Breast Tenderness

Breast tenderness is a common complaint made by women of all ages. It is also called mastalgia or mastodynia, which means breast pain. The condition can range from mild discomfort to severe pain. It has a variety of causes. Your caregiver will find out the likely cause of your breast tenderness by examining your breasts, asking you about symptoms and perhaps ordering some tests. Breast tenderness usually does not mean you have breast cancer.

CAUSES

Breast tenderness has many possible causes. They include:

  • Premenstrual changes. A week to 10 days before your period, your breasts might ache or feel tender.

  • Other hormonal causes. These include:

  • When sexual and physical traits mature (puberty).

  • Pregnancy.

  • The time right before and the year after menopause (perimenopause).

  • The day when it has been 12 months since your last period (menopause).

  • Large breasts.

  • Infection (also called mastitis).

  • Birth control pills.

  • Breastfeeding. Tenderness can occur if the breasts are overfull with milk or if a milk duct is blocked.

  • Injury.

  • Fibrocystic breast changes. This is not cancer (benign). It causes painful breasts that feel lumpy.

  • Fluid-filled sacs (cysts). Often cysts can be drained in your healthcare provider's office.

  • Fibroadenoma. This is a tumor that is not cancerous.

  • Medication side effects. Blood pressure drugs and diuretics (which increase urine flow) sometimes cause breast tenderness.

  • Previous breast surgery, such as a breast reduction.

  • Breast cancer. Cancer is rarely the reason breasts are tender. In most women, tenderness is caused by something else.

DIAGNOSIS

Several methods can be used to find out why your breasts are tender. They include:

  • Visual inspection of the breasts.

  • Examination by hand.

  • Tests, such as:

  • Mammogram.

  • Ultrasound.

  • Biopsy.

  • Lab test of any fluid coming from the nipple.

  • Blood tests.

  • MRI.

TREATMENT

Treatment is directed to the cause of the breast tenderness from doing nothing for minor discomfort, wearing a good support bra but also may include:

  • Taking over-the-counter medicines for pain or discomfort as directed by your caregiver.

  • Prescription medicine for breast tenderness related to:

  • Premenstrual.

  • Fibrocystic.

  • Puberty.

  • Pregnancy.

  • Menopause.

  • Previous breast surgery.

  • Large breasts.

  • Antibiotics for infection.

  • Birth control pills for fibrocystic and premenstrual changes.

  • More frequent feedings or pumping of the breasts and warm compresses for breast engorgement when nursing.

  • Cold and warm compresses and a good support bra for most breast injuries.

  • Breast cysts are sometimes drained with a needle (aspiration) or removed with minor surgery.

  • Fibroadenomas are usually removed with minor surgery.

  • Changing or stopping the medicine when it is responsible for causing the breast tenderness.

  • When breast cancer is present with or without causing pain, it is usually treated with major surgery (with or without radiation) and chemotherapy.

HOME CARE INSTRUCTIONS

Breast tenderness often can be handled at home. You can try:

  • Getting fitted for a new bra that provides more support, especially during exercise.

  • Wearing a more supportive or sports bra while sleeping when your breasts are very tender.

  • If you have a breast injury, using an ice pack for 15 to 20 minutes. Wrap the pack in a towel. Do not put the ice pack directly on your breast.

  • If your breasts are too full of milk as a result of breastfeeding, try:

  • Expressing milk either by hand or with a breast pump.

  • Applying a warm compress for relief.

  • Taking over-the-counter pain relievers, if this is OK with your caregiver.

  • Taking medicine that your caregiver prescribes. These might include antibiotics or birth control pills.

Over the long term, your breast tenderness might be eased if you:

  • Cut down on caffeine.

  • Reduce the amount of fat in your diet.

Also, learn how to do breast examinations at home. This will help you tell when you have an unusual growth or lump that could cause tenderness. And keep a log of the days and times when your breasts are most tender. This will help you and your caregiver find the right solution.

SEEK MEDICAL CARE IF:

  • Any part of your breast is hard, red and hot to the touch. This could be a sign of infection.

  • Fluid is coming out of your nipples (and you are not breastfeeding). Especially watch for blood or pus.

  • You have a fever as well as breast tenderness.

  • You have a new or painful lump in your breast that remains after your period ends.

  • You have tried to take care of the pain at home, but it has not gone away.

  • Your breast pain is getting worse. Or, the pain is making it hard to do the things you usually do during your day.