Discomfort behind the breast upon swallowing has different possible causes including cancer – but not breast cancer.

Furthermore, a heart problem may be a possible cause that occurs to the person experiencing pain in this area.

So the fear then becomes a wrestling match between cancer and a pending heart attack.

The good news is that a pending heart attack does not cause any pain or funny feeling that results from swallowing.

It’s important to note that this article is about normal swallowing rather than difficulty swallowing.

Pain or something hurting “behind the breast” does not necessarily involve breast tissue.

In fact, breast cancer rarely causes pain, and when it does, it’s not associated with swallowing.

“Behind the breast” to some people means behind the breastbone (sternum) or the chest area.

What’s under there? The heart, of course, but so is the esophagus (the so-called food pipe).

“Chest discomfort when swallowing may be indicative of an esophageal abnormality, such as irritation or inflammation of the lining of the esophagus, or abnormal contractions of the muscles of the esophagus,” says Dr. Neil Sengupta, MD, a general gastroenterologist and assistant professor at the University of Chicago, and Recipient of the Young G.I. Investigator grant by the G.I. Research Foundation.

It can also be caused by esophageal cancer.

Dr. Sengupta adds. “This symptom typically requires direct evaluation with testing including an upper endoscopic evaluation.”

Make sure that your pain is actually behind or beneath the chest, sternum or breast as opposed to in the throat. There may be an overlap in perception of location.

Irritation or Inflammation of the Esophageal Lining and Cancer

Irritation and inflammation are usually caused by acid reflux. The acid is harsh and over time may damage the lining of the food pipe.

An ulcer may also develop. Both these conditions can cause discomfort upon swallowing and need prompt treatment.

It’s one thing for acid reflux to strike occasionally and cause heartburn and other symptoms like coughing or a sour taste in the mouth, but chronically severe acid reflux that damages the inner lining will result in a condition called Barrett’s esophagus.

In Barrett’s, the cells of the inner lining have been altered, and this alteration is a risk factor for esophageal cancer.

Abnormal Muscle Contractions

The esophagus is made up of a type of muscle – and muscle always has the potential to go into a spasm.

An esophageal spasm will cause chest pain which can be severe. Contractions can also lead to hurting when swallowing.

Upper GI Evaluation

An upper endoscopic evaluation, though not the most enticing experience, will certainly tell a gastroenterologist a lot about what’s going on.

Much more likely than not, the cause is benign. Esophageal cancer is on the rare side, with about 17,200 diagnoses in the U.S. every year, says the National Cancer Institute Surveillance, Epidemiology and End Results Program.

• People between 55 and 74 comprise 57.7 percent of these new diagnoses.

• People over 75 are 29.7 percent of the cases.

• For those 54 and under it’s only 12.7 percent.

If you’re having any kind of pain, ache or discomfort when you swallow – that seems to be coming from behind your breast or chest and it isn’t going away – it’s time to see your doctor.

Dr. Sengupta’s research interests involve optimizing the care and outcomes of patients hospitalized with gastrointestinal bleeding. Specific interests include GERD, colon cancer screening and fatty liver disease.  
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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