HealthSheets™

Adhering to the principles of health literacy, this extensive library of evidence-based, peer-reviewed information was written specifically for patients and covers diseases and conditions, diagnosis and treatments, surgeries and procedures, and wellness and safety for people of all ages and walks of life.

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Breast Pain

Breast pain is very common in women. Most women have breast pain at some time in their lives. It may be any discomfort or pain in the breast as well as in the areola and nipples.

Pain is rarely a sign of breast cancer. There are many causes for breast pain. They include hormones, muscle or tissue pain, wearing a new bra, medicines, new activities and stress. Sometimes we can’t find the reason.

This handout will help you learn about breast pain and what you can do to help relieve it. There is no single remedy that helps all women with breast pain.

Types of breast pain

Keep track of when you have breast pain and other symptoms. This will help you know if your pain is cyclic or non-cyclic.

Cyclic pain is related to female hormones and the menstrual cycle. Female hormones include estrogen, progesterone and prolactin.

You may feel a dull ache in your whole breast but more in the upper outer area next to your arm pit. The pain usually affects both breasts. Sometimes one breast will be more painful than the other. Cyclic breast pain often decreases or goes away with menopause.

Non-cyclic pain usually affects only one breast. It isn’t related to changing hormone levels in your menstrual cycle.

This pain is often a sharp, burning, or stabbing pain. You may feel it anywhere in the breast. It is most common in the middle of the breast around the nipple area. Non-cyclic breast pain is often more painful than cyclic breast pain.

The cause of non-cyclic breast pain can be hard to find. Causes of non-cyclic breast pain may be:

Hormones made by our bodies such as estrogen
Medicines such as hormones, water pills, heart and blood pressure pills, antidepressants, and stomach or digestive medicines
Dilated or enlarged milk ducts under the nipple. This is called ductal ectasia.
Injury to the breast
Recent breast biopsy or surgery
Breast infection
Breast cysts
Eating a lot of soy products or tofu. These products have an estrogen-like effect on the body which can cause breast tenderness or pain.
Herbal products such as Ma Hung, Guarana, Kola nut, ginseng and Dong Quai have ingredients that stimulate the body and may cause breast pain.
Breast size: Women with large breasts may have ligament pain due to the size of their breasts. Neck, shoulder and back pain may also be due to large breasts.
Pain that starts outside the breast in the chest wall, muscles or joints can spread to the breast but not actually involve the breasts.
There is good evidence that stress can contribute to breast pain.

Treatment

Different techniques help different women. The comfort measures marked with ** are based on research.

Comfort measures

**Time
Most breast pain will go away on its own with no treatment.

Heat
Put heat on your breasts for 20 minutes, three or four times a day. Use a heating pad, hot packs, hot towels, shower, bath, or whirlpool. It may help to alternate heat and cold packs.

Cold
Use cold packs for 20 minutes, three or four times a day. Place a thin towel between your skin and the cold pack to avoid frostbite. It may help to alternate cold and heat packs.

**Castor oil compresses
Castor oil packs often get rid of breast pain, especially if the breast tissue is swollen. Put the castor oil packs on your breasts for one hour three times a week. Do this for two or three months. After that, use the packs once a week to prevent pain.

**Bras that fit well
Wear a bra that fits well. It should reduce the movement of your breasts. Your bra should not be too tight or too loose. If you are not sure, have a bra fitting done. Many women wear the wrong size bra.

Foods
** Reduce how much fat you eat to only 15 to 20% of your total calories. A low fat diet can reduce the amount of estrogen that your body makes. This can reduce cyclic breast pain a lot.

** Be sure to use iodized salt in your salt shaker. A lack of iodine can cause breast pain.

Eat less salt. Too much salt causes your body to collect fluid. Eating less salt may reduce breast pain for some women.

**Relax
Studies show that listening to a relaxation tape daily helps relieve breast pain.

Caffeine
Cutting out caffeine or drinking less caffeine might reduce breast pain. Some women find it helps and others say it has no effect. The only way to know if caffeine causes your breast pain is to take it out of your diet and see if this makes a difference.

Caffeine is in coffee, tea, soft drinks, chocolate, and some over-the-counter cold and pain products.

Slowly reduce the caffeine you drink to prevent withdrawal headaches. After you remove all caffeine from your diet, it may take two months or more before you have less breast pain.

Supplements
Taking one of these supplements may reduce breast pain:

**Vitamin E 400 IU 3 times a day
**Evening primrose oil 1000 mg 3 times a day
**Ground flaxseed 2 Tbsp once a day. Sprinkle on your cereal or other food. Or add ¼ to ½ cup when baking muffins or bread.

If you try a supplement, stop taking it if your breast pain does not improve after 4 to 6 months. Please tell your healthcare team if you take any kind of supplement.

Medicines
Ibuprofen or acetaminophen may reduce pain and inflammation.

Call your primary care provider

or the Breast Health Center if you have:

New pain in one spot that does not go away.
A lump, hard knot or thickening in your breast or underarm.
Swelling, warmth, redness or darkening of your breast.
A change in the size or shape of your breast.
Dimples or puckers in your skin or pulling in of the nipple.
Itchy, scaly sore or rash on your nipple.
Discharge from your nipple.