Understanding Different Types of Breast Pain

by PJ Hamel Patient Expert

That uncomfortable burning sensation you feel just before your period. The soreness and tenderness that seems to come out of nowhere, sometimes so bad you can't even stand to put on your bra. A sharp, stabbing pain that happens several random times a day.

A source of pride as young women, sustenance for our babies, always part of our sexual life (till we lose them), breasts mark us as women. And while they can be a source of pleasure and satisfaction, they can also betray us in a number of ways: in rare cases, by developing cancer. And less seriously, but certainly just as important, by becoming a source of pain.

The good news is, pain is almost never a symptom of breast cancer. Only about 5% of women with breast cancer experience pain in their affected breast prior to diagnosis. The exception to this is inflammatory breast cancer, a rare cancer that can begin with pain and soreness. But in general, that pain you're feeling in your breast is probably NOT cancer.

Breast pain is usually divided into two types: pain associated with your menstrual cycle (cyclic pain), and non-cyclic pain. Each has different causes.

  • Cyclic pain tends to come and go in synch with your period, building in the 2 weeks just prior, then subsiding afterwards. This pain can range from a mild ache to extreme tenderness and soreness. It's usually felt in the upper/outer parts of both breasts, though sometimes it centers on one breast; and can sometimes extend under your arms, as well.

This type of pain, tied as it is to menstruation, affects younger women, and women in peri-menopause (older women still having occasional periods). It can be accompanied by swelling, and even the development of lumps.

Cyclic pain is the result of hormones, which cause you to retain fluid just before your period. This fluid retention in your breasts stretches and irritates nerves and tissue, causing pain.

  • Non-cyclic pain is unrelated to the menstrual cycle. If you're having pain of any kind that has no monthly pattern to it; or pain that develops at any time during your cycle, and then continues without abatement once your period is over, you're experiencing non-cyclic pain.

Non-cyclic pain may be felt in both breasts, or only one. Like cyclic pain, it can range from ache to burning to tenderness to soreness to sharp pain.

This type of pain has many sources, some actually within your breast, some not. A breast injury; an infection (mastitis; an infected milk duct), or a pulled muscle in your chest can all be painful. A cyst may grow and become uncomfortable; or you may be experiencing rib pain, or even heart pain, and interpreting it as breast pain. Women with very large breasts may experience pain due to lack of adequate support, which creates muscle strain.

In addition, non-cyclic breast pain can be totally unrelated to your breasts. A fatty acid imbalance in your cells system-wide can cause breast pain. And certain medications can cause pain as well, including some hormone-based drugs (birth control pills, infertility treatment, hormone replacement therapy); and certain antidepressants: Prozac, and Zoloft, most commonly.

So, you're experiencing breast pain: what do you do?

  • Determine whether it's related to your period. If pain comes and goes in a regular monthly pattern, and can be felt in either breast or both at once, it's cyclical. Check with your doctor to see if (s)he has any suggestions for lifestyle changes (diet, exercise); or treatment options (cold compresses, drugs). Pain and soreness is commonly associated with premenstrual syndrome (PMS).

  • If the pain isn't cyclical, track it and see if it's becoming more frequent, more intense, or if it's gradually fading. If it's going away, you'll probably just want to wait it out. If it's getting worse, it's time to act.

If the pain is fairly constant (i.e., you experience it every day); and if it continues more than a couple of weeks, go see a doctor. If the pain is accompanied by swelling, heat, itchiness, redness, soreness, or other signs that make it seem as if your breast is infected, see a doctor ASAP.

But bottom line don't panic. About 95% of the time, breast pain, though it can be a real challenge, has nothing to do with breast cancer.

PJ Hamel
Meet Our Writer
PJ Hamel

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.