Pain beneath the right breast, often called the right subcostal area, usually originates from structures other than the breast itself. This region, also known as the right upper quadrant, contains a complex array of muscles, bones, and internal organs. The discomfort can stem from the chest wall structure or be referred pain from deeper organs like the gallbladder or liver. Understanding these potential sources, which range from minor strains to serious internal conditions, is the first step toward appropriate care.
Musculoskeletal and Chest Wall Causes
The physical structure of the rib cage and the muscles surrounding it are frequent sources of pain in the right subcostal region. Costochondritis is a common cause, involving inflammation of the cartilage connecting the ribs to the breastbone. This condition typically causes a sharp or aching pain that worsens with deep breathing, coughing, or direct pressure on the affected joints. Costochondritis often affects the second through fifth ribs.
Another common musculoskeletal source is an intercostal muscle strain, affecting the small muscles situated between the ribs. These strains often result from sudden, vigorous upper-body movements, intense coughing fits, or overexertion during exercise. The discomfort is usually localized, tender to the touch, and intensifies with twisting motions or when taking a full breath. Minor trauma, such as a fall or a direct impact to the chest, can also cause a rib contusion or microfracture, leading to localized tenderness and sharp pain.
Digestive System and Organ-Related Pain
Pain under the right breast can also be referred pain, originating from organs located in the upper right quadrant of the abdomen. The gallbladder, situated just beneath the liver, is a frequent culprit, especially when gallstones block the ducts and cause inflammation, a condition called cholecystitis. Gallbladder attacks, or biliary colic, manifest as sudden, intense pain that may radiate from the upper abdomen to the right shoulder blade or back. This pain is often triggered and intensified following the consumption of fatty or large meals because the gallbladder contracts to release bile for digestion.
Conditions affecting the liver can also present as discomfort in this area. Liver inflammation from hepatitis or pain due to fatty liver disease may cause a dull, aching sensation under the right rib cage. Furthermore, issues in the upper gastrointestinal (GI) tract can refer pain upward toward the chest wall. Acid reflux, or gastroesophageal reflux disease (GERD), and hiatal hernias can cause a burning sensation or pressure that may be felt near or under the right breast, especially after eating or when lying down. Peptic ulcers in the stomach or duodenum can also cause pain that is sometimes perceived in the upper right abdominal area.
Recognizing Serious Symptoms
While many causes of pain under the right breast are benign, certain accompanying symptoms signal an urgent need for medical evaluation. Sudden, severe, or crushing pain that does not subside warrants immediate attention. Pain that is accompanied by difficulty breathing or shortness of breath should be considered an emergency.
Other indicators of a potentially serious underlying condition include the development of a fever or chills, which can suggest an infection or acute inflammation, such as severe cholecystitis. Persistent vomiting, especially if it prevents keeping liquids down, is also a concerning symptom. The appearance of jaundice, a yellowing of the skin or the whites of the eyes, is a direct sign of a problem with the liver or a blockage in the bile ducts. Any pain that rapidly worsens, or is accompanied by systemic symptoms like these, requires prompt consultation with a healthcare professional to determine the cause and prevent complications.