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Breast pain is also called mastalgia. It means that you have pain rather than just tenderness in your breasts. The pain can make you uncomfortable and worried. But it's rarely a sign of a serious problem, such as breast cancer. Many women get breast pain.

It is normal for your breasts to feel tender at certain times, such as just before your period, in early pregnancy and when you are breastfeeding. This tenderness is caused by normal changes in your hormones.¹ You probably won't worry about these normal changes.

But you may worry if your breasts are painful rather than just tender, and the pain is so bad that it interferes with your life.

There are two main types of breast pain:²

• Cyclical breast pain is linked to your periods (menstrual cycle) and is worst just before your period. It is the most common type of breast pain.
• Non-cyclical breast pain is not linked to your periods. It means that your breasts may feel painful some of the time, a lot of the time or even constantly.

You may be worried that the pain in your breasts is due to cancer. But pain on its own is not a common symptom of breast cancer. Less than 1 in 10 women with breast cancer have breast pain as their main symptom.³ A study of women who had a mammogram (an X-ray of the breast) because they had breast pain found that they were no more likely to have cancer than those who didn't have breast pain.⁴

Most women with breast pain never know the cause of their pain. Because cyclical pain is linked with periods, some doctors think hormone imbalances may be to blame. (Hormone imbalances occur when your body produces too much or too little of one or more hormones.) But there is no evidence that hormone imbalances cause breast pain.² Other doctors think that cyclical pain is caused by the water retention in your breasts before your period. But again there is no proof for this.⁵

Breast pain that's not linked to periods (non-cyclical breast pain) can be caused by:³

• Pregnancy
• A breast infection that affects breastfeeding mothers (mastitis)
• A knock or blow to your breast
• A cyst
• A tumor
• Inflammation of a vein in your breast (thrombophlebitis)
• A problem in the muscles, bones or joints in your chest, such as arthritis.

But usually there's no sign that anything's wrong and the cause remains a mystery.²

Lots of researchers have looked at whether breast pain is caused by psychological problems, such as depression and anxiety. Some of them found that women with breast pain were more likely to be depressed or anxious. But it could be that the women in the study got depressed because they had breast pain, not that their depression caused their breast pain.³

What type of breast pain you get seems to change with age. You are most likely to get cyclical breast pain in your twenties and thirties. Non-cyclical breast pain tends to start later, usually in your thirties or forties. But it can also start after menopause.²

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.