Leading breast surgeon: Is it normal to experience severe pain while breastfeeding - when to worry

Breastfeeding often comes with discomfort, lumps, swelling, tenderness, but when does breast pain become something more serious? A common concern among breastfeeding women is whether sore breasts could be a sign of breast cancer.
 

According to Associate Professor Sanjay Warrier, one of Australia's leading breast surgeons and cancer researchers, most breast pain during breastfeeding is completely normal. However, new, persistent or unusual symptoms should never be ignored.
 

"Welcoming a new baby to the family is both an exciting and tiring experience. For mums breastfeeding, it can be an anxious time with so many changes happening to the breasts," Associate Professor Warrier said.
 

"Breast health is important during all stages of a woman's life including breastfeeding. If something doesn't feel right, it is important to see your GP and get it checked out. While the risk of breast cancer may be low, don't wait or brush your concerns aside. Time is never your friend when it comes to serious disease."
 

Associate Professor Warrier is one of the world's leading breast health and breast cancer surgeons who has built a highly respected practice in Sydney. The practice spans three locations with its main surgical centre located at the Chris O'Brien Lifehouse in Camperdown, and the other sites at BMA House, Macquarie Street, Sydney and Bondi Junction Medical, Oxford Street, Bondi Junction.
 

In addition to Associate Professor Warrier's breast health and surgical work, he also dedicates considerable time to research exploring and developing advancements in breast cancer detection and treatments to improve outcomes for patients. He also codeveloped Australasia's first Master of Advanced Surgery (Breast Surgery) which is delivered through the University of Sydney.
 

Why breastfeeding can cause breast pain
 

There are several common and usually harmless causes of breast pain during breastfeeding. One of the most frequent is engorgement, when the breasts become overly full and tight due to missed feeds, oversupply or irregular feeding. This can cause discomfort and tenderness, which usually settles once feeding resumes or excess milk is expressed.
 

Blocked milk ducts are another cause. These can feel like painful, firm lumps that shift or decrease in size after a feed. If a blocked duct becomes infected, it may develop into mastitis, an inflammatory condition that causes swelling, redness and flu-like symptoms. While unpleasant, mastitis is not associated with breast cancer and can typically be resolved with rest, warm compresses, proper drainage and sometimes antibiotics.

Pain can also occur as part of the let-down reflex, especially in the early stages of breastfeeding. Sharp or tingling pain when milk is being released is normal for many new mothers and tends to ease with time.
 

Could it be breast cancer?
 

Breast cancer during breastfeeding is rare but possible. The danger lies in assuming every lump or change is related to lactation. Associate Professor Warrier warned that if a lump persists despite regular feeding, does not shift or soften, or is accompanied by other symptoms such as nipple inversion, skin dimpling or abnormal discharge, it should be investigated promptly.
 

"Breastfeeding changes the breast, but it doesn't mean we should dismiss persistent or new symptoms," he said.
 

"While pain is not usually a sign of cancer, a firm lump that does not move or reduce should be taken seriously."
 

Why breast cancer can be harder to detect while breastfeeding
 

Breast tissue becomes denser during lactation, making it harder to assess through physical examination alone. However, modern imaging techniques such as ultrasound are highly effective in evaluating suspicious lumps, even in breastfeeding women.
 

"If something feels off, we can investigate it safely without interrupting breastfeeding," Associate Professor Warrier said.
 

What to look out for
 

Key warning signs that warrant further investigation include a lump that does not go away after a feed, swelling that worsens or doesn't respond to treatment, redness that spreads, skin puckering, or persistent discharge not related to milk. These symptoms are not always linked to cancer, but they should not be ignored.
 

Trust your instincts and seek help
 

Associate Professor Warrier urged all breastfeeding women to trust their instincts and prioritise their health.
 

"Too often women put their own wellbeing last, especially after giving birth," he said.
 

"If you notice a change in your breasts that doesn't feel right, see your GP or a breast specialist. It's usually nothing serious, but if it is, early detection makes all the difference."
 

More information on breast cancer detection and screening is available at www.drsanjaywarrier.com.au.
 

About Associate Professor Sanjay Warrier
 

Associate Professor Sanjay Warrier is a past President and current committee member of Breast Surgeons of Australia and New Zealand (BreastSurgANZ). His views are those of his own, not BreastSurgANZ. Associate Professor Warrier's surgery is located at the Chris O'Brien Lifehouse and he also has clinics at Oxford Street, Bondi Junction and Macquarie Street, Sydney. He is published in numerous peer-reviewed journals and won the Royal Prince Alfred Hospital's Patron's Prize for best scientific research.