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Symptoms – Breast or Nipple Pain

While most breast cancers do not cause pain, some patients may experience breast or nipple pain. Pain in the breast or nipple that does not go away should be reported to a doctor for evaluation.1

Normal breast changes that cause pain

Breast tissue is a mix of connective tissue, glandular tissue, and fatty tissue. The glandular tissue contains milk glands and milk ducts. Breast tissue changes over time with hormonal changes and aging, but women should tell their doctor about any unusual change that is different in look or feel. Some common changes that occur due to hormonal changes and aging include:2

  • During menstruation, breast tissue often becomes lumpy, swollen, and more tender. Changes that occur during menstruation typically go away after a period is over.
  • During pregnancy, the breasts get larger and tender as the milk glands increase in size and number, which can cause more lumps in the breasts.
  • Some women experience mastitis while breastfeeding – inflammation, potentially caused by an infection, that occurs when a milk duct gets blocked and causes the breast to feel warm, painful, lumpy, and appear red.
  • As a woman nears menopause, periods may become less frequent, and the breasts may become more tender or lumpy.

Any pain that is not related to normal hormonal changes should be checked by a doctor. If a woman is unsure about the cause of the pain, it’s best to talk to a doctor about it.

Paget disease of the nipple

Paget disease of the nipple is a rare form of breast cancer that causes changes to the skin of the nipple and areola (the darkened skin around the nipple). The nipple area may appear scaly, flaky, crusty, or red, and the skin can burn, tingle, or itch. There may also be discharge from the nipple. Paget disease of the nipple begins in the milk ducts and spreads to the nipple and areola. Many people with Paget disease also have one or more tumors inside the same breast tissue.3,4

Other symptoms of breast cancer

Besides a change in the size or shape of the breast, breast cancers may cause symptoms, including5:

  • A lump or area of thickened tissue in or around the breast
  • Changes to the nipple, such as a turning inward (or retraction) of the nipple
  • Changes to the skin of the breast, including a dimple or puckering
  • Discharge from the nipple (other than breast milk), possibly bloody fluid
  • Changes to the areola (the darker area of skin around the nipple), including scaly, red, or swollen tissue
  • Multiple dimples on the skin of the breast that resembles an orange skin (peau d’orange)
  1. Simon S. Breast cancer symptoms: what you need to know. American Cancer Society. Available at https://www.cancer.org/latest-news/breast-cancer-symptoms-what-you-need-to-know.html. Accessed 7/30/18.
  2. Understanding breast changes. National Cancer Institute. Available at https://www.cancer.gov/types/breast/breast-changes/understanding-breast-changes.pdf. Accessed 7/30/18.
  3. Paget disease of the breast. National Cancer Institute. Available at https://www.cancer.gov/types/breast/paget-breast-fact-sheet. Accessed 7/30/18.
  4. Paget disease of the nipple. American Cancer Society. Available at https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/types-of-breast-cancer/paget-disease-of-the-nipple.html. Accessed 7/30/18.
  5. Breast cancer treatment (PDQ). National Cancer Institute. Available at https://www.cancer.gov/types/breast/patient/breast-treatment-pdq. Accessed 7/27/18.