What’s Causing Your Breast Pain or Tenderness?

What’s going on when your breasts feel achy, tender or downright uncomfortable? Is it a feature of your menstrual cycle, a sign you need to go bra shopping or something more serious?

The good news is that it’s typically not a sign of something serious. “Most patients who come in with breast tenderness are worried about breast cancer, but that’s actually a less common cause,” says Ob/Gyn Jennifer Grabenstetter, MD. “Most women do not have breast tenderness with breast cancer.”

There are several other explanations for breast pain and discomfort, she says.

Cyclical breast pain and your menstrual cycle

The most common source of breast pain is hormonal fluctuations relating to your menstrual cycle. You may notice that your breasts feel more swollen and tender right before your period starts.

“If the breast tenderness occurs in a pattern and affects the breast tissue equally on both sides, then it’s usually less worrisome,” Dr. Grabenstetter says.

Fibrocystic breasts — breasts with more fibrous or lumpy tissue — are especially prone to ongoing breast pain that worsens between ovulation and the start of your period. “This typically affects both breasts equally and, again, isn’t an indicator that anything is wrong,” she says

What may cause non-cyclical breast pain?

“There are several possible causes of breast pain that don’t relate to your menstrual cycle,” Dr. Grabenstetter says.

• Large breasts. If you’re particularly well-endowed, you’re more likely to have breast pain. Large breasts can stretch Cooper’s ligaments — connective tissues that help give your breasts their shape — which may cause aches and pains.
• Breast cysts. Fluid-filled sacs within the breast can also cause pain. Cysts may occur one at a time, or you may have several in one or both breasts.
• Mastitis. This infection of the breast tissue usually (but not always) relates to lactation and breastfeeding.
• Pain from elsewhere. Sometimes breast pain doesn’t have anything to do with your breasts. The pain you feel in your breasts may actually originate in your chest wall or pectoral muscles. Or you may feel nerve pain from a problem in your spine in your breasts.
• Cancer. In rare cases, inflammatory breast cancer can cause pain. “But this type accounts for less than 5% of all breast cancers, so it isn’t a particularly likely culprit if your breasts are hurting,” Dr. Grabenstetter says.

How to soothe your tender breasts

Dr. Grabenstetter offers five tips for easing cyclical breast pain:

• Get a professional fitting for a new bra. Bras that don’t fit well can cause pain by squeezing breast tissue or providing inadequate support. Keep in mind that your breasts change over time — so a bra that fits well at one time may not fit anymore.
• Apply warm or cold compresses.
• Take over-the-counter painkillers occasionally.
• Follow a low-fat, high in complex carbohydrate diet.
• Limit alcohol and caffeine.

Non-cyclical breast pain treatments vary, depending on what’s causing your pain.

If large breasts are the culprit, a better bra or breast reduction may offer relief. Cysts may resolve on their own, or your doctor may need to drain or remove them. Antibiotics typically treat mastitis. The bottom line about breast tenderness? Don’t freak out, but don’t ignore it. “A large percentage of women, about 70%, will have breast pain in their lifetime,” Dr. Grabenstetter notes. “We shouldn’t ignore breast tenderness, even though most of the time it does turn out to be benign. If you’re having persistent pain, speak to your physician.”