Women experiencing breast pain often don't have to worry about it. There are symptoms, however, that may prompt the need for an examination.

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Three-quarters of women are thought to suffer from breast pain (also called “mastalgia”) at some point in their lives, and many automatically assume that it could red-flag breast cancer. However, breast pain isn’t typically a symptom of breast cancer.

Breast pain can manifest as slight tenderness, a dull, heavy ache, or a burning sensation. There are two main types: cyclic, and non-cyclic.

Cyclic breast pain: This occurs in both breasts as a result of the hormonal swings that occur around the menstrual period or during menopause (it also can affect postmenopausal women who are taking hormone replacement therapy). Fibrocystic breasts (which are composed of tissue that is ropey and/or lumpy) also make you susceptible. Cyclical breast pain may be accompanied by swelling, and the pain may radiate to your underarms.

You often can reduce cyclic breast pain by reducing your intake of caffeine, consuming a low-fat and low-sodium diet that is high in fiber and fruits and vegetables, and losing weight if necessary. If the discomfort is severe, your doctor may prescribe birth control pills or another hormone-based treatment, but keep in mind that these drugs may have side effects.

Some women report relief while taking a supplement called evening primrose oil, but if you decide to give this a try, be sure to let your doctor know, since it may be contraindicated in some people (for example, people who take blood thinners such as warfarin, and people with seizure disorders).

Non-cyclic breast pain: This tends to occur mainly in postmenopausal women. Although it often isn’t clear what is causing non-cyclic breast pain, it tends to be more likely in women with benign tumors called fibroadenomas, and women with breast cysts.

Previous breast trauma or surgery also makes women more susceptible to non-cyclic breast pain—and if you have particularly large breasts you also may suffer pain that radiates to your neck and shoulders (wearing a more supportive bra can help if this is the reason for your breast pain). Certain drugs and supplements also may be involved in non-cyclic breast pain—for example, selective serotonin reuptake inhibitors (SSRIs), which are a type of antidepressant, and ginseng.

Non-cyclic breast pain also may be referred pain that originates elsewhere even though it feels like it is centered on the breast. Culprits may include the heartburn that results from gastroesophageal reflux disease (GERD), the heart condition angina, gallstones, or a condition called costochondritis (inflammation of the cartilage that connects the ribs to the sternum). If you have one of these health conditions (or your doctor diagnoses you with one of them while evaluating your breast pain), taking steps to manage the problem should help to ease your discomfort.

Diagnosing Breast Pain

Your doctor will likely examine your breasts and abdomen, as well as listen to your heart and lungs in order to determine whether your breast pain may be related to an underlying heath problem.

If any thickened areas or lumps are felt during the exam, you will be referred for imaging tests, such as mammography and possibly an ultrasound if the mammogram is inconclusive. Rarely, a biopsy may be necessary.

Could Your Breast Pain Be Serious?

Rest assured that most breast pain isn’t a sign of a more serious problem—but always take the precaution of mentioning it to your doctor, particularly if you also notice:

• Discharge and/or a rash from one or both nipples.
• A change in the appearance of one or both nipples.
• Dimpled skin on your breasts.
• A change in breast size or shape.
• A lump or distinctly thickened area in your breast or underarm area.

Originally published in June 2016 and updated.