Most breast symptoms and breast changes are caused by benign (noncancerous) conditions. Breast pain, cysts, fibroadenomas, nipple discharge, and other breast changes are common and often do not require treatment. However, a new or persistent breast change should still be evaluated. Depending on your symptoms, evaluation may include a breast exam, diagnostic mammogram, breast ultrasound, or other testing.
Finding a breast lump can understandably be concerning, but many breast lumps are benign. Common causes include breast cysts and fibroadenomas. The appropriate evaluation depends on your age, symptoms, examination, and previous breast imaging. A new breast lump should generally be evaluated rather than assuming that it is benign based on how it feels.
Breast pain is very common and, when it occurs without another concerning breast finding, is rarely caused by breast cancer. Sometimes there is no clear cause.
Breast pain may be related to:
Hormonal changes related to the menstrual cycle, pregnancy, perimenopause, or menopause
Hormonal medications, including some forms of birth control or menopausal hormone therapy
Breast cysts or other benign breast changes
A poorly fitting or unsupportive bra
Previous breast surgery, injury, or radiation
Inflammation of the muscles or chest wall, which can sometimes feel like pain within the breast
Less commonly, infection or another breast condition
Persistent pain in one specific area of the breast may sometimes need breast imaging, particularly if it is new or does not resolve. The type of imaging recommended depends on your age, symptoms, examination, and previous breast imaging.
Breast pain often improves over time. While you're waiting for it to resolve, some things that may help include:
Wear a well-fitting, supportive bra. Some patients find a sports bra particularly comfortable.
Try warm compresses, an ice pack, or gentle massage.
If you can safely take them, consider an over-the-counter pain reliever such as ibuprofen (Motrin/Advil) or acetaminophen (Tylenol).
A topical anti-inflammatory medication such as diclofenac (Voltaren) gel can be particularly helpful for localized breast or chest-wall pain. Topical NSAIDs are considered a first-line medication option for mastalgia.
If your breast pain began after starting or changing a hormonal medication, let us know. Sometimes adjusting the medication can help if symptoms persist.
You may hear recommendations to eliminate caffeine or chocolate, follow a low-fat diet, or take supplements such as vitamin E or evening primrose oil for breast pain. Some patients feel that these changes help, but research has not consistently shown that they improve breast pain. If you notice that a particular food or drink seems to make your symptoms worse, it is reasonable to try reducing it and see whether you notice a difference.
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Nipple discharge can have many causes. Milky discharge from both breasts may be related to pregnancy, breastfeeding, medications, hormonal conditions, or an elevated prolactin level.
Discharge is more likely to need breast imaging when it occurs spontaneously without squeezing, comes from only one breast or one duct, or is bloody or clear. New nipple inversion, persistent scaling or irritation, or other new nipple changes should also be evaluated.
Large or heavy breasts can contribute to neck, shoulder, and back pain, skin irritation, difficulty exercising, and bra-strap discomfort. For patients with persistent symptoms, breast reduction surgery may be an option.
Insurance coverage varies. Many plans require documentation of symptoms and previous attempts at conservative treatment before breast reduction will be covered.