Cyclical and Noncyclical Breast Pain

Symptoms, Causes, and Treatment Options

Breast pain can be experienced in many different ways, and it may be related to your menstrual cycle (cyclic) or unrelated to your menstrual cycle (noncyclical). The pain can range from a vague feeling of tenderness or achiness to a constant throbbing or sharp, stabbing pain. 

Episodes of breast pain may come on a regular schedule, may happen only once, or may endure for long periods of time. It may occur in only one breast (unilateral) or in both (bilateral).

Most of the time breast pain does not mean breast cancer. Even so, some people with breast cancer do have pain, and the symptom should never be dismissed.

There are a number of different terms used to describe breast pain including mastodynia, mastalgia, and mammalgia.

Cyclical Breast Pain

Cyclical Breast Pain and Menstrual Cycle
Differences between the causes of cyclical and noncyclical breast pain. Art © Pam Stephan

Cyclical breast pain happens during a woman's menstrual cycle or at least varies in intensity at different points in the cycle. A range of sensations in one or both breasts can accompany the hormonal ebb and flow that a premenopausal woman normally experiences. 

Breast pain is often one of the components of premenstrual syndrome (PMS) and can present alongside fatigue, irritability, and abnormal hormone levels. Breast pain may also occur before your periods without the other common symptoms of PMS.

Breast pain associated with PMS is often achy with a sensation of your breast feeling full, heavy, or swollen. The discomfort often begins a few days before your period starts and may continue until your period has stopped, though it often decreases in severity as time goes on.

Associated Conditions

Cyclical breast pain may also be due to benign breast conditions. There are three such conditions commonly seen by healthcare providers

Cyclical breast pain may be considered "normal" but, nevertheless, be severe enough to interfere with one's quality of life. If faced with this level of cyclical breast pain, do not hesitate to see a healthcare provider as soon as possible.

Noncyclical Breast Pain

Noncyclical breast pain is unrelated to your menstrual cycle or occurs after menopause. The pain can vary in intensity and be caused by an infection, injury, weight gain, prior breast surgery, or breastfeeding.

Even wearing an ill-fitting bra can cause lead to increasing levels of breast pain with continued ongoing use.

Several drugs are also known to cause breast pain in some women, including:

Noncyclical breast pain may occur in both breasts or only one breast. You may have pain in one specific area, or it may be generalized.

Managing Breast Pain

If you are premenopausal, you may be able to distinguish if your pain is cyclical or noncyclical by keeping a chart of your cycle and tracking your pain. Journalling helps identify the pattern of the pain as well as any triggers that make it better or worse. It also helps your healthcare provider with the diagnosis.

Your healthcare provider may recommend certain treatments to help alleviate breast pain:

  • Medications: Cyclical and noncyclical breast pain may benefit from over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen), prescription NSAIDs like Topricin (diclofenac), and hormonal treatments such as Parlodel (bromocriptine) or Danocrine (danazol).
  • Support bras: A bra-fitting may go a long way toward alleviating breast pain. A change to support bras may be especially useful in people with larger busts. A sports bra during exercise is essential.
  • Caffeine avoidance: Some studies suggest that drinking more than two cups of coffee per day increases the risk of mastalgia.
  • Smoking cessation: Similarly, smoking more than five cigarettes a day increases the risk of mastalgia by more than 10-fold compared to non-smokers.

For severe, persistent pain, breast reduction surgery or even mastectomy may be considered. Even so, around 50% of such procedures will not improve pain, according to a 2014 review of studies in the Indian Journal of Surgery.

When Breast Pain Isn't

Pain can arise from any of these structures which can easily be mistaken for breast pains. Examples include:

Your breasts rest on the chest wall muscles and ribs just above your heart, lungs, and other structures of the thorax. Within your breasts are a rich supply of nerves, blood vessels, and connective tissues.

Is It Breast Cancer?

Breast cancer is an uncommon cause of breast pain, and the majority of breast cancers do not cause pain.

With that said, pain is a symptom that many women with breast cancer ignore. Contrary to the popular belief that breast pain is painless, breast cancer can and sometimes does cause pain. In some cases, pain may be the first symptom of cancer.

A 2017 study in Cancer Epidemiology reported that more than one in five women with breast cancer experience pain in the three months leading to their diagnosis. Some forms of breast cancer, such as inflammatory breast cancer, typically start with pain.

If your breast pain is persistent or worsening, you should see your healthcare provider about having a clinical breast exam. Certainly, if you notice a lump, changes in your skin such as redness, thickening, or an orange peel appearance you should see your healthcare provider right away.

A Word From Verywell

With breast cancer affecting roughly one in eight people in the United States, any symptom related to the breasts can cause significant anxiety, understandably so. This is especially true if you have a family history of breast cancer.

One way to reduce those fears is to adhere to breast cancer screening guidelines issued by the Centers for Disease Control and Prevention (CDC). Screening can start as early as 40 with recommendations varying based on your age and risk factors. Speak with your healthcare provider to discuss your screening options.

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11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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