There are many possible causes for breast pain. For example, hormonal fluctuations related to menstruation or pregnancy are often responsible for breast tenderness. Some degree of swelling and tenderness just before your period is normal. The question, really, is how tolerable (or intolerable) the discomfort is to you.

Although many women with pain in one or both breasts understandably fear breast cancer, breast pain is a very unusual symptom of breast cancer.

Boys and men have breast tissue. If a male has breast tissue that is visible, this is called gynecomastia. As a normal part of development, adolescent boys can have some breast swelling and tenderness. Like breast tenderness in women, this is due to hormonal changes.

Some degree of breast tenderness is normal, caused by hormonal fluctuations from:

• Menstruation
• Pregnancy -- tends to be more common during the first trimester and pregnancy at a young age
• Puberty -- in both girls and boys
• Breast feeding
• Approach of menopause (often, once you are post-menopausal -- meaning that your menstrual periods have stopped completely -- breast tenderness goes away unless you are taking hormone replacement therapy)

Soon after childbirth, your breasts may become engorged with milk. This can be very painful and is usually accompanied by swelling and, possibly, generalized redness. If the redness is localized, it may indicate an infection called mastitis.

Other common causes of breast pain include:

• Fibrocystic breast changes
• Mastitits -- breast infection due to a blocked milk duct, usually associated with breast feeding
• Premenstrual syndrome (PMS)
• Alcoholism with liver damage (including in men because liver disease can cause gynecomastia)
• Injury (such as a bite or trauma)

Fibrocystic breast tissue is a very common condition. It involves breast lumps and bumps throughout the breast tissue that tend to be more tender just before your menstrual period.

Certain medications may also cause breast pain, including digitalis preparations, aldomet, aldactone and other potassium-sparing diuretics, anadrol, and chlorpromazine.

Shingles can lead to pain felt in the breast if the painful blistering rash appears on the skin over one of your breasts.

For fibrocystic breasts or other breast tenderness that occurs just before your period:

• Avoid caffeine.
• Try taking vitamin E and vitamin B complex with extra B6. (These supplements help some but not all women.) Some women also report improvement from evening primrose oil.
• Eat a diet low in fat and high in fiber.
• Talk to your doctor about possibly taking birth control pills. These can help relieve pain.

If you have a breast infection, you will need antibiotics. Look for signs of infection like localized redness, nipple discharge, or fever. Contact your doctor if you have these signs.

Just after an injury to the breast occurs, apply a cold compress such as an ice pack (wrapped in a cloth -- don't apply directly to the skin) for 15 to 20 minutes. Take a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen to reduce the likelihood of developing persistent breast pain or swelling.

Call your doctor if you have:

• Discharge from your nipples, especially blood or pus
• Given birth within the last week and your breasts are swollen or hard
• Signs of a breast infection, including localized redness, pus, or fever
• Noticed a new lump associated with the pain that does not go away after your menstrual period
• Persistent, unexplained breast pain

Your health care provider will perform a breast examination and ask questions about your breast pain, such as:

• How long have you had the symptoms?
• Are one or both of your breasts affected?
• Do you have any nipple discharge?
• Do you perform breast self-examination?
• Have you noticed any lumps or anything unusual when you examine your breasts?
• When was your last mammogram?
• What other symptoms are present? Do you have fever?
• What medication are you currently taking?

• Breast biopsy
• Culture of nipple discharge to test for infection
• Cytology (microscopic evaluation) of nipple discharge
• Mammography
• Fine needle aspiration -- a small needle is inserted into the breast to remove fluid that may have collected in a cyst (usually not cancerous)

Treatment may include the following:

• Pain relievers may be prescribed.
• Changes to your diet may be suggested.
• Certain medications may be changed or discontinued.

Your health care provider should schedule a follow-up visit in case the symptoms have not resolved in a given period of time. He or she may recommend consultation with a specialist if the symptoms do not go away or if you have a complicated condition.

Wear a well-fitting brassiere for support, especially if your breasts are large.

Perform monthly breast self-examination 3-5 days after your period (when the breast tissue is the least tender). This is important to feel for any changes in your breast tissue. If you detect any change from the previous month, it is important to notify your doctor.

Having fibrocystic breast tissue, mastitis, or breast tenderness related to PMS does not put you at increased risk for breast cancer. Having fibrocystic breasts does, however, make your self-exam more confusing since there are many lumps and bumps. Some general ways to prevent breast cancer for all women, in addition to performing monthly breast self-exams, include:

• Exercise regularly
• Reduce fat intake
• Eat lots of fruits, vegetables, and other high fiber foods
• Limit alcoholic beverages to no more than 1 to 1 1/2 per day.