Cyclical and Noncyclical Breast Pain

Breast Pain That Is or Is Not Related to Your Period

Breast pain can be experienced in many different ways. You may have a vague feeling of tenderness or a dull ache or instead suffer from constant throbbing pain. Episodes of breast pain may come on a regular schedule, may happen only once, or may endure for long periods of time. 

There are a number of different terms used to describe breast pain including mastodynia, mastalgia, mammalgia, or mastitis (though the term mastitis is more often is used to describe an infection or inflammation of the breasts).

Most of the time breast pain does not mean breast cancer, though some people do have pain with breast cancer.

To begin to define the cause of your pain one of the first questions to answer is whether your breast pain is cyclical—occurring at regular intervals associated with your period, or noncyclical—unrelated to your menstrual period or occurring after menopause.

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.  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 along with fatigue, irritability and a reduced concentration level. 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 or swollen. The discomfort often begins a few days before your period starts and may continue until your period has stopped.

Cyclical breast pain may be normal and associated with normal hormonal changes. It may also be due to the benign breast conditions fibrocystic breast changes or mammary duct ectasia.

With fibrocystic breast changes, you may note generalized achiness with diffuse areas of your tenderness in your breasts. Your breasts may feel firm and thick. Both microcysts (which can't be felt) and macrocysts (which can be felt) may occur. Larger cysts can be seen on ultrasound, and a needle biopsy to drain the cyst may be needed to diagnose the condition. Mammary duct ectasia is more common in perimenopausal women and often causes tenderness in the nipple and areola.

Breast pain associated with oral contraceptive use may require changing to a different combination birth control pill.

Noncyclical Breast Pain

Noncyclical breast pain is unrelated to your menstrual cycle or occurs after menopause. The pain may vary in intensity, but instead of changes caused by hormones may be caused by an illness or injury, weight gain, breast surgery, or certain medications.

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.

Wearing an ill-fitting bra is a common cause of noncyclical breast pain, but it won't cause breast cancer

Breast cancer is an uncommon cause of breast pain, and the majority of breast cancers do not cause pain. That said, roughly one in five or six women with breast cancer experience pain during the 3 month period before their diagnosis, and an uncommon form of breast cancer, inflammatory breast cancer, often begins with pain.

Pain Near Your Breast

Your breasts rest on your chest wall muscles and ribs. Within your breasts are a rich supply of nerves, blood vessels, and connective tissues.

Arthritis in your spine or ribs may cause noncyclical breast pain, as well as muscle strains that affect the muscles of your chest. Nerves can be pinched or veins inflamed leading to pain.

If your pain is in your left breast it's important to make sure that your pain isn't related to heart disease. Chest pain related to a heart attack is often different in women than in men and can be vague and subtle in character.

How To Handle 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.  

If your pain is persisting you should see your doctor to have 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 doctor right away.

Treatments that have been effective for non-cancer related cyclical and noncyclical breast pain include topical anti-inflammatory medications such as Topricin (diclofenac), oral anti-inflammatory drugs such as Advil (ibuprofen), and hormonal treatments such as Parlodel (bromocriptine) or Danocrine (danazol). For severe, persistent pain, surgery (mastectomy) is sometimes needed.

And if your body and breasts have changed, perhaps it is simply time for a bra fitting session and some pretty, supportive, new bras.

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