Breast tenderness after menopause is rarely caused by cancer. Breast pain after menopause is more likely caused by hormones, medications, benign cysts or possibly an infection.
If you experience breast pain after menopause, you may be concerned that it's a symptom of a serious medical condition like breast cancer 25. Good news: Sore, painful or tender breasts are rarely a breast cancer symptom.
Breast pain, also known as mastalgia, is typically related to hormonal changes 2. Cyclical breast pain (the most common type of breast discomfort) refers to pain that comes and goes with a woman's menstrual cycle, according to Harvard Medical School 12.
Postmenopausal women may still experience breast pain but it is considered non-cyclical, meaning it is unrelated to menstruation 2. Symptoms can include a tight, burning or sore feeling, typically in a localized area of one breast, according to the Mayo Clinic 2. Pain may be constant or intermittent 2.
Non-cyclical breast pain can affect women after menopause for a variety of reasons 2. Here's what you need to know about mastalgia after menopause.
Hormonal Breast Pain
Roshni Rao, MD, chief of the Breast Surgery Program at Columbia Medical University, spoke with LIVESTRONG.com about why women can experience breast pain after menopause 2. It may surprise you to learn that reproductive hormones can still play a significant role.
"We do see postmenopausal breast pain but it's not as common as premenopausal breast pain," says Dr. Rao 12. This is because premenopausal women have more estrogen, a key female hormone. Estrogen causes the milk ducts in the breast to grow in the days before menstruation. This can cause swelling and breast tenderness. But, "postmenopausal women do create some estrogen," says Dr. Rao. And that estrogen can cause breast tenderness after menopause.
Dr. Rao also points out that if postmenopausal women gain weight or experience weight fluctuations — which is very common — they may experience more breast tenderness. This is because "fat cells generate estrogen," says Dr. Rao.
Estrogen levels aren't the only cause of breast pain after menopause 2. In some cases, breast pain can indicate an injury, cyst or be a symptom of an underlying condition 2. The following are other possible causes.
Injury to the Breast
Breast surgery or an injury to the breast can cause persistent pain, per the Mayo Clinic 2. Additionally, heavy breasts can stretch ligaments and tissues, causing discomfort, according to Harvard Medical School.
Benign Cysts in the Breast
Cysts are fluid-filled sacs which can develop in any part in the body. According to the American Cancer Society, breast cysts occur when fluid builds up in the breast glands 3. Breast cysts are most common in women in their 40s but they can happen at any age, including after menopause. Cysts begin as microscopic but can eventually grow to be 1-2 inches and possible to feel by touch.
Cysts may cause tenderness, swelling or soreness but they are not usually a cause for concern. Per the American Cancer Society, breast cysts are usually benign, meaning they are non-cancerous 3. Only in rare cases will a solid type of cyst (called a complex cyst) be potentially cancerous. Having breast cysts won't increase your risk of developing breast cancer later on.
Infection of the Breast
A breast infection, also called mastitis, can a cause severe pain, according to Harvard Medical School 12. Mastitis most commonly affects women who are breastfeeding but it can happen at other points in life. If the skin on breast or nipple becomes chaffed or irritated, it can allow bacteria to enter the breast and spread infection. Mastitis symptoms include redness, swelling, tenderness and possibly fever. This condition is typically treated with normal antibiotics.
Postmenopausal Hormone Therapies
Until about 10 years ago, hormone replacement therapy was the standard treatment in helping women manage their menopause symptoms, according to the Cleveland Clinic 4. There are many positive benefits to taking replacement female hormones (estrogen and progesterone) 4. But breast pain can be a side effect, per the Mayo Clinic 2. This makes sense. As Dr. Rao mentioned before, higher levels of estrogen are linked to breast tenderness and swelling.
Additionally, evidence now indicates these therapies may also lead to an increased risk of heart attack, stroke and breast cancer, per the Cleveland Clinic 24. If you are interested in hormone replacement therapy, be sure to discuss these risks with your doctor.
Read more: Estrogenic Foods to Avoid
Other Medications Side Effects
Breast tenderness can be a side effect of certain medications other than estrogen-progesterone therapy. Per Harvard Medical School, some antidepressants and cardiovascular medications can also cause non-cyclical mastalgia.
Pain Outside the Breast
In some cases, pain in the breast may come from another source in the body. For example, pericarditis — a swelling and irritation of the membrane sac surrounding the heart — can cause sharp, dull or aching pain behind the left breast, according to the Mayo Clinic. If you are experiencing chest pain on the left side, see a doctor. Chest pain on the left side can also be a symptom of a heart attack.
Breast Cancer Is Unlikely
Breast pain or soreness is not likely to be a sign of cancer, according to the National Breast Cancer Foundation 25. Only 2-7 percent of women with non-cyclical mastalgia receive a cancer diagnosis related to their breast pain, according to Harvard Medical School 125.
Though breast pain on its own is not generally a cause for concern, you should see a doctor if you are experiencing other breast-related symptoms 2. See your doctor if you notice a solid lump in your breast, have bloody or clear discharge from your nipple or have itchy, red or scaly skin, per the National Breast Cancer Foundation 5.
Read more: The Results of Exercise on the Female Breast
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