's monthly menstrual cycle. Women with non-cyclical breast pain feel it in one area of the breast. An injury or breast trauma or undergoing a biopsy may result in a woman having this type of pain. Physical exertion, such as heavy lifting may also cause an episode of non-cyclical breast pain.

Causes of Breast Pain

It isn’t always possible to identify the exact cause of breast pain; some known causes include but are not limited to:

  • Hormones: Breast pain seems to be  strongly linked to a woman’s hormones and her menstrual cycle. Pain is known to markedly decrease or disappear entirely as a result being pregnant or going through menopause.
  • The structure of the breast: Pain often begins as a result of changes in the milk ducts or glands. Cysts can develop. An earlier breast surgery, or a trauma to the breast can cause breast pain.
  • Medications: Some medications, such as those that treat infertility and oral birth control pills as well as hormonal medications, may cause breast pain.
  • A woman’s breast size: Large breasts may result in breast pain and possibly cause additional pain in a woman’s neck, shoulder, and back.
  • Breast surgery: Breast surgery and scar tissue formation may cause ongoing breast pain.

Breast Evaluation

It is time to see a physician and have your breast evaluated when you experience pain in one area of your breast, which seems to be worsening; it interferes with your normal activities; and has lasted for more than a few weeks.

Although breast cancer risk is low in women whose main symptom is breast pain, if your physician recommends an evaluation, it's important to have one.

During the evaluation, the physician will examine you and perform a clinical breast exam to check for any physical changes in your breast, such as a lump or thickening, He may refer you for additional tests including:

  • a mammogram: If your physician feels a lump or thickening during your clinical exam, he will refer you for a diagnostic mammogram, an x-ray exam to evaluate the area that is of concern.
  • an Ultrasound. An ultrasound exam uses sound waves to make images of your breasts. This exam may be necessary to focus on the source of your pain. An ultrasound may be done, even if your mammogram is considered to be normal.
  • A breast biopsy. A mammogram and an ultrasound may not be conclusive enough for your physician to make a diagnosis; he may need you to have a breast biopsy performed. A small sample of your breast tissue will be removed from the site of your pain; the sample will be examined by a pathologist and a report on findings sent to your physician.

Breast Pain Treatment

Breast pain often doesn’t require any treatment; it may go away over time without any intervention.

If your pain requires an intervention, your physician may suggest that you work on eliminating anything that might be a cause by:

  • adjusting your birth control pills on the advice of your physician
  • stopping the use of ​menopausal hormone therapy
  • taking a prescription medication from your physician to treat pain and tenderness

Breast Pain Following Breast Cancer Surgery

For most women who have had breast cancer surgery in the past, getting a new pain in the breast area where a cancer was removed, or where their breast used to be, can set off the fear of recurrence. In the months and even years after breast surgery, some women will develop chronic pain that has nothing to do with recurrence.

Post-mastectomy Pain Syndrome (PMPS)

Following breast cancer surgery, many women report nerve (neuropathic) pain that they experience in the chest wall, the armpit, and in the arm. The pain doesn’t disappear over time. This pain is referred to as post-mastectomy pain syndrome (PMPS) as it was initially described as pain experienced by women who had mastectomies. It is also reported by women following a breast-conserving surgery. It is estimated that 20 percent to 30 percent of women report symptoms of PMPS following breast cancer surgery.

While the exact causes of PMPS are not certain, present day thinking is that PMPS may be linked to damage to the nerves in the armpit and chest that occurred during breast cancer surgery.

Pain from PMPS can result in you favoring your arm and not using it as it should be used. Without medical intervention, you may lose the ability to use your arm normally, over time, if you continue to restrict its use to avoid pain.

If you have PMPS, the best way to proceed with pain control is to work with your physician or, if needed,  see a pain management specialist to find the right medication. Not all medications work well with nerve pain.

Another cause of post breast cancer pain is lymphedema, which is a condition that may occur as a result of removing or damaging lymph nodes during breast cancer surgery. Pain is a result of swelling that pinches nerves, or from damaged nerves as a result of swelling being severe, or lasting a long time. 

It is important for women diagnosed with lymphedema to have treatments that can limit the extent of their swelling, as well as the length of time of the swelling. Women with this condition are advised to watch their diet and exercise regularly. They need to avoid wearing clothes or jewelry that is a tight fit.

A Word From Verywell

Pain due to a breast cancer surgery can occur for years; the rare, brief, pinching feeling within remaining breast tissue may come on suddenly and leave as quickly as it came, not to occur again for some time.

Breast pain, whatever its cause, needs to be medically evaluated. In many cases, it can be reduced or alleviated. Pain can be physically wearing and emotionally draining. When we don’t know its cause, it can become an ongoing anxiety. Don't suffer; get medical attention.


American Cancer Society. Breast Biopsy. Last Medical Review: 07/21/2014 Revised:10/20/2015 Diagnostic vs. screening mammograms? Last modified on September 17, 2012

National Institutes of Health. National Breast Cancer Foundation. Breast PainUpdated 11/04/2014

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