The feeling that your breasts are hot, sharp, or intensely burning can be distressing. This symptom, known generally as mastalgia, has many potential causes, often pointing toward inflammation, nerve irritation, or shifts in hormone levels within the body. While alarming, this common complaint requires a careful look at recent changes in your health or lifestyle to determine its origin.
Acute Causes: Infection and Inflammation
An intense, localized burning sensation frequently signals an active infection or significant inflammation within the breast tissue. The most common infectious cause is mastitis, where bacteria enter the breast, often through a cracked nipple or milk duct opening. While prevalent in lactating individuals, mastitis can also affect non-lactating individuals and men.
The burning pain is caused by the body’s immune response, leading to rapid swelling and pressure buildup within the tissue spaces. The affected area typically becomes red, hot to the touch, and severely tender, often presenting with a wedge-shaped pattern of swelling. Systemic signs like fever, chills, and flu-like aches often appear quickly, signaling a spreading bacterial infection that requires prompt medical attention.
Mastitis can progress into a breast abscess, a localized pocket of pus that forms as the infection progresses. This complication causes continuous, throbbing pain that is usually more severe than simple mastitis and requires drainage in addition to antibiotics.
Hormonal and Cyclical Pain
Fluctuations in reproductive hormones are a frequent cause of breast pain, sometimes manifesting as a burning or heavy sensation. Changing levels of estrogen and progesterone throughout the menstrual cycle lead to cyclical mastalgia, which regularly starts and stops with the period. This pain typically intensifies in the luteal phase, the week or two leading up to the menstrual flow, as hormone levels peak.
Estrogen stimulates milk duct growth, while progesterone encourages the swelling of milk glands. This combination leads to fluid retention and tissue expansion. This monthly engorgement stretches surrounding nerves, which the brain interprets as heavy or burning discomfort. The pain usually resolves once menstruation begins and hormone levels drop back to their baseline.
Hormonal shifts at other life stages can also trigger similar sensations. Individuals experiencing pregnancy, perimenopause, or taking hormone-based medications like oral contraceptives or hormone replacement therapy (HRT) may notice non-cyclical breast tenderness or a burning feeling. These changes affect the density and fluid content of the breast, altering the mechanical pressure on the internal structures.
Neurological and External Irritants
A burning sensation without swelling or redness may originate from irritated nerves, either within the breast or from the chest wall. Conditions like intercostal neuralgia involve the nerves that run between the ribs. When these nerves are compressed or damaged, the pain can be referred to the breast area. This nerve pain is often described as a sharp, electrical, or burning jolt that is highly localized.
Pain can also be referred from the chest wall, known as extramammary pain, meaning it originates elsewhere but feels like it is in the breast. For instance, costochondritis, which is inflammation of the cartilage connecting the ribs to the breastbone, can cause sharp pain radiating into the breast tissue. Previous surgeries, such as those involving breast implants or a mastectomy, can also result in long-term nerve damage (neuropathy) that presents as a chronic burning discomfort.
External factors that irritate the skin or underlying tissue can also create a surface-level burning feeling. Contact dermatitis, an allergic reaction to a new detergent, soap, or lotion, can cause skin inflammation and a burning itch. Friction from a poorly fitting or unsupportive bra, especially during exercise, can rub the skin raw and lead to a superficial burning sensation.
Recognizing Serious Symptoms and Seeking Care
While most causes of breast burning are benign and relate to hormones or minor inflammation, certain symptoms warrant immediate medical evaluation. Any breast pain that persists beyond one menstrual cycle or does not respond to simple anti-inflammatory measures should be discussed with a healthcare provider. A specific cause for concern is the presence of a new, firm, or fixed lump, or any unusual nipple discharge that is bloody or clear.
Red flags that require urgent attention include a rapid increase in breast size, accompanied by persistent redness, swelling, or an ongoing burning sensation. Inflammatory Breast Cancer (IBC) is a rare but aggressive malignancy that causes cancer cells to block the lymph vessels in the skin, leading to these inflammatory signs. The skin may also take on a pitted appearance, described as peau d’orange, or the nipple may become inverted. If these symptoms are present, a prompt diagnosis is necessary.