Breast pain

Breast pain is very common in women of all ages and can also affect men.

It can have lots of different causes but, on its own, breast pain is rarely a sign of breast cancer.

Many women have breast pain as part of their normal menstrual cycle (periods). This is called cyclical breast pain.

Lasting pain in the breast that’s not related to periods is known as non-cyclical breast pain.

Sometimes pain that feels as though it's in the breast is coming from somewhere else, such as a pulled muscle in the chest. This is called chest wall pain.

Breast pain linked to periods (cyclical breast pain)

Cyclical breast pain is linked to changing hormone levels during the menstrual cycle.

Many women feel discomfort and lumpiness in both breasts a week or so before their period. 

The pain can vary from mild to severe and the breasts can also be tender and sore to touch.   

You may feel heaviness, tenderness, a burning, prickling or stabbing pain, or a feeling of tightness.

The pain usually affects both breasts but it can affect just 1. It can also spread to the armpit, down the arm and to the shoulder blade. 

Cyclical breast pain often goes away once a period starts. In some women, the pain will go away by itself, but it can come back.

This type of pain usually stops after the menopause, though women taking HRT can also have breast pain.  

Breast pain can also be associated with starting to take or changing contraception that contains hormones.

Breast pain not linked to periods (non-cyclical breast pain)

It’s often unclear what causes non-cyclical breast pain.

It can be related to:

• A benign (not cancer) breast condition
• Previous surgery to the breast 
• Injury to the breast
• Having larger breasts 
• A side effect from a drug treatment, such as certain antidepressant drugs, and some herbal remedies such as ginseng
• Stress and anxiety

Non-cyclical breast pain may be continuous or it may come and go. It can affect women before and after the menopause. 

The pain can be in one or both breasts and can affect the whole breast or a specific area. It may be a burning, prickling or stabbing pain, or a feeling of tightness. 

Non-cyclical breast pain often goes away by itself over time. This happens in about half the women who have it.

Chest wall pain

Chest wall pain may feel as though it’s coming from the breast, but really it comes from somewhere else.

It can have several causes, such as pulling a muscle in your chest.

Make an appointment with your GP if you’re concerned about breast pain that’s new or different for you, or you’ve also got other symptoms in your breast, like a lump, swelling, changes to the nipple or a change in colour.

Your GP will examine your breasts and ask you about the type of pain you have and how often you get it. 

To check how long the pain lasts, how severe the pain is or if the pain is linked to your periods, your GP may ask you to fill in a simple pain chart. 

If your GP thinks you may have non-cyclical breast pain or chest wall pain, they may ask you to lean forward during the examination. This is to help them assess if the pain is inside your breast or in the chest wall. 

Your GP may refer you to a breast clinic where you’ll be seen by specialist doctors or nurses for a more detailed assessment.

The options for treating cyclical and non-cyclical pain are often the same, though non-cyclical pain is not always as easy to treat. 

If you have cyclical breast pain, your GP may reassure you that what you’re experiencing is a normal part of your monthly cycle. 

Diet 

Your GP may suggest changes to your diet that might help reduce pain, but there’s limited evidence to show these work. These include eating a low-fat diet, eating more fibre and reducing caffeine and alcohol.

Well-fitting bra

Wearing a supportive and well-fitting bra during the day, during any physical activity and at night can be helpful. 

Relaxation and complementary therapies 

Some women have found relaxation therapy useful in reducing their symptoms of cyclical breast pain, such as relaxation CDs or apps, or other complementary therapies such as acupuncture and aromatherapy. 

Contraception

If your pain started when you began taking a contraceptive pill, changing to a different pill may help. If the pain continues, you may want to try a non-hormone method of contraception such as condoms, a non-hormonal coil (also called copper coil or IUD) or a cap (diaphragm). 

HRT

If your pain started or increased while taking HRT and does not settle after a short time, tell your GP. HRT can sometimes cause benign (not cancer) changes in the breast, which may need to be seen by your GP or specialist.

Evening primrose or starflower oil

There’s evidence that having low levels of an essential fatty acid called GLA can contribute to cyclical breast pain. However, research has shown that taking additional GLA does not always help the pain.

Your GP may suggest you try evening primrose or starflower oil (which contain GLA), as some women have found it helps them to feel better generally. Your GP will tell you how much to take and for how long. 

Evening primrose oil does not usually cause side effects, but a few people may feel sick, have an upset stomach or get headaches. It’s best not to take it if you’re pregnant or trying to get pregnant.

If you’ve had breast cancer in the past, speak to your GP or treatment team before taking evening primrose or starflower oil.

People with epilepsy are usually advised not to take evening primrose or starflower oil. 

Pain relief 

Research has shown that non-steroidal anti-inflammatory pain relief, such as ibuprofen, can help breast pain, particularly non-cyclical pain. 

You can apply this type of pain relief directly to the affected area as a gel or take it as a tablet.

Before using this type of pain relief, you should be assessed by your doctor, especially if you have asthma, stomach ulcers or any kidney problems. They can talk to you about the correct dose, how long you should use it for and any possible side effects.

Paracetamol can also help breast pain, either with or without anti-inflammatory pain relief.  

Hormone drugs

If your pain is severe, goes on for a long time or you’ve tried the things listed above and they have not helped, your doctor may consider giving you a hormone-suppressing drug, such as tamoxifen

Tamoxifen has side effects, so it will only be recommended after a discussion about the benefits and possible risks.

If it’s prescribed for you, your specialist or GP will tell you what dose to take and for how long.

There’s some evidence that younger women may benefit from a short course of treatment, which can be repeated as necessary. But older women who are near to or going through the menopause may benefit from a longer course of treatment.

Tamoxifen

Tamoxifen is not licensed to treat breast pain and is commonly used to treat breast cancer. Research has shown it’s also effective in treating cyclical breast pain, so it’s sometimes used for this.

Tamoxifen works by blocking the hormone oestrogen.

Side effects of tamoxifen can include:

• Hot flushes
• Night sweats
• Mood changes

Having breast pain can be upsetting, especially if the pain persists and your specialist cannot tell you the exact cause. 

If breast pain is affecting your daily activities, it may make you feel anxious or low in mood.

If you’d like more information or support, you can call our free helpline on 0808 800 6000 to speak to one of our specialist nurses.

Having breast pain on its own is rarely a sign of breast cancer. But it’s still important to be breast aware and go back to your GP if the pain gets worse or changes, you notice any other changes in your breasts, or you need support.