Merck Manual

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Breast Pain

(Mastalgia)

By

Lydia Choi

, MD, Karmanos Cancer Center

Reviewed/Revised Jun 2022 | Modified Sep 2022
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Topic Resources

Many women experience breast pain. Breast pain may occur in one or both breasts.

The Breasts
VIDEO

Causes of Breast Pain

Likely causes of breast pain depend on whether the pain is felt in a particular place or throughout the whole breast.

If pain occurs in one area, it may be caused by

If pain affects the whole breast, it may be caused by

Changes in the levels of the female hormones estrogen and progesterone can cause breast pain. Levels of these hormones increase just before or during a menstrual period and during pregnancy. When these levels increase, they cause the milk glands and ducts of the breasts to enlarge and the breasts to retain fluid. The breasts then become swollen and sometimes painful. Such pain is usually felt throughout the breasts, making them tender to touch. Pain related to the menstrual period may come and go for months or years. Taking birth control pills (oral contraceptives) or hormone therapy after menopause can also cause hormone levels to increase and cause this kind of pain.

Evaluation of Breast Pain

Warning signs

Certain symptoms and characteristics are cause for concern:

  • Severe pain, redness, and swelling

  • Presence of a lump, an inverted nipple, or certain changes in the skin

When to see a doctor

Women with severe pain, redness, or swelling may have a breast infection and should see a doctor within a day or two.

What a doctor does

Doctors ask the woman to describe the pain. They ask whether pain occurs at certain times of the month (related to the menstrual cycle). They also ask about other symptoms, disorders, and drugs (such as birth control pills) that may suggest a possible cause.

Doctors examine the breast and nearby tissues for abnormalities, such as changes in the skin, lumps, and tenderness. If no abnormalities are present, the pain is probably due to hormonal changes or large breasts.

A pregnancy test is done if the woman has symptoms that suggest pregnancy, such as a missed menstrual period and early-morning nausea. Other tests may be done based on the woman's other symptoms.

Treatment of Breast Pain

Mild breast pain usually disappears eventually, even without treatment.

For severe pain during menstrual periods, danazol (a synthetic hormone related to testosterone) or tamoxifen (a drug used to treat breast cancer) may be used. These drugs inhibit the activity of the female hormones estrogen and progesterone, which can make the breasts swell and be painful. If taken a long time, these drugs have side effects and are thus usually used for only a short time.

For breast pain related to pregnancy, wearing a firm, supportive bra, taking acetaminophen, or both, can help.

Stopping use of birth control pills or endocrine therapy may help relieve symptoms.

Evening primrose oil, a nutritional supplement, may help relieve breast pain related to menstrual periods or pregnancy in some women.

If a specific disorder is identified as the cause, the disorder is treated. For example, if a cyst is the cause, draining the fluid from the cyst usually relieves the pain.

Key Points

  • The cause of breast pain depends on whether it occurs in one area (usually caused by cysts) or the whole breast (caused by hormonal changes, fibrocystic changes, or large breasts).

  • If breast pain is the only symptom, it is usually not a sign of breast cancer.

  • Breast pain that is severe or that lasts for more than 1 month should be evaluated.

  • Whether testing is needed depends on the woman's other symptoms.

  • Treatment depends on the cause, but drugs such as acetaminophen or NSAIDs, can sometimes help relieve the pain.

Drugs Mentioned In This Article

Generic Name Select Brand Names
7T Gummy ES, Acephen, Aceta, Actamin, Adult Pain Relief, Anacin Aspirin Free, Apra, Children's Acetaminophen, Children's Pain & Fever , Comtrex Sore Throat Relief, ED-APAP, ElixSure Fever/Pain, Feverall, Genapap, Genebs, Goody's Back & Body Pain, Infantaire, Infants' Acetaminophen, LIQUID PAIN RELIEF, Little Fevers, Little Remedies Infant Fever + Pain Reliever, Mapap, Mapap Arthritis Pain, Mapap Infants, Mapap Junior, M-PAP, Nortemp, Ofirmev, Pain & Fever , Pain and Fever , PAIN RELIEF , PAIN RELIEF Extra Strength, Panadol, PediaCare Children's Fever Reducer/Pain Reliever, PediaCare Children's Smooth Metls Fever Reducer/Pain Reliever, PediaCare Infant's Fever Reducer/Pain Reliever, Pediaphen, PHARBETOL, Plus PHARMA, Q-Pap, Q-Pap Extra Strength, Silapap, Triaminic Fever Reducer and Pain Reliever, Triaminic Infant Fever Reducer and Pain Reliever, Tylenol, Tylenol 8 Hour, Tylenol 8 Hour Arthritis Pain, Tylenol 8 Hour Muscle Aches & Pain, Tylenol Arthritis Pain, Tylenol Children's, Tylenol Children's Pain+Fever, Tylenol CrushableTablet, Tylenol Extra Strength, Tylenol Infants', Tylenol Infants Pain + Fever, Tylenol Junior Strength, Tylenol Pain + Fever, Tylenol Regular Strength, Tylenol Sore Throat, XS No Aspirin, XS Pain Reliever
Danocrine
Nolvadex, Soltamox
NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
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