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.
Read more: 5 Possible Causes of a Swollen Breast — and When to See a Doctor
- It may surprise you to learn that reproductive hormones can still play a significant role. "
- And that estrogen can cause breast tenderness after menopause.
Injury to the Breast
What Are the Causes of Burning Sensations in the Breast?
Learn More
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.
- Cysts are fluid-filled sacs which can develop in any part in the body.
- Breast cysts are most common in women in their 40s but they can happen at any age, including after menopause.
Infection of the Breast
Red Blotches on the Breast
Learn More
**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.
- A breast infection, also called mastitis, can a cause severe pain, according to Harvard Medical School 1.
- Mastitis most commonly affects women who are breastfeeding but it can happen at other points in life.
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
- Until about 10 years ago, hormone replacement therapy was the standard treatment in helping women manage their menopause symptoms.
- There are many positive benefits to taking replacement female hormones (estrogen and progesterone) 4.
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.
- In some cases, pain in the breast may come from another source in the body.
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
Related Articles
References
- Harvard Medical School: "Breast Pain: Not Just a Premenopausal Complaint"
- Mayo Clinic: "Breast Pain"
- American Cancer Society: "Fibrosis and Simple Cysts in the Breast"
- Cleveland Clinic: "Estrogen & Hormones"
- National Breast Cancer Foundation: "Breast Pain"
- Alkabban FM, Ferguson T. Cancer, Breast. [Updated 2019 Jun 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482286/
- Powell RW. Breast Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 169. Available from: https://www.ncbi.nlm.nih.gov/books/NBK277/
- Powell RW. Breast Examination. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 176. Available from: https://www.ncbi.nlm.nih.gov/books/NBK285/
- InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Pain management in metastatic breast cancer. 2012 Feb 14 [Updated 2016 Apr 7]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK361025/
- Cingam SR, Karanchi H. Cancer, Adrenal Metastasis. [Updated 2019 Jan 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441879/
- Khattab A, Monga DK. Cancer, Male Breast Cancer. [Updated 2019 Feb 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526036/
- Ajmal M, Van Fossen K. Breast Fibroadenoma. [Updated 2018 Dec 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535345/
- National Cancer Institute. Inflammatory Breast Cancer. Updated 01/06/16. https://www.cancer.gov/types/breast/ibc-fact-sheet
- Alkabban FM, Ferguson T. Cancer, Breast. [Updated 2019 Jun 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- Powell RW. Breast Pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 169.
- National Breast Cancer Foundation. Breast Pain. nationalbreastcancer.org
- Koo MM, von Wagner C, Abel GA, McPhail S, Rubin GP, Lyratzopoulos G. Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis. Cancer Epidemiol. 2017;48:140–146. doi:10.1016/j.canep.2017.04.010
- Smith RL, Pruthi S, Fitzpatrick LA. Evaluation and management of breast pain. Mayo Clin Proc. 2004;79(3):353-72.
- Morrow M. The evaluation of common breast problems. Am Fam Physician. 2000;61(8):2371-8, 2385.
- Powell RW. Breast Examination. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 176.
- Lee MD, Michelle, Owen MD, Wendi. My Breast Hurt. Should I be Worried? Society of Breast Imaging. sbi-online.org September 27, 2019
- Molckovsky A, Fitzgerald B, Freedman O, Heisey R, Clemons M. Approach to inflammatory breast cancer. Can Fam Physician. 2009;55(1):25–31.
- InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Pain management in metastatic breast cancer. 2012 Feb 14 [Updated 2016 Apr 7].
- Rostami R, Mittal S, Rostami P, Tavassoli F, Jabbari B. Brain metastasis in breast cancer: a comprehensive literature review. J Neurooncol. 2016;127(3):407-14.
- Cingam SR, Karanchi H. Cancer, Adrenal Metastasis. [Updated 2019 Jan 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- Sanguinetti A, Polistena A, Lucchini R, et al. Male breast cancer, clinical presentation, diagnosis and treatment: Twenty years of experience in our Breast Unit. Int J Surg Case Rep. 2016;20S(Suppl):8–11. doi:10.1016/j.ijscr.2016.02.004
- Khattab A, Monga DK. Cancer, Male Breast Cancer. [Updated 2019 Feb 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- Yıldırım AC, Yıldız P, Yıldız M, Kahramanca Ş, Kargıcı H. Mastalgia-Cancer Relationship: A Prospective Study. J Breast Health. 2015;11(2):88–91. Published 2015 Apr 1. doi:10.5152/tjbh.2015.2492
- Ajmal M, Van Fossen K. Breast Fibroadenoma. [Updated 2018 Dec 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
- Crandall CJ, Aragaki AK, Cauley JA, et al. Breast tenderness and breast cancer risk in the estrogen plus progestin and estrogen-alone women's health initiative clinical trials. Breast Cancer Research and Treatment. 2012. 132(1):275-85. doi:10.1007/s10549-011-1848-9
- McCann B, MIaskowski C, Koetters T, et al. Associations between pro- and anti-inflammatory cytokine genes and breast pain in women prior to breast cancer surgery. The Journal of Pain. 2012. 13(5):425-37. doi:10.1016/j.jpain.2011.02.358
- National Cancer Institute. Inflammatory Breast Cancer. Updated 01/06/16.
Resources
Writer Bio
Robin Wood-Moen began writing in 2000. She is an academic researcher in health psychology, psychoneuroimmunology, religion/spirituality, bereavement, death/dying, meaning-making processes and CAM therapies. She holds a Bachelor of Arts in forensic-social sciences from University of North Dakota, a Master of Science in psychology and is working on her Ph.D. in health psychology, both from Walden University.