The Fear Factor
Breast pain can be scary. Your mind immediately thinks cancer, but in all likelihood, cancer is not the cause. “The important thing for patients to realize is that while it can be a sign [of cancer], it is very rare,” says Dr. Michael Cowher, a breast surgeon with Cleveland Clinic. Breast Cancer rarely produces painful symptoms, and the best way to detect it is still with your fingers. Breast pain is often related to hormonal changes, but there are other causes. Here are some to consider.
Women often feel heaviness in their breasts right before their period — even to the point of experiencing pain while walking up stairs. This is because the surge in the hormones estrogen and progesterone cause the breast’s milk glands and ducts to enlarge and the breasts to retain water. This type of pain usually resolves during or shortly after the menstrual cycle, when hormones have returned to their normal levels.
This is an arthritic pain in the middle of the chest, between the ribs and breastbone, and it is caused by poor posture or aging. Women describe it as a burning sensation in the breast. The symptoms may mimic those of a heart attack or other heart condition. If swelling is involved, it might be a condition called Tietze Syndrome. Applying heat or ice or taking ibuprofen can usually treat this type of pain.
Noncyclical Breast Pain
This type of pain, which is not related to a woman’s menstrual cycle, is often isolated to one specific area of the breast. Women may experience it following a breast biopsy, breast injury, or trauma; pain from tissue or muscles surrounding the breast may also cause it. The condition is most common in women between ages 40 and 50, although it can strike both pre- and postmenopausal women, and it normally lasts a couple of years.
Fibrocystic Breast Condition
Formerly referred to as a disease, fibrocystic breast condition is now recognized as a natural change that women’s breasts undergo. More than 50 percent of women experience it at some point. The condition is characterized by breast tissue that feels lumpy or ropelike, and it causes pain and tenderness in the upper and outer areas of the breasts, usually right before your period.
Too Much Caffeine
Your regular cup of coffee may be the cause of your breast pain. Cowher says that caffeine intake is one of the first things he asks about — and for an estimated 25 percent of women, reducing or eliminating caffeine resolves breast pain. A Duke University study showed that 61 percent of women with breast pain who cut out caffeine had reduced pain. Caffeine causes blood vessels to dilate, which can cause the breasts to swell and feel painful.
An Old Bra
“I see plenty of postmenopausal women who may not have purchased a bra in several years, and that’s why they are getting pain,” Cowher says. “Both the elastic in the bra and in the body wear out as you age. Sometimes you have to adjust elastic in the bra to adjust for the elastic in the body.” Typically, weight gain or loss will cause those changes to occur, he adds.
Mastitis is a typical infection in which bacteria gets into the breasts and causes pockets of pus to form, Cowher says. Those need to be drained, since antibiotics cannot penetrate the pus. Breast abscesses can also form, typically during breastfeeding. Cowher says that if an infection is accompanied by a red swelling in the breast, fever, or chills, women should consult their physician.
Thoracic Outlet Syndrome
Breasts are full of nerve endings, and in rare cases, women may have pain caused by a neurological condition called thoracic outlet syndrome, in which some nerves that pass through the breast are compressed. If you have more of a shooting pain — say, a pain that shoots down the arm — you may have this condition. Still, persistent arm pain could also be symptomatic of a heart attack or other cardiovascular condition, Cowher says, so it should be checked out.
Also known as Zuska’s disease, this condition causes small abscesses beneath the nipple and painful discharge. Smoking is a cause, so smoking cessation is important in treating it, Cowher says. It is often misdiagnosed as breast cancer, leading to unnecessary mastectomies. It’s treated with antibiotics.