Does Having Breast Pain Increase Breast Cancer Risk?

Why breast pain may not mean what you think

Woman laying in grass with hand on her chest Images

When you frequently experience breast pain, you might wonder if it raises your risk for breast cancer. Breast pain, or mastalgia, is very common and is often related to benign causes.  When might breast pain be associated with an increased risk of developing breast cancer, and when is it mostly a nuisance?

Hormones and Breast Pain

There is a difference between cyclical and noncyclical breast pain.  Between puberty and menopause, most women have some cyclical breast pain and tenderness as hormone levels change. At menopause, when your menstrual periods end, most breast pain also ceases. Your ovaries will produce lower levels of estrogen during menopause, which results in less swelling and tenderness in your breasts and stomach. Menopausal breast pain is noncyclical and usually hurts in only one breast. Noncyclical breast pain is not hormonal and can be caused by illness, injury, weight gain, or certain medications.

Breast Pain Doesn't Always Mean Breast Cancer

At the Breast Care Center of University Hospital, Syracuse, New York, researchers did a study with 5463 women who visited their clinic. Of these 861 of these women who were diagnosed with breast cancer, and of that group, only 14 percent of those women reported any breast pain. The majority of women who complained of breast pain did not have breast cancer. Having breast pain is uncomfortable and upsetting, but it is rarely a sign of breast cancer, and seldom increases cancer risk.

Certain benign breast conditions can cause breast pain, but these have a very small impact on your risk for developing breast cancer. These breast conditions are made of non-proliferative cells, which grow and divide at a normal rate.

Benign Breast Conditions With Low Risk

Causes pain and affects breast cancer risk over normal: Very Slight Increase
Non-proliferative cells - normal rate of cell growth and division

Benign Breast Conditions With Moderate Risk

Causes pain and raises risk over normal: 150 - 200% Increase
Proliferative cells without atypia - faster than normal rate of cell growth with no abnormal cells

Fibroadenomas and scar tissue can be removed with surgery or non-invasive ablation by laser, freezing, radio waves, or vacuum. A breast fibroadenoma must be diagnosed with a breast biopsy, so the cells can be tested to rule out other conditions.

Benign Breast Conditions With Heightened Risk

Causes pain and raises risk greatly: 4 to 5 Times Normal
Proliferative with atypia - faster than normal rate of cell growth and having abnormal cells

Hyperplasia is a benign condition in which cells grow faster than normal. Atypical hyperplasia is considered a precancerous condition. Atypical cells are abnormal and have the potential to develop into noninvasive breast cancer, such as ductal carcinoma in situ. Discuss the benefits of surgically removing any atypical hyperplasia with your doctor.

Breast Pain, Hormone Replacement Therapy, and Breast Cancer

For women who are using hormone replacement therapy, breast pain may be a source of concern.  In the Women's Health Initiative Study - the study which raised red flags about hormone use contributing to breast cancer—breast pain was a cause for concern.  In women who used combination therapy—that is, estrogen plus progesterone—new onset breast pain and tenderness was associated with an increased risk of developing breast cancer. 

This was not the case for women using estrogen replacement alone.  This association between pain after using combination estrogen and progesterone replacement was especially concerning in women who had tenderness before beginning therapy.  Anyone who is considering combination hormone replacement therapy should have a careful discussion with her doctor about not only the increased risk of breast cancer but the significance of breast pain.

The Bottom Line

It is true that sometimes breast pain can be the first symptom of breast cancer.   Some painful breast conditions do raise the risk, while most others do not.  If you have breast pain, don't panic, but make sure to talk to your doctor.  Breast cancer is most treatable in the early stages of the disease and any breast cancer symptom that is new to you is important to address thoroughly.

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View Article Sources
  • American Cancer Society. What are the Risk Factors for Breast Cancer? Updated 01/15/16.
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