What do I need to know about breast pain?

Many women have breast tenderness and pain, also called mastalgia. It may come and go with monthly periods (cyclic) or may not follow any pattern (noncyclic).

• Cyclic pain is the most common type of breast pain. It may be caused by the normal monthly changes in hormones. This pain usually occurs in both breasts. It is generally described as a heaviness or soreness that radiates to the armpit and arm. The pain is usually most severe before a menstrual period and is often relieved when a period ends. Cyclic breast pain occurs more often in younger women. Most cyclic pain goes away without treatment and usually disappears at menopause.
• Noncyclic pain is most common in women 30 to 50 years of age. It may occur in only one breast. It is often described as a sharp, burning pain that occurs in one area of a breast. Occasionally, noncyclic pain may be caused by a fibroadenoma or a cyst. If the cause of noncyclic pain can be identified, treating the cause may relieve the pain.

Breast pain can get worse with changes in your hormone levels or changes in the medicines you are taking. Stress can also affect breast pain. You are more likely to have breast pain before menopause than after menopause.

Does breast pain indicate breast cancer?

Breast pain is not a common symptom of breast cancer. However, sometimes painful lumps are caused by breast cancer.

What can I do for breast pain?

You may be able to relieve breast pain by using nonprescription medicines, including:

• Acetaminophen, such as Tylenol or Panadol.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil or Motrin), naproxen (Aleve or Naprosyn), or aspirin (Anacin, Bayer).

Be sure to follow all labels and instructions. If you are pregnant or trying to become pregnant, talk to your doctor before using any medicine. Do not take aspirin if you are younger than 20 because of the risk of Reye's syndrome.

Danazol, bromocriptine, and tamoxifen citrate are prescription medicines used for the treatment of severe cyclic breast pain. These medicines are rarely used because they have significant side effects. It is important to determine whether the benefits will outweigh the risks of taking these medicines.

You may also be able to relieve breast pain by:

• Using birth control pills (oral contraceptives). These may help reduce cyclic breast pain and breast swelling before periods. But breast pain is also a known side effect of birth control pills.
• Taking magnesium. Magnesium supplements taken in the second half of the menstrual cycle (usually the 2 weeks before the next period) relieve cyclic breast pain as well as other premenstrual symptoms.
• Reducing dietary fat to 15% or less of your dietary intake is likely to reduce breast pain over time. A small study has shown that making this long-term dietary change significantly reduces breast pain.

Studies have not shown that avoiding caffeine relieves breast pain. But some women feel they have a decrease in breast pain when they decrease the amount of caffeine they consume.¹

Can I prevent breast pain?

You may be able to prevent breast pain, tenderness, or discomfort by wearing a sports bra during exercise. It is important that the sports bra fit properly. It should keep the breasts almost motionless and allow them to move together with the chest, not separately. It is important to replace your sports bra as the material stretches and become less supportive. A young woman with developing breasts may need to buy a new bra every 6 months.