The area between the breasts contains the sternum or the breastbone. The sternum serves as an anchor for the attachment of the clavicles (also known as collarbones) and the ribs. Together, they form a shield that protects the internal organs like the heart, the lungs, and the esophagus from the impact of external physical forces. The surface of the sternum is covered by connective tissue and skin.
Pain between the breasts could arise from causes that affect any of the above mentioned tissues and organs that lie in this region. The pain could be due to the breastbone or its various joints and muscles. It could also be due to causes that affect the heart, lungs, and blood vessels that lie beneath the sternum. The pain could also arise from the connective tissues and the skin that covers the sternum. In women, pain between breasts may indicate a cause within the breasts, especially some factor that affects the medial side of the breasts.
What are the causes of pain between breasts?
The various causes of pain between the breasts are described below.
Pain between breasts can arise due to a number of conditions that affect the skin over the breastbone. However, these conditions are rarely localized to the region of the breastbone and may cover a wide area of skin over the chest.
- Sunburns that affect the skin on the chest lead to redness, swelling and pain due to skin tenderness. These symptoms usually arise 8-24 hours after prolonged exposure to the sun.
- Shingles causes skin rash and pain that especially affects the chest area. Persons who have had chicken pox infection are prone to get shingles, which is caused by a reactivation of the dormant chicken pox virus in the body.
- Acne on the chest area is another cause of pain between the breasts. Acne vulgaris is characterized by pimples on the skin, caused by infection of blocked hair follicles.
- Eczema, or dermatitis, is an inflammation of the skin that occurs due to a variety of reasons. One of the most common causes is contact of the skin with an allergen or irritant such as jewelry, cloth, or cream. The skin may also become intensely itchy in these conditions.
Bone, cartilage and joint conditions
Pain between breasts could also arise from conditions that affect the bones, cartilages and joints that lie in this region. These structures include the sternum, the ribs, and the costal cartilages that connect the ribs to the sternum.
- A fractured sternum is a possible cause of intense pain between breasts, especially when it is preceded by a physical trauma such as a blow to the chest or a vehicle accident. Such trauma could also result in pain due to fractures in the ribs and the clavicles.
- Inflammation of the costal cartilages that connect the ribs to the sternum also cause pain between the breasts. This condition is also known as costochondritis. If pain is also accompanied by swelling in the region, then the condition is referred to as Tietze syndrome.
- Joint pain caused by arthritis could also result in pain between breasts. Arthritis may affect the joints between the sternum and the clavicles, or the joints between the sternum and the ribs. Two common forms of painful arthritis are rheumatoid arthritis and osteoarthritis.
Muscle, tendon and ligament conditions
- Muscle strain in the pectoral muscles and other muscles that lie over the chest can also cause pain between breasts. Strain develops when the muscle is overexerted. The affected muscles can then go into spasm and cause intense pain. Moving the muscles in the affected region exacerbates the pain.
- Muscles connect to bones through connective tissues known as tendons. Painful inflammation of these tendons (tendonitis) is often associated with muscle strain. These tendons could also rupture, leading to loss of movement and pain.
- Ligaments are connective tissues that stabilize the joints between two or more bones. Excessive stretching of joints may lead to sprain in the ligaments that can then cause pain. Pain between breasts could result from sprained costo-clavicular, sterno-clavicular, or chondro-sternal ligaments.
The heart lies beneath the breastbone. Therefore, pain arising from the heart, or the aorta could also be perceived as pain between breasts.
Insufficient blood supply to the heart muscles could cause pain due to angina pectoris or myocardial infarction (heart attack). Dizziness, excessive sweating and pain that travels down the left arm may also accompany the pain between the breasts that occurs in these conditions.
Pericarditis, or inflammation of the pericardium that surrounds the heart, can also cause pain between the breasts. Pericarditis could occur due to both infectious and non-infectious causes. Pain behind the sternum could also be associated with aortic aneurysm, which is characterized by an abnormal swelling of the aortic walls. The swelling may also progress to rupture and painful inflammation.
Inflammatory conditions that affect the lungs and the airways that lie beneath the sternum could also cause pain between the breasts. Tracheitis (inflammation of the trachea) and bronchitis (inflammation of the bronchi) also cause pain between the breasts. These inflammations could either arise from infections or allergies such as asthma.
Inflammation of the lungs is known as pneumonia is associated with painful chest. Painful chest symptoms are also associated with inflammation of the lining of the lungs. This condition is known as pleuritis. Pain between breasts may also be a late symptom of lung cancer.
Reflux of acid from the stomach into the esophagus causes intense pain in the upper chest region. This condition is known as gastro-esophageal reflux disease or GERD and the associated symptoms are often referred to as “heartburn”. In addition to GERD, pain between breasts could also result from inflammation of the esophagus (esophagitis) or the presence of esophageal ulcers.
In women, pain between breasts may be associated with normal physiological growth of the breast tissue. Breast cancer could be a more serious cause of pain in this region. However, a range of other breast conditions could also cause pain in the cleavage area, including breast cysts and breast abscesses.