Health / Expert Advice

Here’s When You Should See a Doctor About Breast Pain

How to tell what's benign and what's cause for concern.

Breasts are tricky. Some days, you wake up and feel like someone punched you in the boob—twice. Other days, they’re sore and tender to the touch (and look like they magically grew a cup size overnight). It can feel like they have a mind of their own. But, you’re not alone. Breast pain happens regularly to tons of women.

“Breast pain is actually a complex subject and a very common one,” says Aparajita Sohoni, M.D., physician lead for QTbreasthealth, an advanced imaging center in Novato, California. “Some studies show that up to 70 percent of women in Western societies experience breast pain in their lifetime.”

But just because breast pain is common doesn’t mean it’s not concerning. There’s a difference between breast pain caused by a constricting sports bra and breast pain caused by an internal issue. So, in honor of Breast Cancer Awareness Month, we talked to experts to get the inside scoop on breast pain, including the different kinds of pain you may experience, how to differentiate between “I wore a crappy sports bra” pain and “I should see a doctor” pain, and how to keep your breast pain in check to make sure the girls feel as good as possible, as often as possible.

The Different Kinds of Breast Pain

When it comes to types of breast pain, the variety can be overwhelming. “As physicians, we generally think of breast pain as either cyclical, noncyclical, or extramammary, implying that the pain is originating from somewhere outside the breast (e.g., the chest wall, the nerves, [or] even from the heart, lungs, or gastrointestinal system),” Dr. Sohoni says. “Breast pain may be unilateral or bilateral, focal (restricted to one area of the breast), or diffuse. It may be associated with a mass, skin changes, or signs of systemic illness such as fever. Breast pain can be mild, moderate, or severe.”

These various types of breast pain—from the “Welp, looks like I’m about to get my period” soreness to more localized pain, such as a pulled muscle—have different root causes.

“Breast pain will differ based on the cause,” says Constance Chen, M.D., a breast reconstruction specialist in New York City. “If breast pain is cyclical, then it’s probably due to hormones related to the menstrual cycle and is dull, heavy, or aching; affecting both breasts, and getting worse as the woman gets closer to her period … [whereas] breast pain that is actually not in the breast can be due to trauma like rib injuries or overuse like torn muscles in the chest or shoulders.”

Differentiating Between Benign and Serious Breast Pain

When it comes to discerning the difference between benign breast pain and something that could be more serious, the key is to pay attention to (a) when the pain shows up and (b) how it shows up.

“Recurring breast pain is cyclical and associated with rising hormone levels during the natural menstrual cycle. The pain increases the week before you get your period and decreases once you get your period,” Dr. Sohoni says. “The pain is usually bilateral and diffuse, meaning throughout the breast, not just one part of the breast. It tends to be worse in upper, outer quadrants of each breast.”

So, that overall sore feeling you feel in your boobs a few days before Aunt Flo pays a visit? It’s completely hormonal and nothing to be concerned about. “[This kind of breast pain] can also occur after a woman has started taking hormones as part of post-menopausal hormone therapy,” Dr. Sohoni says.

On the other hand, if your breast pain shows up at random or if it’s centralized to one breast (or a specific area of said breast), you may need to pay closer attention. “If the breast pain is noncyclical and localized to one area of one breast, then it may be more cause for concern,” Dr. Chen says. In this case, your best bet is to play it safe and ring your doctor.

Other Symptoms to Look Out For

Depending on the type you’re experiencing, breast pain can be a red flag. But there are also other symptoms that can alert you to something more serious than period pain.

“If a woman develops any of the signs for serious breast disease—fever, redness, swelling, palpable mass, skin/nipple changes, or bloody nipple discharge—then they should call their physician immediately,” Dr. Sohoni says. Also, if you notice a lump in your breast, it’s important to get it checked out immediately. “A lump that is painful to the touch could indicate an underlying infection and in rare cases could also indicate rare forms of cancer like inflammatory breast cancer,” Dr. Chen says.

What if your lump doesn’t hurt? You still need to get it examined. “For breast cancer, isolated breast pain is not a very common symptom,” Dr. Sohoni says.  Any palpable lump needs to be further assessed, first by your physician and then likely afterward by ultrasound.”

How to Make Your Breasts (and Yourself) Feel Better

We can’t stress this enough: If you think your breast pain is cause for concern, get to your doctor, pronto. But if you’re positive you’re dealing with ordinary boob discomfort, there are things you can do to keep the pain at a minimum.

“Benign breast pain can be managed by wearing a well-fitting bra to give more support. Hot or cold compresses can also provide relief. Oral over-the-counter pain relievers, such as acetaminophen or an NSAID (e.g., ibuprofen) can also be used,” Dr. Sohoni says.

If a better bra, a compress, and a dose of Tylenol don’t do the trick, you may need to see your doctor to determine if a change in hormones can help alleviate the pain. “If the pain is persistent despite these interventions, or severe, then you can consider oral contraceptives to control the hormone rise of the normal menstrual cycle. Or, in the case of a post-menopausal woman, decreasing the dosage of hormone replacement therapy,” Dr. Sohoni says.

Take Care of Your Breasts

Breast pain can be, well, a pain. But understanding that pain—and how to determine which types are cause for concern versus which are a free pass to go back to bed with a hot compress and a pint of Ben & Jerry’s—is one of the best things you can do for yourself and the girls.

So take care of your breasts. Pay attention to what’s going on. Loop in your doctor when necessary. And maybe invest in a better sports bra.

Expert Advice Health

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