Breast pain: causes, treatment and when to see a GP

The NHS says breast pain is usually linked to periods, and that sometimes it can be caused by a health condition or medicine. Breast Cancer Now divides it into cyclical breast pain, linked to the menstrual cycle, non-cyclical breast pain, which is lasting pain not related to periods, and chest wall pain, where pain that feels as though it is in the breast is coming from somewhere else, such as a pulled muscle in the chest.

Patient.info says up to 7 in 10 women develop breast pain at some stage, and that it is usually classed as cyclical or non-cyclical. If you are not sure which you have, it suggests keeping a pain diary for 2 to 3 months, recording the days you have breast pain and how severe it is.

The NHS suggests taking paracetamol or ibuprofen, or rubbing painkilling gel on your breasts, and wearing a properly fitted bra during the day and a soft bra to sleep in. It says there is little evidence that vitamin E tablets or evening primrose oil help.

Breast Cancer Now says the options for treating cyclical and non-cyclical pain are often the same, though non-cyclical pain is not always as easy to treat. If you have cyclical breast pain, your GP may reassure you that it is a normal part of your monthly cycle. A supportive, well-fitting bra worn during the day, during activity and at night can be helpful. NSAID pain relief such as ibuprofen can help breast pain, particularly non-cyclical pain, and can be applied directly as a gel or taken as a tablet, but you should be assessed by a doctor first if you have asthma, stomach ulcers or kidney problems. Paracetamol can also help.

Breast Cancer Now says that if your pain started when you began a contraceptive pill, changing to a different pill may help, and if it started or increased on HRT and does not settle after a short time, you should tell your GP. It says your GP may suggest dietary changes such as a low-fat diet, more fibre and less caffeine and alcohol, but that there is limited evidence these work, and that some women find relaxation therapy useful.

If pain is severe, goes on for a long time or the above has not helped, Breast Cancer Now says a doctor may consider a hormone-suppressing drug such as tamoxifen. It says tamoxifen is not licensed to treat breast pain, has side effects, and will only be recommended after a discussion of the benefits and risks.

Patient.info says that for cyclical breast pain the problem may settle by itself within 3 to 6 months, that studies show it goes away within three months in about 3 in 10 cases, and that in up to 6 in 10 women where the pain has gone, it develops again within two years. So cyclical breast pain may come and go over the years.

Breast Cancer Now says that cyclical breast pain usually stops after the menopause, though women taking HRT can also have breast pain, and that non-cyclical breast pain often goes away by itself over time in about half the women who have it.

The NHS says breast pain by itself is unlikely to be a symptom of cancer, and Breast Cancer Now says it is rarely a sign of breast cancer. It is still important to be breast aware: Breast Cancer Now says to make an appointment with your GP if you are concerned about breast pain that is new or different for you, or you have other symptoms in your breast such as a lump, swelling, changes to the nipple or a change in colour.

The NHS says to ask for an urgent GP appointment or NHS 111 help if you have breast pain and also have a very high temperature or feel hot, cold or shivery; any part of the breast is red, hot or swollen; there is a hard lump in the breast that does not move around; nipple discharge which may be streaked with blood; one or both breasts change shape; the skin on the breast is dimpled like orange peel; or a rash on or around the nipple, or the nipple has sunk into the breast.

The NHS says to see a GP about breast pain if it is not improving or painkillers are not helping, there is a history of breast cancer in your family, or you have any signs of pregnancy, in which case you could do a pregnancy test first.

Breast Cancer Now says your GP will examine your breasts and ask about the type of pain you have and how often you get it, and may ask you to fill in a simple pain chart. If they think you may have non-cyclical or chest wall pain, they may ask you to lean forward during the examination. Your GP may refer you to a breast clinic for a more detailed assessment.

The NHS lists pregnancy and hormone changes during the menopause among the other causes of breast pain, and says that if you have any signs of pregnancy you could do a pregnancy test before seeing a GP.

Breast Cancer Now says cyclical breast pain usually stops after the menopause, though women taking HRT can have breast pain, and that HRT can sometimes cause benign changes in the breast that may need to be seen by your GP or specialist.

On the NHS, breast pain is assessed by a GP, who may refer you to a breast clinic if a lump or other concerning features are present. Most breast pain can be managed with reassurance, a supportive bra and simple painkillers.

Some people choose a private breast clinic appointment, often with same-visit imaging, for reassurance. If you do, ask for results to be shared with your GP, and remember that breast pain on its own is unlikely to be a sign of cancer.