Non-operable benign conditions are common, with pain likely resulting from hormonal fluctuations, stress, costochondritis, caffeine, and fatty food intake.
Breast pain is a common reason that women seek consultation with a breast specialist. Patients are concerned that their pain may be signaling a more serious condition, but only an estimated 4% of patients with breast cancer will experience pain as a symptom.
Breast pain can happen as a result of a change in hormone levels is cyclic breast pain. Women may experience more pain, or their breasts can feel swollen or more sensitive around their menstrual cycle. Other things that change hormone levels such as birth control pills or hormone therapy for menopause can cause similar symptoms.
When pain is not a result of hormone level changes, it is noncyclic breast pain. The pain can be caused by an injury, infection, certain medications, or large breast size. It can be caused by breast cancer, however, that is rare.
Fibrocystic breast changes can cause breast pain due to fluid-filled cysts and areas with fibrosis, which is a thickening of breast tissue that can be felt through the skin. Fibrosis can also happen without the presence of cysts. These types of changes are common and don’t require medical treatment. They don’t increase the risk of developing cancer, however, fibrocystic changes may make it more difficult to detect breast cancer.
These changes occur most often in premenopausal women and are caused by hormonal changes. In addition to “lumpy, bumpy” feeling breast tissue in one or both breasts, pain, tenderness, and nipple discharge can also be present due to fluctuating hormone levels.
Other common triggers for breast pain include caffeine or stress. Omitting coffee, tea and soda can be helpful in reducing breast pain. Other things are also known to cause breast pain, include chocolate, cheese, bananas, nuts, red wine, "energy’ drinks, over-the-counter diet pills, and migraine medications. Changing your diet to exclude these can be helpful in reducing breast pain.
Fibrocystic conditions are seen on mammograms and ultrasounds as normal breast tissue.
Costochondritis is a common form of localized breast pain caused by inflammation of the costal cartilages around the ribs that are located behind the breast. It might feel like the pain is from the breast itself, but the pain actually is coming from somewhere else.
While it can be caused by an injury, strained or torn muscle, conditions such as rheumatoid or osteoarthritis, or ankylosing spondylitis, joint infections caused by bacteria, viruses, or fungi, or both noncancerous and cancerous tumors, sometimes there isn’t a clear cause.
It occurs most often in women and in people older than age 40. Costochondritis in teenagers and young adults can be caused by a rare musculoskeletal disease called Tietze syndrome.
Breast imaging such as mammograms, ultrasounds, MRI, chest x-rays, and CT scans will not diagnose costochondritis but can confirm that there are no other abnormalities in the breast or chest.
Some women with fibrocystic breast changes can develop cysts in their breasts. There are different types of benign breast cysts. Although doctors and scientists don’t know what causes breast cysts to occur, some research has shown that they may be a result of hormonal changes in the body.
Typically, cysts are small and will go away by themselves. If the cyst is enlarging, painful or there is a question as to the type of cyst it may be, fluid may be drained from the cyst using a needle. A breast surgeon or radiologist would perform this procedure called an ultrasound-guided cyst aspiration. This is often used for large and unsightly or painful cysts.
Breast surgeons rarely recommend surgical removal of a benign cyst. Most women find that benign cysts will resolve after menopause, especially if they are not taking any type of hormone replacement medications.
Having breast cysts does not increase a person’s risk of developing future breast cancer.
To help alleviate the pain that can be caused by breast cysts, breast specialists may recommend modifications to a person’s diet as well as wearing a well-fitted bra (sports bra when active), using vitamin E, and treating pain with non-steroidal anti-inflammatory medications (NSAIDs)
This is a small area of fat located under the skin of the breast. It is usually near a scar that has hardened after losing its blood supply. This can happen after trauma to the breast, including bruising of the breast, or as a result of a breast biopsy or surgery. This is seen on ultrasound imaging as a benign-appearing lump.