Breast Symptoms

Is this your symptom?

  • Breast pain, swelling or lump(s)
  • Breast skin changes
  • Discharge or bleeding from the nipple
  • Change in appearance or feel of the breast or nipple
Causes of Breast Symptoms
  • Breast lump: may be a fibroadenoma (not cancer), fluid filled cyst (not cancer) or cancer
  • Nipple discharge: can be milk, blood, pus or clear fluid
  • Infection: short term breast pain with redness on one side
  • Pregnancy: short term breast pain and full-feeling without redness on both sides
  • Cyclic Mastalgia: repeat breast pain with menstrual cycles. See more info below.
  • Shingles(nerve pain from past chicken pox) in the upper chest area
  • Fibroadenoma, cyst or marijuana use: long-term breast pain on one side. Not related to menstrual periods.
Cyclical Breast Pain and Swelling(with menstrual cycles)
  • Caused by extra body fluid from female hormone cycles
  • Mainly noticed in the week before menstrual periods
  • Gets better during menstrual periods and goes away between periods
  • Often begins 2 years after periods start
  • Other symptoms are headache and swollen feet
  • Treatment:
    • Ibuprofen
    • Support bra
    • Exercise
    • Getting enough sleep
    • Birth control pills
Causes of Breast Lumps; Most are Not Dangerous
  • Cysts: round, smooth and hard lumps. Common in women over 35 years old. Less common after menopause. They can be different sizes and change size during your period. Most go away on their own. If they are large and/or painful, a doctor might be able to drain fluid from the cyst. Always get checked by your doctor to find out if your lump is a cyst.
  • Fibroadenomas / Fibrocystic Breast Disease: cause lumps in the breasts. These are not cancer. The lumps can be moved and do not hurt when touched. Common in young women in their early 20s. See a doctor to find out if the lumps are fibroadenomas and if care is needed.
  • Injury to the Breast: can cause bad bruising that forms a lump.
  • Mastitis (breast infection): happens in a collection of fluid in the breast or in the breast tissue itself. It can cause an abscess (pocket of pus) to form. The area will likely be red, warm, swollen and painful to touch. Most common in breast feeding women. You may have a fever, chills and feel sick. You do not need to stop breast feeding if you have this infection. Ask your doctor if an antibiotic is needed.
  • Breast Cancer: can happens in men and women. Often not painful. Common symptoms can include:
    • Lump in the breast
    • Lump in the underarm
    • Dimpling or puckering of the skin
    • Thicker skin, like an orange peel texture
    • Rash around nipple
    • Hard nipple
    • Nipple that is pulled in
    • Nipple leaks fluid
    • Different looking breasts
    Lumps may feel hard or different than the rest of the breast. They can be odd shaped, red, or dimpled. Always see your doctor if you find a lump. Many breast cancers can be treated if found early.
  • Paget’s Disease of the Breast: rare form of breast cancer. Most common in women older than 50. Early signs are red, dry and flaky nipple. Nipple may leak bloody fluid. Nipple becomes flattened or drawn in. The area under the nipple may feel thick or lumpy. Cancer can spread to other parts of the breast.
Causes and Risk Factors of Breast Cancer The causes of breast cancer are not fully known. These may raise your risk:
  • Old age
  • Someone in your family had breast cancer
  • You had breast cancer in the past
  • Having lumps that were not cancer in the past
  • Being tall or overweight
  • Drinking alcohol
Non-Cyclical Breast Pain
  • This pain is not related to periods
  • Infection / Mastitis in the breast tissue. It can occur within the breast or could follow an injury or insect bite. There may be redness and or a lump with the infection. Abscesses may also form which need drainage.
  • Chest wall pain from the muscles, breastbone and ribs that lie beneath the breast tissue. In a problem called osteochondritis, the joints where the ribs join the breastbone become inflamed. The pain and tenderness may feel like breast pain.
  • Breast changes with pregnancy and breast feeding
  • Shingles may cause breast pain, tingling and burning before the rash appears. The rash is also very painful.
  • Fluid filled cysts can cause breast pain, but it is unusual for breast cancer to cause pain without there being a lump present.
  • Enlarged Breasts in Men: this is not serious and may go away on its own. One or both breasts may grow due to hormone changes, other health problems, street drugs or alcohol. It can affect the male breasts unevenly, so one breast is larger than the other. The breast tissue may be painful. Can happen at any age.

When to Call for Breast Symptoms

When to Call for Breast Symptoms

Call Doctor or Seek Care Now

  • Breast is painful to touch
  • Red area or red lump with a fever
  • Nipple discharge that is pus (thick green or yellow) or bloody
  • You feel very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Red area or red lump without fever
  • Breast implants have changed in size or causing are discomfort
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Other breast lumps
  • Changes to the nipple - crusting, flaking, discharge, nipple drawn in (inverted) or flattened
  • Could be pregnant (breast fullness/tenderness and missed menstrual period)
  • Change in shape or appearance of breast
  • Change in the skin on the breast - puckering, dimpling, pitting
  • Nipple discharge that is clear or milky (except just after you had a baby)
  • Breast pain and cause is unknown. Exception: continue if only occurs before menstrual periods or with vigorous exercise.
  • Red, moist, raw skin underneath breasts (in women with larger breasts)
  • You have other questions or concerns

Self Care at Home

  • Breast pain in both breasts occurs monthly before menstrual periods
  • Breast pain after exercise
  • Breasts are not the same size, questions about (normal breast asymmetry)

Call Doctor or Seek Care Now

  • Breast is painful to touch
  • Red area or red lump with a fever
  • Nipple discharge that is pus (thick green or yellow) or bloody
  • You feel very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Red area or red lump without fever
  • Breast implants have changed in size or causing are discomfort
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Other breast lumps
  • Changes to the nipple - crusting, flaking, discharge, nipple drawn in (inverted) or flattened
  • Could be pregnant (breast fullness/tenderness and missed menstrual period)
  • Change in shape or appearance of breast
  • Change in the skin on the breast - puckering, dimpling, pitting
  • Nipple discharge that is clear or milky (except just after you had a baby)
  • Breast pain and cause is unknown. Exception: continue if only occurs before menstrual periods or with vigorous exercise.
  • Red, moist, raw skin underneath breasts (in women with larger breasts)
  • You have other questions or concerns

Self Care at Home

  • Breast pain in both breasts occurs monthly before menstrual periods
  • Breast pain after exercise
  • Breasts are not the same size, questions about (normal breast asymmetry)

Home Care Advice

Breast Pain or Tenderness Before Menstrual Periods

  1. What You Should Know:
    • Some women have breast pain and fullness on a monthly basis. This occurs just before their menstrual period, when they are between the ages of 30 and 50.
    • The discomfort can range from mild to moderate and often starts 3-5 days before the period. It affects both breasts.
    • Pain and swelling goes away between menstrual periods.
    • Cause: normal changes caused by hormone cycles. Can be affected by hormonal birth control pills or hormone replacement therapy (HRT).
    • Medical name: cyclic mastalgia.
  2. Pain Medicine:
    • To help with pain, take an ibuprofen product (such as Advil). Ibuprofen is best for this type of pain.
    • Use as needed but do not take more than the maximum recommended dosage as stated on the package.
    • If you are not sure what to take, ask a pharmacist.
  3. Other Medicines:
    • If this care advice doesn’t work and the pain is more than moderate, there are meds which block female hormones. Examples are tamoxifen or danazol. These may be prescribed, but they may have side effects. Talk to your doctor.
  4. Wear a Support Bra:
    • Wear a well-fitted support bra or sports bra when breast pain occurs.
    • This is especially important when you exercise.
    • Some women with large breasts are more comfortable wearing a bra even when sleeping.
  5. Reduce Caffeine:
    • Some women report increased breast pain after drinking coffee or colas.
    • If that applies to you, avoid caffeine or reduce your intake.
  6. What to expect:
    • Pain should go away between menstrual periods.
    • If symptoms are not better between periods, make an appointment to see your doctor.
  7. Call Your Doctor If:
    • Breast pain doesn't go away between periods
    • You miss a period or pregnancy test is positive
    • You feel a lump
    • You think you need to be seen
    • Your pain gets worse

Breast Pain During or After Exercise

  1. What You Should Know:
    • Breast pain during or after hard exercise is common.
    • Cause: stretching of ligaments inside the breast.
    • Most common in women with large breasts.
    • Large breasts may also cause back pain.
    • The pain most often lasts 1 or 2 days.
  2. Wear a Sports Bra:
    • Wear a good quality sports bra when you exercise.
  3. Pain Medicine:
    • To help with pain, take an ibuprofen product (such as Advil). Ibuprofen is best for this type of pain.
    • Use as needed but do not take more than the maximum recommended dosage as stated on the package.
    • If you are not sure what to take, ask a pharmacist.
  4. Call Your Doctor If:
    • You feel a lump
    • Breast pain lasts more than 2 days
    • You think you need to be seen
    • Breast pain becomes worse

Breast Size Unequal

  1. What You Should Know:
    • A difference in breast size is common and normal.
    • After the breasts are mature, 25% of women still have unequal breasts. Usually the left is larger.
    • The difference is most often minor.
    • Medical name: normal breast asymmetry.
  2. Treatment for Breast Asymmetry:
    • Wearing a bra pad on the smaller side is an option.
    • If the difference is major, referral to a plastic surgeon can be considered.
  3. Call Your Doctor If:
    • You think you need to be seen
    • You have other questions or concerns

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2023 Schmitt Decision Logic LLC.

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