Up to 80% of women will experience breast pain
at some point in their lifetime.
ξ Most commonly between the ages of 30
ξ For some women after menopause.
ξ This pain can be “severe” in 1 out of 5
ξ This pain is rarely a sign of cancer.
ξ Often resolves on its own without any
What is the most likely cause of my breast
Your provider will consider a number of things
about your breast pain, including whether the
ξ Cyclical (changes with your menstrual
cycle) or non-cyclic
ξ associated with the chest wall (muscle) or
the breast tissue itself
ξ involves both breasts or just one
ξ just one spot in the breast or if the pain
spreads to most of the breast or to the
ξ constant, versus only occurring once in a
ξ persistent (lasts for a long time) versus
only a short time
Your provider will also assess your risk of breast
cancer by asking about your personal history as
well as your family history.
Do I need any breast imaging to help decide
what is causing my breast pain?
Your provider will decide whether to get a
mammogram or ultrasound based on your history,
physical exam, family history of breast cancer,
What are common causes of breast pain?
The causes of breast pain differ based on whether
the pain changes with your menstrual cycle
(cyclic) or is constant.
ξ Causes of cyclical pain: Fibrocystic
breast tissue, contraceptive hormones,
hormone replacement therapy
ξ Causes of non-cyclical pain: Some
prescription medicines, poor fitting bra,
stress, smoking, caffeine, other benign
breast conditions (duct ectasia,
fibroadenoma, etc), and rarely breast
Does my breast pain mean that I have breast
ξ It is very uncommon for a breast cancer to
present with breast pain.
ξ Of all new breast cancer diagnoses, only
0.5 -3.3% present with breast pain.
ξ For most women, their breast pain is
completely unrelated to cancer.
Signs or symptoms that may make your
provider think more about breast cancer
ξ The pain is limited to a small area of the
ξ Pain is constant over a long period of time
ξ There is a mass in the breast
ξ There are changes in the skin of the breast
ξ Discharge from the nipple
What Is Fibrocystic Breast Tissue?
Fibrocystic breast tissue is one of the most
common causes for cyclical breast pain. Many
women have fibrocystic breast changes at some
point in their lives. Women with fibrocystic
breast tissue may notice that their breasts feel
“lumpy” or “ropy”. The lumps may seem to
change in size with the menstrual cycle. This may
cause the breasts to become more tender or
painful just before the monthly period, with some
relief following. The symptoms may also become
worse during the years surrounding menopause.
These changes are believed to be a result of
hormone effects on the gland type tissue in the
breast. After menopause many of these
symptoms go away.
Does Having Fibrocystic Breast Tissue
Increase My Risk of Breast Cancer?
Having fibrocystic breast tissue does NOT
increase a woman’s risk of developing breast
How Can My Symptoms Be Relieved?
First steps to address breast pain
ξ Wear a well-fitting support bra.
ξ Try to keep a pain diary. Watch for a
pattern to when the pain develops, such as
a relationship with your menstrual cycle,
caffeine intake, food, etc.
ξ Try Tylenol for mild cyclic pain.
ξ Reduce or stop drinking caffeine, this
would include drinks such as coffee, tea,
and colas. Chocolate contains caffeine,
stop eating chocolate.
ξ Lowering the amount of processed fat you
eat and ensuring you eat a high fiber diet
may reduce estrogen levels and improve
ξ Stop smoking.
ξ Reduce stress.
If the pain is moderate to severe and is persistent,
oral ibuprofen can be considered instead of
Tylenol. This should be taken consistently
(every day) for a 4-6 week period following the
directions on the bottle.
Next steps to consider
Evening primrose oil may reduce breast pain for
some women when taken orally. This should
NOT be used if there is a chance you could
become pregnant or are breast feeding.
ξ There are many forms of evening
primrose oil (EPO) available. Dosing
options: include 1-3 grams or 2.4
milliliters of EPO, 1-6 capsules of EPO,
or 240-320 milligrams of GLA (Efamast®,
Efamol®) by mouth 1-3 times daily.
ξ Side effects: The most common symptom
is abdominal bloating. It may cause low
blood pressure or increase risk of bleeding
when combined dosing with prescription
medicines or other supplements, so you
should review all medications with your
doctor before starting. This should also
be stopped prior to undergoing anesthesia.
ξ Length of treatment: Evening primrose
oil can be taken until the breast pain goes
away or for up to 6 months.
Flaxseed has been shown to reduce breast pain
for some women.
ξ Dosing: The recommended dose is 2-4
Tb each day.
ξ Side effects: The most common side
effects are gastrointestinal, including
bloating, gas, nausea, abdominal pain,
constipation and diarrhea.
ξ Length of treatment: Flaxseed can be
taken for as long as it is being effective.
Prescription medicines (if other treatments
Topical diclofenac is a non-steroidal medicine
(similar to ibuprofen) that comes in the form of a
gel. It can be applied directly to the breast to help
ξ Dosing: Apply 2 gm to painful area up
to 4 times daily
ξ Side effects: Most people who take
this medicine have few side effects.
You should let your provider know if
you develop swelling of the
weight gain, or signs of kidney
problems (such as change in the
amount of urine).
ξ Length of treatment: This can be used
until breast pain goes away or up to 3
Tamoxifen is a medicine that works by interfering
with the effects of estrogen in the breast tissue.
ξ Dosing: 10 mg once daily
ξ Side effects: The most common side
effects are menopausal symptoms (hot
flashes, irregular periods, vaginal
dryness, moodiness, etc). Less
common side effects include blood
ξ Length of treatment: Initial treatment
could be tried for 3 months, and
renewed for up to 6 months if it is
improving the breast pain.
How Do I Know When I Should See a Health
Care Provider About a Breast Problem?
Tell your health care provider about any new
change in your breast tissue. These changes can
ξ A change in skin color or texture, skin
puckers, or dimples,
ξ A change in how the nipple looks (change
in direction, inversion, elevation,
ξ Sudden size increase of one breast
ξ A single lump that does not feel like the
rest of the breast tissue or gets bigger over
ξ Finding a new lump or thickening in the
breast tissue that does not go away after
you get your period
ξ If a lump continues to grow.
Chances are great that nothing will be wrong, but
it is best to report this to your health care provider
Your health care team may have given you this information as part of your care. If so, please use it and call if you have any
questions. If this information was not given to you as part of your care, please check with your doctor. This is not medical advice.
This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health needs are different, you
should talk with your doctor or others on your health care team when using this information. If you have an emergency, please call
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