When to Worry About Breast Pain

Breast soreness and pain is one of the most common complaints women have. For many, it's a normal part of their menstrual cycle, but in some cases, breast tenderness may signal something more serious. Tonya K. Flaugh, ARNP, UnityPoint Health, explains the many breast pain causes and key warning signs that mean it’s time to call your provider.

What Causes Breast Tenderness and Pain?

Breast pain comes from a wide variety of sources, including:

Hormones

Hormonal fluctuations are the most frequent offender of breast pain and tenderness. I It's normal to feel dull, heavy or achy breast pain in both breasts a few days before and during your period. This can also happen during ovulation (mid-cycle).

“You can experience breast pain during pregnancy or due to hormone fluctuations during perimenopause and menopause, too,” Flaugh says.

Bras

An ill-fitting or unsupportive bra, especially during exercise, can cause pain and put stress on your breast tissue and surrounding muscles.

Caffeine

The exact reason isn’t clear, but for some women, caffeine can make breast pain (often linked to fibrocystic changes) worse. It's thought that too much caffeine might affect hormone levels, leading to more swelling and discomfort. Although it hasn't been definitively proven in studies, many women feel better when they reduce their caffeine intake.

Injury

Any kind of trauma to the chest or breast — from a car accident seatbelt injury to something simple like a toddler kicking you — can cause a sharp pain in the breasts. This happens because the impact damages the delicate fatty tissue and supporting ligaments inside the breast, leading to potential bruising and swelling. While the pain is usually temporary, sometimes the trauma can create firm, non-cancerous scar tissue where the injury occurred.

Medications

Certain medications can cause pain in the breast and tenderness as an unwelcome side effect. These drugs influence your body’s chemistry, which may include subtle shifts in fluid balance or hormone activity that cause discomfort and swelling in the breast tissue. If you recently started a new medication and notice breast pain, talk to your doctor.

Medications sometimes associated with breast tenderness include:

• Diuretics (water pills)
• Mental health medications (antidepressants or antipsychotics)
• Heart medications (especially certain blood pressure drugs)
• Medications used to treat anemia (due to their iron content or effect on the endocrine system)

Non-Breast Pain: What Causes Pain in the Middle of the Chest Between Breasts?

It’s common for pain in the chest wall, ribs or middle of the chest to be mistaken for pain under the left breast or pain under the right breast.

“Pain that’s reproduced when you press on the area between breasts is often related to the cartilage of the rib cage (costochondritis). While pain under the breast can sometimes be related to the lungs or severe heartburn,” Flaugh says. "This can feel like a sharp pain under the left breast."

Non-Cancerous Conditions

There are several non-cyclical, or persistent, breast pain causes often localized to a specific spot. These issues require medical evaluation because they’re related to changes within the breast tissue itself:

• Cysts: Breast cysts are common, benign (non-cancerous) fluid-filled sacs that can be painful, especially when touched or pressed. If the cyst is large enough, you may feel pain without it being touched.
• Infection: Conditions like mastitis (inflammation/infection during breastfeeding) or an abscess typically cause pain described as a constant burning or stabbing sensation. This pain is accompanied by visible signs like redness, swelling and warmth.
• Scar Tissue: Pain can linger long after a surgery or injury — leading to scar tissue that causes persistent, localized discomfort.

Is Breast Cancer Painful?

The reassuring news for many women is breast pain is typically not a sign of cancer.

Flaugh says, “A lot of times when you’re concerned with cancer, you’re not really having pain. It’s usually a mass that’s non-painful.”

In fact, the pain itself can be a reassuring indicator that the issue is likely benign.

What Does Breast Cancer Pain Feel Like?

While breast pain usually doesn’t mean cancer, any pain associated with a new, distinct lump or mass is concerning. Always have it evaluated by a doctor.

In rare cases, such as with inflammatory breast cancer (IBC), pain can be severe, accompanied by widespread swelling, warmth and redness across the breast. Regardless of the sensation, any new, distinct or persistent pain must always be evaluated by a healthcare provider.

How to Decrease Breast Pain

Once you’ve ruled out any serious underlying causes, you can manage common menstrual or muscle-related pain several ways, including:

• Over-the-counter anti-inflammatories, like ibuprofen or acetaminophen, especially for cycle-related aches
• Supportive bra to help with pain caused by movement
• Applying a heating pad for general aches or infection-related pain, such as mastitis
• Vitamin C may help due to its anti-inflammatory properties
• Extra pumping or breastfeeding can help manage mastitis pain

When to Worry About Breast Pain

Out-of-the-norm breast pain and tenderness should always be a conversation with your provider. However, here are specific signs that warrant seeking treatment:

• Persistent pain: Constant pain that doesn't subside within two to three days, even with the use of anti-inflammatories or a better supportive bra.
• Lumps or masses: You feel a distinct, new mass or lump that's different from your normal breast tissue.
• Signs of infection: The breast has redness, warmth or drainage.
• Skin changes: You notice dimpling of the skin (like an orange peel), an inverted nipple or other abnormal changes.

When to Worry About Breast Pain After Menopause

If you’re postmenopausal, any new breast pain that’s persistent or accompanied by a new lump or mass needs to be evaluated.

Ultimately, Flaugh advises women to know their bodies and be evaluated whenever breast pain and tenderness is out of the norm.

“Anytime you have breast discomfort and you’re concerned about it, talk to your doctor,” she says.

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