When is that pain in your breast "normal" - and when should you see a doctor? When is it too soon to worry - and how long is too long to wait? A checklist for understanding and dealing with breast pain.
You wake up one morning, and realize your left breast is aching.
Did you sleep awkwardly and pinch a nerve? Pull a muscle playing tennis? Are you about to get your period?
Should you call the doctor?
With all the awareness around breast cancer these days, more women than ever are being proactive about breast health. The good news is, acknowledging that you’ve felt a change in your breast can help you head off any serious issues. The bad news is, this heightened awareness may lead you to question and worry about every little twinge and ache.
The following five points can serve as a reality check when you experience breast pain - which can include everything from a dull ache to burning to tenderness to soreness to sharp pain. Use this checklist to decide whether you need to call the doctor right away, or can wait to see if things resolve on their own.
Is the pain/soreness in both breasts?
If it is, then it’s almost certainly hormonal in nature; or indicative of something more systemic (e.g., the body aches associated with a case of the flu). Cancer almost never presents symptoms in both breasts at once; so it would be exceedingly unusual for bilateral breast pain to be a symptom of cancer.
If you’re feeling other flu-like symptoms, it’s OK to wait it out. If you feel fine otherwise, see if the pain abates in a week or so. If it does, it’s probably safe to assume it wasn’t serious. If the pain gets worse, call your doctor.
Are you pre-menopausal, or post-menopausal?
The vast majority of breast pain in pre-menopausal women is due to changes in hormone levels associated with the menstrual cycle. If you’re still having periods, make a note of when the pain started, and how long it lasts. If it starts prior to your period, and ends shortly thereafter, it’s probably hormonal - even if you’re feeling the pain in just one breast.
If you’re post-menopausal, it’s much less likely the pain you feel is due to hormones, since you’re no longer experiencing a monthly cycle. However, it’s also unlikely the pain is breast-cancer related, since only about 5% of breast pain is due to cancer (with the exception of inflammatory breast cancer, IBC, whose chief symptom is often pain). Track the pain - its severity, and duration. If it hasn’t started improving after a few days, see a doctor to find out what’s up.
Is the pain accompanied by redness, general swelling, and/or heat?
If so, then it’s time to take it seriously. IBC can manifest itself with redness, swelling, and heat, among other symptoms; but it’s a rare form of cancer. More commonly, women with these symptoms have mastitis or some other breast infection - which can also be serious. If you’re experiencing noticeable redness and swelling, see a doctor ASAP.
Are you taking any medications that might cause breast pain?
Certain medications - including some hormone-based drugs (birth control pills, infertility treatment, hormone replacement therapy); and certain antidepressants (Prozac and Zoloft, most commonly) can cause breast pain. In addition, a fatty acid imbalance in your cells system-wide can cause breast pain. (Hamel, 2007)
If the pain lasts longer than a week or so; or if it recurs on an irregular schedule (i.e., not in synch with your period), then ask your doctor if you might be experiencing a medication side effect.
Have you had cysts in the past, or been told you have a condition called fibrocystic change?
Many women, especially between the ages of 20 and 50, experience cysts - small, fluid-filled pockets that, when present in the breast, can sometimes become large enough to press on a nerve and cause pain. Fibrocystic change, also common in pre-menopausal women, can result in benign breast tumors (fibroadenomas) which, while not serious, can be painful.
How do you know if your pain might be due to a cyst? Typically, it’ll be in one (not both) breasts; and will hurt worse just prior to your period. You may be able to feel a soft, moveable lump in the painful area, as well. For a definite diagnosis, however, see your doctor; s/he can order an ultrasound, which is very reliable in identifying breast cysts.
If your pain doesn’t fit any of the categories above, it’s best to see a doctor, rather than stress about what might be causing your discomfort. Action trumps worry any day; you won’t find the solution if you don’t even address the problem, so make an appointment and get things started.
Hamel, PJ (2009, March 14). Understanding Different Types of Breast Pain. Retrieved July 20, 2014, from https://www.healthcentral.com/breast-cancer/c/78/63099/breasts-breast
PJ Hamel is senior digital content editor and food writer at King Arthur Flour, and a James Beard award-winning author. A 16-year breast cancer survivor, her passion is helping women through this devastating disease. She manages a large and active online survivor support network based at her local hospital and shares her wisdom and experience with the greater community via HealthCentral.com.