Causes and Types of Mastalgia (Breast Pain)

Up to 70% of females see a healthcare provider about mastalgia (breast pain) at some point in their lives. While the pain is most commonly due to normal changes in the breasts during the menstrual cycle, it may also be the result of an infection or disease ranging from a benign cyst to breast cancer. Even males can experience breast pain.

How breast pain feels can give you clues as to the underlying cause—such as whether the pain is dull or sharp, localized or generalized, or felt in one breast or both. Although the treatment ultimately varies by the cause, there are at-home remedies that can help manage the pain.

This article describes the causes and types of mastalgia and how they feel. It also explains how mastalgia is diagnosed and treated and the odds that cancer is the cause.

What Does Mastalgia Feel Like?

The symptoms of mastalgia depend on what is causing it. Common symptoms include:

• Breast tenderness
• Sharp, burning pain
• A tight feeling in the breast

The pain can be constant or only happen occasionally. Some people have mild pain while others have severe pain.

What Triggers Mastalgia?

Mastalgia is put into a category based on whether it's affected by a person's menstrual cycle. The breast is either cyclic or noncyclic.

Cyclic Mastalgia

Cyclic mastalgia is breast pain related to the menstrual cycle. The hormone changes throughout the month alter how the breasts look and feel.

The pain is often described as a dull, heavy ache in both breasts, although one may be affected more than the other. Usually, the pain is generalized and not felt in a specific spot. The pain may also extend to the armpits.

Cyclic mastalgia is usually worse just before a person's cycle begins. The pain gets better on the first day of a person's period and gradually goes away in the next few days.

Since this type of pain is linked to menstruation, people who have not gone through menopause yet are the most likely to have it. Cyclical breast pain can also be related to birth control pills or hormone replacement therapy (HRT).

Some people have a condition called fibrocystic breasts. This a common condition in which your breast may feel lumpy, swollen, or sore right before your period. It is not a disease but rather normal changes in the consistency of the breasts that occur in some people during the menstrual cycle.

Noncyclic Mastalgia

Noncyclic mastalgia is breast pain that is not related to the menstrual cycle and doesn't vary with hormone changes throughout the month.

The pain can be sharp or burning. It is often felt in just one breast as well as in a specific part of the breast. Noncyclic mastalgia is sometimes called "trigger zone" breast pain because a person can easily point to where the pain is. 

Breast pain in people who have gone through menopause is usually noncyclic. This type of breast pain is most common in people between the ages of 30 and 50.

Noncyclical breast pain can be caused by:

• Injuries
• Surgery
• Breast infections
• Breast fibroadenoma (a type of breast cyst)
• Inflammatory breast cancer

Having large breasts can also cause noncyclic mastalgia. The stretching of the bands of connective tissue that support and shape the breast tissue (Cooper's ligaments) can hurt. A person with large breasts might be able to reduce or avoid pain by wearing a properly fitting and supportive bra.

How Is Mastalgia Diagnosed?

A diagnosis of mastalgia is usually made based on a person's symptoms. A healthcare provider can also touch the breasts and feel for changes in the tissue.

Sometimes, breast imaging tests are needed. If a provider notices something that is not normal when they look at and feel the breasts, having pictures of the inside of the breast can help them figure out what it is.

Mastalgia and Risk of Cancer

Breast cancer does not usually cause pain. The chance of mastalgia being a symptom of breast cancer is very low. However, breast pain can be a symptom of cancer in some cases.

Based on current statistics, 12.9% of women born in the United States today will develop breast cancer at some time during their lives.

The risks are greater for females who:

• Are over 50
• Have a family history of breast or ovarian cancer
• Have dense breasts
• Started having periods before the age of 12
• Started menopause over the age of 55

If you have breast pain, tell your healthcare provider. It's also important to keep up with the recommended screenings—especially if you're at risk for breast cancer.

How Do You Treat Breast Mastalgia?

The best way to treat mastalgia depends on what is causing it.

For most people, the first step is getting reassurance from their healthcare provider that the breast pain is not being caused by cancer. From there, people can work with their healthcare providers to find ways to manage breast pain.

Home Remedies

People may try home remedies to treat cyclic and noncyclic pain. The research is mixed on whether or not they are helpful. Consider trying them to see if they make your symptoms better.

• Wear a well-fitting bra: Wearing a bra that fits helps keep painful breasts from being pulled on or strained.
• Managing stress: Being under a lot of stress can affect your hormone levels. If hormonal shifts cause your breast pain, it might feel worse when you're stressed.
• Exercise: Physical activity lowers levels of a hormone called estrogen. However, it's not clear whether this will also reduce pain from mastalgia. Also, if you are not wearing something to support your breasts during physical activity, they might hurt more.
• Make lifestyle changes: The evidence is mixed on whether making lifestyle changes is an effective way to treat breast pain. For example, research has examined whether reducing your caffeine intake or eating a low-fat diet can help breast pain. Some people may notice positive effects on breast pain when they make these lifestyle changes, but they may not help everyone.
• Track your symptoms: Keeping a journal can also be helpful. Noting your pain levels over time can help you see patterns. If you find that the pain is linked to your menstrual cycle, using an app to track your cycle could be useful. You might also notice that certain activities or stress trigger the pain.

Medications

Over-the-counter (OTC) pain relievers like Tylenol (acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) may help reduce breast pain.

If taking OTC pain medicine isn't enough, your healthcare provider may write you a prescription for a medication like Nolvadex (tamoxifen) and Danocrine (danazol). While they can treat breast pain, the medications have side effects.

Some studies have shown that tamoxifen helps people with breast pain the most. However, danazol is the only medication that is currently approved by the Food and Drug Administration (FDA) to treat mastalgia.

Summary

Mastalgia is common. Breast pain can be linked to a person's menstrual cycle or not. It is very uncommon for breast pain to be a sign of cancer.

Once the cause of mastalgia has been found, there are several options for treatment. OTC pain relievers and lifestyle changes may help. If these treatments don't work, prescription medications might be necessary.