Breast Pain: Tenderness, Causes, Diagnosis & Treatment

Types of Breast Pain

Different types of breast pain can help in identifying the underlying causes and seeking appropriate treatment. Many people wonder why my breast is paining or why breast pain occurs, especially when it affects daily comfort. Below are the primary types of breast pain:

Cyclic Breast Pain

• Hormonal Changes: Often linked to the menstrual cycle, cyclic breast pain is influenced by hormonal fluctuations, particularly estrogen and progesterone. This is a common reason for breast pain before period and may also be noticed as breast pain pregnancy related changes.
• Timing: This pain typically occurs in the days leading up to menstruation and subsides once the period begins.
• Symptoms: It is usually described as a dull, heavy, or aching pain and often affects both breasts, particularly the upper outer areas.
• Age Group: Commonly affects women in their 20s to 40s.

Non-Cyclic Breast Pain

• Unrelated to Menstrual Cycle: Non-cyclic breast pain is not connected to the menstrual cycle and can occur at any time.
• Localized Pain: This type of pain is often described as a sharp, burning, or stabbing sensation and may be localized to one specific area of the breast.
• Causes: Potential breast pain causes include injury, breast cysts, fibroadenomas, and sometimes more serious conditions like breast cancer.

Extramammary Breast Pain

• Originates Outside the Breast: Despite being felt in the breast, extramammary pain originates from sources outside the breast, such as the chest wall, muscles, joints, or heart. This may present as side breast pain or left side breast pain.
• Common Sources: Conditions like costochondritis (inflammation of the rib cartilage), or even referred pain from angina or a heart attack can cause this type of breast pain.
• Diagnosis: Proper diagnosis often requires a thorough examination and sometimes imaging tests to identify the exact source of pain.

Mastitis-Related Breast Pain

• Infection: Mastitis is an infection of breast tissue that results in swelling, redness, and intense pain, often accompanied by fever and flu-like symptoms. It is also one of the common nipple pain reasons.
• Common in Breastfeeding: This condition is more common in breastfeeding women due to blocked milk ducts or bacteria entering the breast.
• Treatment: Treatment typically includes antibiotics and measures to relieve pain and inflammation.

Causes of Breast Pain

Common breast pain reasons and breast pain causes include:

• Hormonal Changes: Fluctuations in estrogen and progesterone during the menstrual cycle, pregnancy, or menopause.
• Menstrual Cycle: Cyclical pain often occurs before periods due to hormonal shifts.
• Pregnancy: Breast tenderness is common in early pregnancy due to hormonal changes and breast growth.
• Breastfeeding Issues: Engorgement, blocked ducts, or mastitis can cause pain, swelling, and tenderness.
• Breast Cysts or Fibrocystic Changes: Fluid-filled sacs or lumpy breast tissue can cause discomfort, especially before periods.
• Injury or Trauma: A blow or strain to the breast or chest muscles can lead to localized pain.
• Medications: Certain drugs, such as hormone therapy, oral contraceptives, and antidepressants, may cause breast pain.
• Ill-Fitting Bras: Lack of proper support can strain breast tissue and cause pain.
• Large Breasts: Can contribute to neck, shoulder, and breast discomfort.
• Infections (Mastitis): Often occurs in breastfeeding women; symptoms include pain, redness, and warmth.
• Stress: Emotional stress may increase sensitivity to pain, especially in non-cyclical cases.

Breast Pain During Breastfeeding

Breast pain during breastfeeding or breast pain during pregnancy can be concerning. Breastfeeding is a natural and nutritious way to feed your baby, but it may cause discomfort due to several conditions:

• Mastitis: Infection of milk ducts causing sharp pain, nipple issues, red streaks, fever, and chills.
• Congestion (Engorgement): When the breasts become too full, they become swollen, tight, and painful.
• Improper Latch: If the baby does not latch properly, it can cause sore breasts and cracked nipples.

Other Causes of Breast Pain

Breast pain can have other causes like:

• Diet: Unhealthy diets high in fat and refined carbs may increase breast pain risk.
• Extramammary Concerns: Breast pain may present as side breast pain due to chest, arm, or back muscle irritation.
• Breast Size: Larger breasts can cause discomfort.
• Breast Surgery: Scar tissue formation post-surgery may lead to persistent pain.
• Medications: Antidepressants, hormone therapy, antibiotics, and heart disease medications can contribute.
• Smoking: Smoking may increase breast soreness.

Symptoms of Breast Pain

• Tenderness
• Swelling
• Sharp or burning pain
• Dull ache
• Pain linked to menstrual cycle
• Non-cyclic pain
• Pain extending to surrounding areas
• Lumpiness
• Nipple sensitivity
• Redness or warmth

When to See a Doctor for Breast Pain?

Knowing when to worry about breast pain is important. If breast pain is sudden and accompanied by chest pain, tingling, or numbness, seek immediate medical attention.

• Changes in breast size or shape
• Nipple discharge
• Rash around the nipple
• Skin dimpling
• Lumps in the armpit
• Persistent pain not related to the menstrual cycle
• Changes in nipple appearance
• Thickened breast tissue or lumps

Diagnosis of Breast Pain

The diagnosis begins with a physical exam to understand why breast pain occurs. The healthcare provider examines the breasts for lumps or unusual changes.

• Mammogram: Recommended for breast lumps.
• Ultrasound: Used alongside mammograms.
• Biopsy: Helps determine lump or cyst nature.

Treatment of Breast Pain

Breast pain treatment depends on whether the pain is cyclical or non-cyclical.

• Support bras
• Reduced sodium intake
• Calcium supplements
• Oral contraceptives
• Estrogen blockers
• Pain relievers

Breast Pain Prevention

• High-fiber diet
• Supportive bras
• Avoid caffeine
• Limit alcohol and smoking

Home Remedies for Breast Pain

• Warm or cold compress
• Supportive bras
• Dietary adjustments
• Massage
• Herbal remedies
• Hydration
• Pain relief
• Stress reduction

Possible Complications if Breast Pain Is Untreated

Most breast pain is not serious, but ignoring persistent or worsening symptoms may lead to complications such as:

• Delay in diagnosing underlying breast conditions
• Worsening infections like mastitis, leading to abscess formation
• Increased discomfort affecting sleep and daily activities
• Progression of hormonal imbalances causing chronic pain
• Anxiety and emotional distress due to ongoing pain
• Missed early signs of serious conditions, including breast cancer
• Complications from untreated cysts or fibrocystic breast changes

Risk Factors

Certain factors may increase the likelihood of developing breast pain:

• Hormonal changes during menstruation, pregnancy, or menopause
• Breastfeeding-related issues such as blocked ducts
• Ill-fitting or unsupportive bras
• Large breast size
• Stress and anxiety
• Use of hormonal medications or oral contraceptives