Diagnosis of breast pain typically begins with a complete medical history, including a description of the pain and its location, followed by a physical examination and a clinical breast examination. This information will help the physician determine the cause of the pain. Some of the questions the physician may ask include:

• Is there any swelling or tenderness? If so, is it recent?
  
  
• What does the pain feel like?
  
  
• Does the pain or swelling affect both breasts?
  
  
• Where in the breast(s) does the pain occur?
  
  
• How severe is the pain?
  
  
• Does the pain or swelling develop at the same time each month?
  
  
• Have menstrual periods been missed or become irregular?
  
  
• Is there a sore on the breast that has not healed in a reasonable amount of time?
  
  
• Are there any warm, red areas of the breast that are painfully swollen?
  
  
• Has breastfeeding caused pain or cracking of the nipples?
  
  
• Is there a problem with the neck or shoulder area?
  
  
• Has there been an injury or trauma to the chest?

During the physical exam, the physician will perform a clinical breast exam to see if there are lumps in either breast. The physician will also look for any swelling, dimpling, nipple discharge, tenderness, persistent pain or redness. The physician will examine the lymph nodes in the lower neck and underarm area, as well as evaluate the heart, lungs, chest wall and abdomen

During the physical exam, the physician will ask about the nature of the breast pain and look for any of the following:

• Overall lumpiness
• Tender breasts
• Small, hard lump that can be moved
• A firm, unmovable lump
• Thickened or dimpled skin
• Scaly or tender nipple
• Nipple discharge

For women who are younger than 35 years of age and who do not have a lump in their breast, no further testing may be required. However, women who are 35 or older may require additional diagnostic tests, such as:

• Mammogram. A specialized x-ray procedure used to create detailed images of the breast. It is the most common screening tool for breast cancer.
  
  
• Breast ultrasound (sometimes called a sonogram). A test that sends and receives high-frequency sound waves to create images of internal organs or tissues. This test helps differentiate whether a lump is solid or cystic (fluid-filled).
  
  
• Breast biopsy. A procedure to obtain a sample of tissue that is then sent to a laboratory for analysis by a pathologist.
  
  
• Breast aspiration. A procedure in which a small needle draws out fluid from a fluid-filled sac in the breast. The sample is then sent to a pathologist for examination.

Women should immediately notify their physician if their breast pain has intensified, persisted for long periods of time or is recurrent.