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Causes
By Mayo Clinic staffMost of the time, it's not possible to identify the exact cause of breast pain. Likely contributors are:
- Reproductive hormones. Cyclic breast pain appears to have a strong link to hormones and your menstrual cycle. Cyclic breast pain often decreases or disappears with pregnancy or menopause so experts theorize that hormones play a role. However, no studies have identified a particular hormonal abnormality as a contributor to cyclic breast pain.
- Anatomical factors. The cause of noncyclic breast pain is likely to be anatomical rather than hormonal, triggered by breast cysts, breast trauma, prior breast surgery or other factors localized to the breast. Noncyclic breast pain may also originate outside the breast — in the chest wall, muscles, joints or heart, for example — and radiate to the breast.
- Fatty acid imbalance. An imbalance of fatty acids within the cells may affect the sensitivity of breast tissue to circulating hormones. This theory provides the rationale for taking evening primrose oil capsules as a remedy for breast pain. Evening primrose oil contains gamma-linolenic acid (GLA), a type of fatty acid. GLA is thought to restore the fatty acid balance and decrease the sensitivity of breast tissue to circulating hormone levels.
- Medication use. Certain hormonal medications, including some infertility treatments and oral contraceptives, may be associated with breast pain. Also, breast tenderness is a possible side effect of estrogen and progesterone hormone therapy, which could explain why some women continue to have breast pain even after menopause. There have also been reports of breast pain associated with prescribed antidepressants, including selective serotonin reuptake inhibitor (SSRI) antidepressants, such as fluoxetine (Prozac) and sertraline (Zoloft).
- Breast size. Women with large breasts may have noncyclic breast pain related primarily to the size of their breasts. This type of breast discomfort is typically accompanied by neck, shoulder and back pain. Some studies have shown that breast reduction surgery sometimes reduces these symptoms. Breast surgery itself, however, also causes pain, which may linger after the incisions have healed.
References
- Smith RL, et al. Evaluation and management of breast pain. Mayo Clinic Proceedings. 2004;79:353.
- Miltenburg DM, et al. Benign breast disease. Obstetrics and Gynecology Clinics of North America. 2008;35:285.
- Richardson J. Breast signs and symptoms: Breast pain. In: Adams Hillard PJ. The 5-Minute Obstetrics and Gynecology Consult. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:22.
- Golshan M, et al. Breast pain. http://www.uptodate.com/home/index.html. Accessed June 1, 2010.
- Millet AV, et al. Clinical management of breast pain: A review. Obstetrical and Gynecological Survey. 2002;57:451.
- Pruthi S, et al. Vitamin E and evening primrose oil for management of cyclical mastalgia: A randomized pilot study. Alternative Medicine Review. 2010;15:59.
- Rodden AM. Common breast concerns. Primary Care: Clinics in Office Practice. 2009;36:103.
- Parsay S, et al. Therapeutic effects of vitamin E on cyclic mastalgia. The Breast Journal. 2009;15:510.
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