Does breast pain always mean breast cancer?

Breast pain does not necessarily indicate breast cancer. In fact, most changes that occur in the breast, including pain, are benign and non-cancerous [1]. Breast pain can be a normal part of the hormonal changes a woman goes through at different stages of her life, such as during menstruation, pregnancy, or perimenopause [3].

Although breast pain is rarely the only symptom of breast cancer, it is always important to consult a healthcare provider when you feel any unusual changes in the breast so they can be properly evaluated [1].

Common causes of breast pain

Breast pain can arise from several causes, most of which are not related to cancer:

• Fibrocystic changes: These changes can include lumps, thickening, and swelling in the breast, and they often occur just before the menstrual period. Breasts may feel painful, swollen, or tender [1].
• Cysts: These are fluid-filled sacs that can be painful [1].
• Fibroadenomas: These are solid, round, rubbery lumps that move easily when pushed, and they occur most often in younger women [1].
• Hormonal changes: Fluctuating hormone levels before menstruation, during pregnancy, or as menopause approaches can lead to breast pain or lumps [3].
• Medications: Some medications can cause breast pain as a side effect [1].

When should breast pain cause concern?

Although most breast pain is benign, there are some signs that raise concern and require a visit to the doctor for evaluation. You should pay attention to any unusual or persistent breast changes [1]:

• Presence of a lump or feeling of lumpiness or thickening in the breast or under the arm [1].
• A change in the size or shape of the breast [1].
• Nipple discharge other than breast milk [1].
• Skin changes such as itching, redness or darkening, flaking, or dimpling on the breast or nipple [1].
• Persistent pain that does not go away or worsens over time, especially if it is not related to the menstrual cycle.

The role of diagnostic tests

If you notice any of these symptoms, your doctor will perform a clinical breast exam and may recommend additional tests to determine the cause [1]. These tests may include:

• Mammogram: An X-ray imaging of the breast [1].
• Ultrasound: Used to evaluate lumps or other changes in the breast [1].
• MRI: May be used in some cases to evaluate the breast in more detail [1].
• Breast Biopsy: This is the only procedure that can confirm whether a suspicious breast change is cancerous or not [2]. It involves removing a small sample of breast tissue to examine it under a microscope [2]. It is important to note that most lumps and changes that are biopsied turn out to be benign [2].

Next steps after discovering a breast lump

If you discover a lump in your breast, the first and most important step is not to panic. Less than 10% of women who are called back for additional testing after a mammogram are found to have breast cancer [3]. However, it is essential to schedule an appointment with your doctor as soon as possible to evaluate the lump. The doctor will determine the appropriate type of test based on the characteristics of the lump and your health history [1].

For more information on breast pain, you can visit Breast pain: When is it normal and when should you be concerned? (Arabic)

Medical references

• Breast Diseases
• Breast Biopsy
• My mammogram was ‘abnormal’—what do I do next?