Breast cancer does not usually cause pain. Breast pain is very common and most often has harmless causes, such as hormonal changes before a period or a breast cyst [1, 2]. When pain is the only symptom and the examination is normal, the chance of cancer is very low [3]. But pain that comes with a lump, a change in the skin or nipple, or redness and swelling of the breast, or pain that stays in one spot and does not come and go with your periods, should be shown to a doctor [3, 7].
Key points
- Breast pain is very common: up to 8 in 10 women have it at some point in their lives, and it is rarely linked to cancer [2].
- Breast cancer does not usually cause pain. More important than pain are a new lump or thickening and changes in the skin or nipple [1].
- Period-related pain, which is in both breasts and gets worse before a period, usually does not need a new ultrasound or mammogram if the examination is normal [3, 10].
- Pain that stays in one spot and is not related to your periods should be checked: with an ultrasound under the age of 30, and from the age of 30 with a mammogram, an ultrasound or both [3].
- Redness, swelling and warmth of the breast that appeared quickly should be checked promptly, especially if it does not get better with treatment for an infection [7, 8].
What does breast pain mean?
Doctors usually divide breast pain into three groups [10]:
- Period-related pain (cyclical pain): about 2 in every 3 cases of breast pain are of this kind, and it is most common in women in their 20s and 30s [10]. It is usually in both breasts, spread across the whole breast, and may spread to the armpit [10]. It is caused by the hormonal changes before a period [1].
- Non-cyclical pain: it is not related to periods, may be in one spot or spread out, and is most common in people in their 30s and 40s [10]. Its causes include some medicines (such as the contraceptive pill, hormone therapy, some medicines for mental health and some heart medicines), an injury to the breast, infection, cysts and benign lumps, and strain on the supporting tissue in large, heavy breasts [1, 10].
- Pain that comes from somewhere else: sometimes the pain comes from the muscles and joints of the chest wall, or from the heart, lungs or stomach, and is only felt in the breast [10].
The type of pain helps your doctor decide whether imaging is needed [3]. If you note down for a few weeks where the pain is and on which days of the month it is worse, it will be easier to explain it to your doctor.
| Feature of the pain | Usually not a worry | Show it to a doctor |
|---|---|---|
| Link with periods | Gets worse before a period and eases after it [1, 10] | Not related to periods and keeps going [3] |
| Where it hurts | In both breasts and spread across the whole breast [3, 10] | In one definite spot, smaller than a quarter of the breast [3] |
| How it changes | Eases or goes away; breast pain often gets better on its own [10] | Stays or gets worse [3] |
| Comes with | No other change in the breast [3] | A lump, a change in the skin or nipple, discharge, or redness and swelling of the breast [1, 3, 7] |
This table is only a guide and does not replace an examination; if you are worried, see a doctor.
Is breast cancer painful? What does breast cancer pain feel like?
Most breast cancers do not cause pain [1]. When pain is the only symptom and the examination is normal, the chance of cancer is very low [3]:
- In a study of nearly 1,000 women who had pain in one or two spots in the breast and no other symptoms, only 3 had cancer at the site of the pain when they were first checked [4].
- In another study of more than 600 women who had only breast pain, fewer than 2 in 100 developed cancer in the painful breast over about 4 years of follow-up; most of these cancers were found months or years after the first check [5].
When cancer does cause pain, the pain is usually in one spot and keeps going [3]. That is why pain that stays in one spot is worth following up, even if the first imaging was normal [5].
Inflammatory breast cancer is a rare but important type of breast cancer that can come with a feeling of heaviness, burning or tenderness in the breast. The skin of the breast turns pink, reddish purple or bruised-looking within a short time, gets small dimples like the skin of an orange, and the breast quickly gets bigger; most often no lump can be felt [7]. Its symptoms look like a breast infection and it is sometimes mistaken for one [7, 8].
When should I call my doctor?
Most breast pain is harmless. But in these cases, do not wait: see a doctor within the next few days:
- A new lump or thickening in the breast or armpit, with or without pain [9]
- A change in the skin of the breast: redness, swelling, dimpling or skin that looks like orange peel [1, 7]
- A new change in the nipple, such as the nipple turning inwards or a discharge that is not milk, especially on one side only [1, 9]
- Pain in one definite spot that stays and does not go away when your period ends [3]
- Redness, swelling and warmth of the breast that appeared quickly, or a breast infection that has not improved after a week of antibiotics [7, 8]
If chest pain comes with shortness of breath, a cold sweat, weakness and light-headedness, or pain in the arm, shoulder, jaw, neck or back, it may be a heart problem: call your local emergency number straight away [12].
What tests are needed for breast pain? Ultrasound or mammogram?
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An examination by your doctor
Your doctor will ask where the pain is, how it relates to your periods and which medicines you take, and will examine your breasts and armpits [10].
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Period-related pain or pain spread across the breast
If the examination is normal, you do not need any imaging beyond the routine screening for your age [3, 10]. Have screening mammograms at the right age: At what age should I start mammograms?
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Understand the result
The imaging result is usually given as a number called BI-RADS; see what each number means in What does my BI-RADS score mean? Most of the things seen at the site of the pain are benign [4]. For cysts and fibroadenomas, see Hypoechoic breast mass, fibroadenoma or cyst.
How can I ease breast pain?
- Be reassured: for most women, knowing that the pain is not a sign of cancer, together with a few simple changes, eases the pain [10, 11]. Breast pain often gets better on its own; pain that is not related to periods goes away without treatment in nearly half of women [10].
- A well-fitting, supportive bra: about 7 in 10 women wear a bra that is not their size. A well-fitting bra reduces the strain on the breast, especially in large breasts, and most women who corrected their bra size felt better [10, 11].
- A pain-relief gel on the skin: anti-inflammatory pain-relief gels such as diclofenac gel, rubbed onto the painful area, are the first medicine recommended and have eased the pain in most women [10, 11].
- Coffee and fatty food: in some studies, cutting down on coffee and fat helped a little, but the evidence is not conclusive [10, 11].
- Hormonal medicines: if the pain started after you began the contraceptive pill or hormone therapy, talk to your doctor; these medicines may be the cause of the pain [10]. Do not stop a medicine on your own.
- Severe, long-lasting pain: for severe pain that does not get better with these measures, a specialist sometimes prescribes hormonal medicines such as tamoxifen for a short time. These medicines have side effects and are used only when simpler measures have not worked [10, 11].
Frequently asked questions
Is breast pain before a period normal?
Is a breast cancer lump painful?
Most breast cancers do not cause pain, so a lump that does not hurt is not necessarily harmless [1]. Show any new lump to a doctor, with or without pain [9]: I found a lump in my breast. What should I do?
What does pain in the left breast mean? Could it be my heart?
Pain in one breast, left or right, may come from the breast itself or from the muscles and joints of the chest wall [10]. But heart pain can also be felt in the centre or on the left side of the chest. If the pain lasts more than a few minutes, goes away and comes back, or comes with shortness of breath, a cold sweat or pain in the arm and jaw, call your local emergency number straight away [12].
Is a burning or shooting pain in the breast a sign of cancer?
Usually not; breast pain and shooting pains most often have a harmless cause [1, 2]. But burning or heaviness in the breast together with redness, swelling and warmth that appeared quickly should be checked promptly, because it can be caused by an infection or, rarely, by inflammatory breast cancer [7].
My mammogram and ultrasound were normal, but the pain continues; what should I do?
A normal result is very reassuring: in one study, almost all women with a normal mammogram did not have cancer at that time [5]. But if the pain stays in one spot or gets worse, or a new change such as a lump appears, see your doctor again; in the same study, most of the few cancers found were diagnosed months or years later [5].
My breast is red, hot and painful while I am breastfeeding; what should I do?
Is breast pain after the menopause a worry?
After the menopause, too, most breast pain is harmless; menopausal hormone therapy is one of the causes of breast pain [10]. Pain that stays in one spot is checked with a mammogram and, if needed, an ultrasound [3]. For hormone therapy, see Does menopausal hormone therapy (HRT) increase the risk of breast cancer?
Do tight or underwired bras cause breast pain or breast cancer?
A bra that does not fit puts more strain on the breast, and a well-fitting bra has helped many women [10]. For bras and breast cancer, see Do deodorants, antiperspirants or bras cause breast cancer?
Notes for doctors (for physicians)
For physicians
ACR Appropriateness Criteria, Breast Pain (2018). Breast pain without an accompanying suspicious clinical finding (e.g. a lump or nipple discharge) has a very low association with malignancy (0%-3.0%); malignancy-related pain tends to be focal (less than one quadrant) and persistent. Clinically insignificant pain (nonfocal [more than one quadrant], diffuse or cyclical) requires no imaging beyond what is recommended for screening. Clinically significant pain (focal and noncyclical): under 30, ultrasound "usually appropriate" and other modalities "usually not appropriate"; 30-39 and 40 and older, ultrasound, diagnostic mammography and DBT all "usually appropriate"; MRI and MBI "usually not appropriate" [3]. The 2017 version: up to 80% of women experience breast pain at some point in their lives [2].
Cancer yield in focal pain. Owen 2019: 944 women with one or two foci of pain and no other symptoms; 113 findings at the site of pain (103 benign or probably benign); 12 biopsies with 3 malignancies (ILC, IDC and DCIS), all three seen on mammography and 2 with an ultrasound correlate; 4 incidental cancers remote from the site of pain at initial evaluation; on follow-up, 9 cancers at the site of pain and 13 incidental cancers. Authors' conclusion: targeted ultrasound may be deferred in women 40 and older with focal pain, no other clinical findings and a negative mammogram [4]. Leddy 2013: 257 patients with focal pain without a lump; cancer incidence 1.2% (n = 3); NPV of mammography and of ultrasound each 100%; adding ultrasound to mammography detected no additional cancers [6]. Noroozian 2015: 617 women with isolated breast pain (mean age 49 years, mean follow-up 51 months); cancer in the painful breast in 11 (1.8%), of which 9 (81.8%) were diagnosed 5-52 months after the initial evaluation; initial diagnostic mammography NPV 99.8%, specificity 98.5% and sensitivity 66.7% [5].
Referral (NICE NG12, updated 2026). Breast pain without other findings is not among the urgent referral criteria. Suspected cancer pathway referral: aged 30 and over with an unexplained breast lump, with or without pain, or aged 50 and over with discharge, retraction or other changes of concern in one nipple only (1.4.1). Consider a suspected cancer pathway referral for skin changes that suggest breast cancer, or an unexplained lump in the axilla at age 30 and over (1.4.2). Under 30 with an unexplained breast lump, with or without pain: consider non-urgent referral (1.4.3) [9].
Inflammatory breast cancer. Minimum diagnostic criteria (international expert panel, 2011): rapid onset of breast erythema, oedema and/or peau d'orange and/or a warm breast, with or without an underlying palpable mass; duration of history no more than 6 months; erythema occupying at least one-third of the breast; and pathological confirmation of invasive carcinoma on core biopsy. Patients may have a history of mastitis that did not respond to at least 1 week of antibiotics [8]. In the United States, 1%-5% of breast cancers are inflammatory; they usually do not form a palpable lump and usually cannot be seen on a mammogram [7].
Treatment of mastalgia. First line: explanation, reassurance and bra-fitting advice; a topical NSAID (e.g. diclofenac) is the first-line drug treatment (SORT B) and gave relief in 70-92% of women in a systematic review [10, 11]. Drugs associated with mastalgia: oral contraceptives, hormone therapy, some psychotropic drugs and some cardiovascular agents [10]. Other drug treatments have serious (often androgenic or menopausal) side effects and are reserved for cases resistant to simpler measures; dopamine agonists are useful but less effective than endocrine treatments such as danazol or tamoxifen [11]. Tamoxifen is the most extensively studied and has shown clear benefit in up to 90% of women [10].
Related cancer types
Related questions
References
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Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
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