Breast Pain

The following questions came from site visitors concerned about breast pain, and were answered by experts from our Professional Advisory Board.

Is breast pain a symptom of cancer?

QUESTION: I've had two mammograms this year. The second one was because about every couple of months, I have some small pains in my right breast. It's never in the left breast. I no longer take the two hormones I was taking; however, I did take them for approximately 10 years. They also performed a sonogram and saw nothing. The first mammogram I had this year the doctor said was a little suspicious, but after having the sonogram, the technician found nothing.

ANSWER: Breast pain is more commonly associated with non-cancerous changes than with cancerous changes to the breast tissue. Equal discomfort in both breasts is most commonly benign. But new and persistent discomfort in only one breast may be of concern, particularly if it's getting worse, not better.

In your situation where you have intermittent right breast pain AND a mammogram that suggests the possibility of cancerous findings, you need to seek further evaluation to make sure everything is OK—even if the sonogram (aka ultrasound) is "OK."

Express your concerns to your doctor. Ask to be referred to a surgeon who specializes in breast cancer (if a simple "ask" doesn't result in a referral, demand it). A simple core needle biopsy of the area of concern seen on mammogram may be recommended. Hopefully all is fine, but it's worth being pushy and demanding in order to get what you need—just to be sure.

—Marisa Weiss, M.D.

Tender lump

QUESTION: I am 37 and will have a mammogram next week. I have a small lump that is tender to the touch and aches in the same breast and shoulder. My doctor assures me breast cancer is not painful. Could this be a sign of breast cancer?

ANSWER: I agree that most cancers are not painful or tender to the touch. The fact that this lump is painful makes it more likely that the lump you have is not cancer. However, this rule is not true in every instance. Therefore, it's very important that all lumps be checked out thoroughly, whether they are painful or not. It's also important to notify the mammography technician or radiologist that you do indeed have a lump, so that appropriate studies may be carried out. This may include additional mammographic images as well as an ultrasound. For each of these studies, they may put a marker on the skin, on top of the lump, to help them locate the tissue underneath that needs extra attention.

—Alan Stolier, M.D.

Swelling and burning

QUESTION: What exactly are the symptoms of breast cancer? One of my breasts has almost doubled in size and I have a burning feeling inside sometimes and it's tender at times. I'm really scared to go to the doctor.

ANSWER: It would be best for you to see your primary care doctor, who can refer you to a breast specialist to help you figure out what is causing your breast changes. It is important to note that swelling and redness of one breast is usually not a sign of cancer but of a benign condition such as hormonal changes (also called fibrocystic change) and breast infection. Breast tenderness and pain are very common in these benign conditions. When it comes to breast cancer, in most instances, a breast lump, a localized thickening in the breast or a dimple, are the only physical signs of breast cancer. However, there are some signs of cancer that occur less frequently, such as breast swelling and redness. To evaluate your situation further, your next best step is to have your doctor—who knows you best—carefully review your situation. Depending on your age and other factors, a mammogram or other breast imaging tests may be ordered, and a biopsy may even be done, in order to better determine the cause of your breast changes.

Don't be scared to go to your doctor—he or she is there to help you. I think you will feel much better following your doctor's evaluation.

—Alan Stolier, M.D.

QUESTION: I am afraid. I have a burning sensation in one breast. I would like to consult a doctor, but I have no money, and I believe that I can't apply for Medicaid because of my legal status. Is there any center where I can go?

ANSWER: A burning sensation in one breast that persists over time should be evaluated by a doctor, just to make sure everything is OK. Don't assume that you have cancer—most likely it's not cancer. But still you need to make sure. Ask around to see if there is a free medical clinic or a hospital clinic that is willing to see people at no cost or at a low cost. Most hospitals have funds set aside for taking care of people who are without the necessary resources. And there are social workers at the hospitals who can help you figure out your options.

We hope your concerns can be sorted out soon, so you can get your peace of mind back. Hopefully everything will be OK. And if there is a problem, it's better to know about it sooner than later so it can be taken care of properly.

—Marisa Weiss, M.D.