Breast Tenderness

Breast Tenderness

Breast tenderness, or mastalgia, is a rather common occurrence.

Understandably, when women are seeing their doctor about mastalgia they are often concerned about the possibility of breast cancer, but only 0.5%-2% of breast cancer shows up as breast tenderness. 

Most breast tenderness happens in conjunction with the second half of the menstrual cycle and gets worse with stress. Usually this is inflammation of a particular tissue in breasts called cystic tissue.

The tenderness is due to hormonal fluctuations so it is almost always most problematic during the years of menstrual cycles and resolves with menopause. It is usually in both breasts, often beginning in the 2 weeks prior to menses starting.  During this time, the breasts can be painful and swollen. 

It’s surprising to many of my patients that nutritional changes can have a big impact on breast tenderness.

  • Decreasing caffeine consumption for the second half of the menstrual cycle and increasing fiber intake often reduces discomfort for most women.
  • Cabbage family vegetables, such as broccoli, cauliflower, cabbage, Brussel sprouts and kale improve estrogen metabolism and can lessen symptoms. 
  • Foods high in magnesium and omega 3 fatty acids can also be helpful, such as salmon, almonds, tofu, chia seeds, and bananas. 
  • Foods high in B vitamins are great additions, such as leafy greens, beans, lentils, and garbanzo beans.
  • Supplementally, Evening Primrose Oil might be recommended by your naturopathic doctor

If tenderness is happening not tied to menstruation, then it’s likely anatomical and probably due to trauma. In this case, it’s important to have a breast exam and a mammogram. 

Mastitis is a cause of breast pain and tenderness that usually happens in conjunction with breastfeeding. It’s very painful and the affected breast is often swollen, tender, and red.  Mastitis is usually accompanied by fever and chills. In this case, it’s very important to check in with your doctor or midwife as antibiotics might be necessary. 

Interestingly, problems unrelated to the breast can also cause breast tenderness.

Arthritis or injury to the underlying ribs could cause breast pain. Shingles could occur along the rib cage and cause breast pain, and internal problems like heart disease, or gallbladder issues could reflect to the chest wall and feel like one-sided breast tenderness. Injury or strain of the pectoral muscles that lay underneath the breast could also present as breast tenderness. 

As mentioned initially, breast tenderness is very rarely a symptom of breast cancer.

However, breast changes such as unexplained swelling, skin irritation, dimpling of the breast, nipple pain or the nipple retracting and turning inward, scaliness of the nipple or breast skin, or discharge (not breast milk) from the nipple are all reasons to contact your doctor. 

In summary, there can be a number of reasons for breast tenderness, some of which can be improved with your daily nutritional choices, and some of which require medical attention. 

If you’re experiencing breast tenderness, it is best to check in with your doctor to discuss the possible cause and steps you can take to improve your health and comfort!

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Dr. Jennifer Potter ND

Dr. Jennifer Potter, ND
Naturopathic Doctor San Jose


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