The fear factor
Experiencing breast pain without knowing why can be scary. Breast soreness and pain are common, and up to 70% of females are affected at some point in their lives.
“Breast pain is almost never a sign of breast cancer,” says Dr. Michael S. Cowher, associate professor of surgery at the University of Pittsburgh School of Medicine.
Breast cancer rarely produces painful symptoms, and the best way to detect it is by getting regular screenings and contacting a doctor if you notice visual changes or feel a lump. Breast pain is often related to hormonal changes, but there are other causes as well. Here are some causes to consider.
Hormonal shifts
Hormonal changes happen during multiple life stages, including during the menstrual cycle, pregnancy, perimenopause andmenopause. Some of these changes may bring breast pain. In about two-thirds of women who experience breast pain, it’s cyclic, meaning it happens a few days out of the month, often linked to hormonal shifts during the menstrual cycle.
A spike in estrogen, progesterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) contributes to cyclic breast pain, says Dr. Marie Nakhoul, chief of integrative medicine and gynecology at the University of Maryland Medical Center.
“The good news,” says Cowher, is that “pericyclical breast pain usually goes away after menopause.”
However, some women may notice the pain more when they’re in perimenopause.
The remaining one-third of women who experience breast pain have non-cyclical pain. This type of pain is not tied to the menstrual cycle, is often isolated to one specific area of the breast and can happen randomly without a pattern. It may be more common when people have larger breasts and can be caused by a breast injury or trauma, a prior surgery, cysts or pain in the surrounding tissue and muscles.
Costochondritis
Costochondritis is an arthritis pain that can be mistaken for breast pain because it’s in the chest. The pain is felt between the ribs and breastbone and may feel like a burning sensation in the breast, which can sometimes be mistaken for a heart attack or heart condition. If swelling is involved, it might be a condition called Tietze syndrome.
The pain is caused by joint inflammation and is most common in people ages 40 to 50. Applying heat or ice or taking ibuprofen can usually treat this type of pain.
Too much caffeine
Your regular cup of coffee may be the culprit of your breast pain. Cowher says he recommends people stop consuming caffeine.
“Even a little bit can still cause breast pain,” says Cowhere. Cutting caffeine can improve breast pain in 25% of those experiencing it. Caffeine causes blood vessels to dilate, which can cause the breasts to swell and feel painful.
Medications
Certain types of medications may cause breast pain as a side effect.
These include:
— Hormonal medications, such as those used for birth control and hormone replacement therapy
The wrong bra
Bras can also be behind breast pain or irritation, depending on how they fit and how they’re made. Nakhoul says bras with wires can be tight on the breast and cause irritation to muscles and costochondral ribs, which can lead to pain. Having a comfortable, supportive bra may help with breast pain. Both Nakhoul and Cowher recommend sports bras.
Collagen in the body, which forms the natural elastic fibers that allow your body’s tissues to stretch and return to their shape, wears out over time, says Cowher.
“If you have larger breasts with weight gain, over time, you need more bra support because you don’t have that natural elasticity in your tissues,” says Cowher.
An infection
Mastitis is an infection in the breast tissue caused by bacteria, and an abscess is a pocket of pus due to mastitis.
Nakhoul says these infections often happen during breastfeeding when a crack in the nipple or breast leads to inflammation. But you don’t have to be breastfeeding to get an infection.
People who smoke and people with diabetes are more susceptible to infections, says Cowher. “It’s sort of like any other soft tissue or skin infection, that it can just happen sometimes, so a red, painful area is something to bring to your doctor’s attention.”
Fibrocystic breasts
Formerly referred to as a disease, fibrocystic breasts are now recognized as a natural change women’s breasts undergo. More than 50% of women experience them at some point.
The condition is characterized by breast tissue that feels lumpy or rope-like, and it causes pain and tenderness in the upper and outer areas of the breasts, usually right before your period.
Subareolar abscesses
Also known as Zuska’s disease, this condition causes small abscesses beneath the nipple and painful discharge. It’s typically linked to smoking.
“Studies have shown that the cellular changes in the breast ducts are very similar to the changes that smoking does to your lung epithelial cells,” says Cowher.
Zuska’s disease is usually treated with antibiotics and sometimes surgery to remove the blocked duct. For people who have repeated subareolar abscesses, Cowher says quitting smoking is key.
Stress
Stress may also play a role in breast pain because it has an effect on hormones. Nakhoul says an increase in the stress hormone cortisol can eventually affect estrogen and progesterone.
“Fluctuation of the hormones does affect breast tenderness and can lead to breast pain,” says Nakhoul.
In addition to making discomfort feel more intense, Dr. Steven Quay, founder of the biopharmaceutical company Atossa Therapeutics, says stress can increase muscle tension in the chest wall.
Heart-related breast pain
Any pain in your chest area can be worrying. Breast pain itself is not heart-related, but pain that comes with a heart attack or a heart problem is felt in the chest. The pain of a heart attack feels different than pain in the muscles surrounding the breasts and pain in the actual breasts.
Nakhoul describes pain linked to a heart problem as a deep pain inside the chest that’s felt in between the breasts rather than a sharp or tingling pain.
A heart attack can also come with shortness of breath, pain that radiates down the shoulder or numbness in the hands.
When in doubt, it’s safest to seek medical attention.
“If you have a sudden onset of sharp or dull chest pain, that is something to seek emergency care for,” says Cowher.
When to see a doctor about breast pain
Whenever you have pain that interferes with your daily life or comes on suddenly, it’s a good idea to get see your doctor or find an OBGYN if you don’t have one.
Nakhoul says red flags you should not ignore include:
— Pain that is non-cyclical (not related to your menstrual cycle) and specific to one area
— Finding a mass or lump
— Redness and thickening of the skin
— Any discharge, bloody or clear
“Even if your symptoms don’t fit a specific checklist, trust your instincts and get evaluated if you feel something is off,” says Quay.
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Breast Pain? Stop Worrying About Cancer originally appeared on usnews.com
Update 10/09/25: This story was published at an earlier date and has been updated with new information.
