Does breast cancer hurt?

Is breast cancer painful?

Often not. The NHS lists the main symptoms of breast cancer as a lump or swelling, skin changes, a change in size or shape, nipple discharge and changes to the nipple. It says you may get pain in your breast or armpit with these symptoms, but you can have them without any pain.

The World Health Organization describes a breast cancer lump or thickening as often without pain, and says anyone with an abnormal breast lump should seek medical care even if the lump does not hurt.

Some people with breast cancer do have pain. The Royal Marsden NHS Foundation Trust says breast pain is a less common symptom of breast cancer, but people do experience it.

Sources: NHS: Symptoms of breast cancer in women; World Health Organization: Breast cancer fact sheet; The Royal Marsden NHS Foundation Trust: Everything you need to know about breast cancer

What usually causes breast pain?

The NHS says breast pain is usually linked to periods. This pain often begins up to 2 weeks before a period, gets worse and then goes away when the period ends. It feels dull, heavy or aching, affects both breasts and sometimes spreads to the armpit.

Other causes of breast pain include:

• injuries or sprains to the neck, shoulder or back, which can be felt as breast pain
• medicines such as the contraceptive pill and some antidepressants
• conditions like mastitis or a breast abscess
• pregnancy
• hormone changes during the menopause

Source: NHS: Breast pain

Does breast pain mean cancer?

Usually not. The NHS says breast pain by itself is unlikely to be a symptom of cancer. Royal United Hospitals Bath NHS Foundation Trust says it is extremely unusual for breast pain to be the first sign of breast cancer, and that having breast pain does not increase your risk of breast cancer.

That does not mean pain should be ignored. NHS England’s screening leaflet says that if you have pain or discomfort in the breast or armpit that is there all or almost all the time, it is best to get it checked.

Sources: NHS: Breast pain; Royal United Hospitals Bath NHS Foundation Trust: Breast pain (mastalgia) leaflet; NHS England (GOV.UK): NHS breast screening – helping you decide

When should breast pain be checked?

The NHS says to see a GP about breast pain if:

• it is not improving or painkillers are not helping
• there is a history of breast cancer in your family
• you have any signs of pregnancy

In the UK, ask for an urgent GP appointment or get help from NHS 111 if:

• you have breast pain and a very high temperature, or feel hot, cold or shivery
• any part of your breast is red, hot or swollen
• there is a hard lump in your breast that does not move around
• you get nipple discharge, which may be streaked with blood
• one or both breasts change shape
• the skin on your breast is dimpled, like orange peel
• you have a rash on or around your nipple, or the nipple has sunk into your breast

Source: NHS: Breast pain

Which breast changes should you get checked, even without pain?

See a GP or doctor if you notice any of these, whether or not they hurt:

• a lump or swelling in your breast, chest or armpit
• a change in the skin of your breast, such as dimpling (it may look like orange peel)
• a change in skin colour – on white skin it may look red, on black or brown skin it may look darker than usual
• a change in the size or shape of one or both breasts
• nipple discharge (if you are not pregnant or breastfeeding), which may have blood in it
• a change in the shape or look of your nipple, such as it turning inwards or a rash on it

In England, NICE guidance for GPs says people aged 30 and over with an unexplained breast lump, with or without pain, should be referred on a suspected cancer pathway.

Sources: NHS: Symptoms of breast cancer in women; NICE NG12: Suspected cancer – recognition and referral (breast cancer)