Pam Fichtner, RMT | Breast and Chest Health Educator | Founder, Sephira Healing | Saskatoon, Saskatchewan

TL;DR
Perimenopause and summer heat can be a brutal combination. Hot flashes, swollen breasts, tight rings, irritated skin, exhaustion, sensory overload, and feeling uncomfortable in your own body are all common experiences during this stage of life that many women are never warned about.

This article explains:
• Why hot flashes and heat intolerance happen
• Why breast tenderness and swelling get worse in summer
• Why your rings, ankles, and body suddenly feel puffier
• Why your skin becomes more sensitive and reactive
• Why noise, crowds, heat, and busy days suddenly feel overwhelming
• What actually helps support your body during this transition

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Heat feels more intense during perimenopause. You’re hotter. Your breasts ache more. Your rings are tighter in the afternoon. Your skin is reacting to things it never did before. You’re more tired, more sensitive, more easily overwhelmed — and you can’t quite explain it to anyone who isn’t living it.

I’m Pam Fichtner, a Registered Massage Therapist and a breast and chest educator and speaker. I’m the founder of Sephira Healing in Saskatoon and I’ve spent nearly 30 years working with the bodies of people navigating hormonal transitions, and every summer I see a surge of clients coming in and telling me about a new pain or symptom.

I’m going to explain what really happens when perimenopause meets the heat, and what can genuinely help.

 

Why Heat Feels More Intense During Perimenopause

 

If you feel like you can’t tolerate the heat like you used to, there’s a physiological reason, and it starts in the brain.

Estrogen affects the part of the brain that controls your body temperature. When estrogen levels are unstable during perimenopause, your body becomes more sensitive to heat and temperature changes.

The result is hot flashes: a sudden surge of heat, often accompanied by flushing, sweating, and sometimes a chill afterward. Research suggests hot flashes affect an estimated 50–80% of people going through the menopause transition.

Night sweats are the nighttime version of hot flashes, and disrupted sleep can make heat intolerance even worse the next day.

 

Why Your Breasts and Chest Feel More Tender, Swollen, or Sensitive

Breast tenderness is one of the most common and least-discussed symptoms of perimenopause. Research from the Centre for Menstrual Cycle and Ovulation Research (UBC) found that approximately one in three women in early perimenopause experience breast tenderness.

This is because breast tissue contains receptors that are sensitive to both estrogen and progesterone. During perimenopause, estrogen levels don’t simply decline. They spike unpredictably before eventually tapering off. These estrogen surges can cause breast ducts to enlarge and tissue to hold more fluid. Progesterone, which normally helps balance estrogen’s effects, is often lower during this phase, making the breast tissue more sensitive, swollen, and tender.

What you might feel:
• Aching, burning, or stabbing sensations in one or both breasts
• Generalized tenderness or a sense of fullness that doesn’t follow your usual cycle
• Nipple sensitivity that feels new or heightened
• Breast tissue that feels lumpier, denser, or more fibrocystic than before
• Swelling that worsens before a period, in heat, or seemingly at random

In summer, this often gets worse. Heat increases fluid buildup in the tissues, and if the lymphatic system is already slowed down by hormone changes, that extra fluid does not drain as easily. The result can be more swelling, heaviness, and tenderness.

What to watch for: tenderness and cyclical swelling are common in perimenopause and are usually benign. However, a new lump that feels different from surrounding tissue, skin dimpling, nipple discharge, or one-sided symptoms that don’t go away, are important to get checked out by your healthcare provider. Get to know what your normal is so you can recognize changes quickly.

 

Why Swelling Gets Worse in Hot Weather

You notice it around your ankles at the end of a long day. Your rings are tighter by midafternoon. Your sleeves may feel tighter on one side than the other. Summer swelling is a real thing, and in perimenopause, it’s often worse.

Two things are happening at once.

First, hormones. Fluctuating estrogen can cause the body to hold onto more fluid. It’s the same reason many women feel swollen before a period. During perimenopause, estrogen levels can spike unpredictably, so the swelling can feel random too.

Second, heat. Hot weather causes blood vessels to widen, which pushes more fluid into the surrounding tissues. Your lymphatic system is responsible for moving that fluid back out, but it does not have a pump. It relies on movement, muscle contraction, and deep breathing to keep fluid moving. Heat can slow that process down even more.

The combination of hormone-related fluid retention and slower lymphatic drainage is why summer swelling during perimenopause can feel so intense.

What helps?
• Gentle movement and walking
• Staying hydrated
• Elevating your legs
• Avoiding long periods of sitting or standing in the heat
• Manual lymphatic drainage for more ongoing or significant swelling

 

Why Your Skin Suddenly Feels More Sensitive in Summer

Estrogen plays a big role in keeping skin strong, hydrated, and resilient. As estrogen levels become more unpredictable during perimenopause, many people notice their skin becoming drier, thinner, more sensitive, and more easily irritated.

You may notice:
• Itching or prickling that seems to come from nowhere (a condition sometimes called pruritus)
• Increased sun sensitivity or faster burning
• Chafing and under-breast irritation from heat and sweat, worsened by tissue sensitivity
• Rashes or heat rashes appearing where they didn’t before
• Products, fabrics, or detergents that previously caused no reaction now causing irritation

The skin under and between breast tissue is especially vulnerable because heat, sweat, friction, and moisture all build up there quickly.

 

WHAT CAN HELP
• Loose, breathable, moisture-wicking clothing
• Proper bra fitting to reduce friction and pressure under the breasts
• Barrier creams for irritated or chafed skin
• Gentle, fragrance-free products during times of increased sensitivity
• Avoiding tight bra bands and synthetic fabrics during hot weather

 

Why Summer Can Feel More Overstimulating and Exhausting

 

This is the symptom most often dismissed, and the one I hear about often from clients.

You used to be able to handle a busy day, a hot afternoon, a social event, or a crowded space. Now those same things can feel overwhelming. You come home depleted in a way that rest doesn’t fully fix. You’re more irritable, less patient, and more sensitive to noise, heat, and sensory input.

Hormone changes during perimenopause affect the nervous system too. Sleep becomes disrupted, stress feels harder to recover from, and summer heat adds even more strain to a body that is already working harder than usual.

“Perimenopause is largely neurological in nature. Neurological symptoms that emerge during perimenopause are indicative of disruption in multiple estrogen-regulated systems, including thermoregulation, sleep, circadian rhythms and sensory processing.” — PMC, 2015

This is all treatable. Your body responds to nervous system support, body-aware care, rest, and reducing stress on the body.

 

What Actually Helps With Summer Body Stress During Perimenopause

There is no single fix. But there are some practical strategies grounded in physiology that can make a real difference.

For heat and hot flashes

• Layer clothing so you can adjust quickly when a flash hits
• Keep a cold water bottle or cooling cloth accessible, particularly at night
• Lower the thermostat or use a fan at night — sleep environment temperature matters significantly for hot flash frequency
• Avoid known triggers where possible: alcohol, caffeine, spicy foods, and warm rooms can all lower the threshold
• Cold water on the wrists and neck provides rapid cooling when a flash is building

For breast and chest tenderness and swelling

• Choose bras with soft, wide bands and no underwire during periods of heightened tenderness — compression worsens congestion
• Moisture-wicking, breathable fabrics reduce under-breast irritation
• Gentle self-lymphatic massage supports fluid movement — this is something I teach clients directly
• Cold compresses can temporarily reduce acute tenderness
• Breast and chest massage therapy addresses tissue congestion directly and is one of the most underutilized supports for this symptom

For general swelling and fluid retention

• Move regularly — even short walks support lymphatic circulation
• Stay well-hydrated; dehydration paradoxically worsens fluid retention
• Elevate legs during rest periods
• Avoid prolonged sitting, particularly in heat
• Manual lymphatic drainage is clinically effective for significant or persistent swelling

For nervous system overload and sensory overwhelm

• Reduce load deliberately: you don’t have to earn rest
• Slow, diaphragmatic breathing activates the parasympathetic nervous system and is one of the fastest tools for nervous system regulation available to you right now
• Somatic bodywork and craniosacral therapy support the nervous system’s ability to shift out of chronic activation — not by talking about stress, but by working directly with the body’s response to it
• Prioritize sleep environment above almost everything else: temperature, light, and noise control matter more during this transition than at most other times in life
• Stop explaining your capacity to people who aren’t experiencing what you’re experiencing. This is real, and it warrants real accommodation.

When Symptoms Should Be Checked by a Healthcare Provider

Most of what’s described in this blog is uncomfortable but not dangerous. Perimenopause is a biological transition, and many of these symptoms are common during this stage of life.

However, some symptoms should be checked out:
• A new lump in the breast or chest that feels different from surrounding tissue or that doesn’t change with your cycle
• One-sided breast swelling, redness, or warmth that persists and worsens
• Nipple discharge that is new, unexpected, or blood-tinged
• Skin dimpling, puckering, or changes in texture on the breast or chest
• Swelling that is severe, sudden, or significantly asymmetrical
• Hot flashes or night sweats severe enough to significantly disrupt daily functioning or sleep over an extended period — these are treatable, and you don’t have to manage them alone
• Any symptom that feels new, unusual for you, or simply wrong in a way you can’t explain

 

You Are Not Imagining It

Perimenopause can make us feel almost crazy at times. We doubt ourselves. We downplay things. And it doesn’t help when we’re told these symptoms are “just part of getting older.”

I want to say this clearly. The heat sensitivity is real. The breast tenderness is real. The swelling, exhaustion, and overstimulation are real too.

Perimenopause affects more than hormones. It can affect body temperature, the nervous system, fluid retention, breast tissue, and skin sensitivity all at once. Summer heat can make all of it feel worse.

Understanding what’s happening in your body matters because it helps you support your body differently instead of fighting against it.

If you’d like help navigating swelling, tenderness, or nervous system overwhelm, I’d love to explore some treatment options with you.

https://www.sephirahealing.ca/treatment-options.html#ld

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Frequently Asked Questions About Perimenopause and Summer Body Changes

Why am I so hot all the time lately?

If you’re in your late 30s to early 50s and have noticed increased heat sensitivity, you may be in perimenopause. Estrogen plays a direct role in the brain’s temperature regulation system. As estrogen levels become erratic, the hypothalamus becomes hypersensitive to small temperature changes — triggering disproportionate heat responses even in mild warmth. It’s not your imagination, and it’s not “just” hot flashes. It’s a shift in how your nervous system processes temperature.

Why do my breasts hurt more in summer?

Summer heat increases circulation and encourages fluid to move into surrounding tissues. If your lymphatic system is already working harder due to hormonal changes, that fluid has less efficient pathways out. Combine this with the erratic estrogen spikes of perimenopause — which cause breast tissue to retain fluid and become more sensitive — and summer can significantly amplify existing breast tenderness. Breast and chest massage therapy and gentle lymphatic drainage are among the most effective hands-on supports for this.

Is the swelling I notice in summer related to perimenopause or just the heat?

Both. Heat dilates blood vessels and pushes fluid into tissues. But perimenopause adds a hormonal layer: high estrogen levels encourage fluid retention independently. If you notice that your summer swelling is more pronounced than it was in previous years, perimenopause is likely contributing. The combination of the two — thermal and hormonal — is why it can feel so disproportionate.

Why do I feel so easily overwhelmed and exhausted in summer now?

Perimenopause affects the nervous system directly — estrogen and progesterone both play regulatory roles in how the brain handles stress, sensory input, and recovery. When their levels fluctuate, the nervous system becomes more reactive and less resilient. Summer adds additional physiological load: heat stress, disrupted sleep from night sweats, and constant thermoregulatory effort. The result is a system working at or near capacity before the day has even started. This is real, it’s documented, and it warrants real rest and support.

Can massage therapy actually help with perimenopause symptoms?

Yes, for several specific symptoms. Manual lymphatic drainage is clinically supported for reducing swelling and fluid retention. Breast and chest massage therapy can address tissue congestion, tenderness, and the discomfort of fibrocystic changes. Craniosacral therapy and somatic bodywork support the nervous system’s ability to regulate — particularly relevant when perimenopause is producing the kind of exhaustion and overwhelm described above. Massage therapy is not a hormonal treatment and won’t stop perimenopause. But it can meaningfully address several of the physical symptoms that make it harder to live in your body during this transition.

When should I see a doctor about breast changes during perimenopause?

Cyclical tenderness, swelling, and density changes are common in perimenopause and are usually benign. See a healthcare provider if you notice: a new lump that doesn’t change with your cycle, skin dimpling or puckering on the breast, unexpected nipple discharge, one-sided swelling that persists, or any change that feels unusual for your body. Trust your instincts. You know your normal better than anyone.

Pam Fichtner, RMT | Breast and Chest Health Educator | Founder, Sephira Healing | Saskatoon, Saskatchewan

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Sources & References

Bhatt DL, et al. (2025). Effects of menopause on temperature regulation. Temperature (Taylor & Francis). https://doi.org/10.1080/23328940.2025.2484499
Brinton RD, et al. (2015). Perimenopause as a neurological transition state. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC9934205/
Prior JC. (2014). Progesterone for symptomatic perimenopause treatment. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC3987489/
Bjelland J. (2025, October). Survey results: Perimenopause and menopause in sensitive and neurodivergent women. https://www.juliebjelland.com/hsp-blog/survey-results-perimenopause-and-menopause-in-sensitive-and-neurodivergent-women-by-julie-bjelland-lmft
Cleveland Clinic. (2024, January). Does menopause cause breast pain? https://health.clevelandclinic.org/breast-pain-menopause
HealthyWomen. Perimenopausal breast tenderness. https://www.healthywomen.org/ask-expert/perimenopausal-breast-tenderness
Healthline. (2024, April 3). Menopause breast pain and tenderness: Causes and treatment. https://www.healthline.com/health/menopause/sore-breasts-menopause
Bonafide Health. (2025, July 16). Hot weather and menopause. https://hellobonafide.com/blogs/news/hot-weather-and-menopause
National Sensory Network. Understanding sensory processing and menopause. https://www.nationalsensorynetwork.org/pages/understanding-sensory-processing-and-menopause
A.Vogel. (2024). Sensory overload: What causes it during perimenopause and menopause. https://www.avogel.co.uk/health/menopause/videos/sensory-overload-what-causes-it-during-perimenopause-and-menopause/

Over the years, both through my personal life and through working with people in healthcare spaces, I’ve learned that a lot of people genuinely want to be respectful and inclusive, but feel nervous about saying the wrong thing or not fully understanding the language. That’s more common than you might think.
I know I’ve had my own learning curve too.

One of the most helpful things I learned was understanding that gender identity, gender expression, biological sex, and attraction are all separate things. They can overlap, but they are not the same.

Learning that helped me better understand people’s experiences, including some of my own, and helped me become more intentional about creating spaces where people feel safer, seen, and less judged.

As someone who identifies as bisexual while also being in a heterosexual relationship, I know what it feels like to carry parts of yourself that are not always immediately visible to other people. I also have a nonbinary child, which deepened my learning and understanding even further in ways that became both personal and important to me.

The more I learned about gender identity, expression, attraction, and the experiences many LGBTQ+ people have within healthcare spaces, the more intentional I became about creating an environment where people feel safe, respected, and able to show up fully as themselves without fear of judgment or assumptions.

One resource that really helped me better understand this was the Genderbread Person. I appreciated it because it broke things down visually in a way that felt approachable instead of overwhelming.

The Genderbread Person explains that every person has different layers to who they are:

Gender Identity

Gender identity is someone’s internal sense of who they are.
Examples:
• Woman
• Man
• Non-binary
• Genderfluid
• Agender
This is about how someone experiences themselves internally, regardless of appearance or body.

Gender Expression

Gender expression is how someone presents themselves outwardly.
This can include:
• clothing
• hairstyle
• voice
• makeup
• body language
Someone’s expression may appear masculine, feminine, both, neither, or change over time.

Biological Sex

Biological sex refers to physical characteristics someone is born with or develops over time, including anatomy, hormones, and chromosomes.
Examples:
• female
• male
• intersex
Biological sex does not automatically determine someone’s gender identity.

Attraction

Attraction refers to who someone is emotionally, romantically, or physically drawn to.
Examples:
• heterosexual
• gay
• lesbian
• bisexual
• pansexual
• asexual
Attraction and gender identity are different parts of a person’s experience.

One thing I appreciated about the Genderbread Person resource is that it also recognizes these experiences can exist on spectrums rather than rigid boxes. Language and understanding continue to evolve over time, and most people are learning as they go.

Why This Matters in Healthcare

Part of why this matters so much to me personally is because I understand what it feels like to move through the world carrying experiences people cannot immediately see.

For a long time, I kept parts of myself quiet because it felt safer or easier that way. I also know what it feels like to navigate healthcare systems while carrying invisible experiences, trauma, fear, uncertainty, or wondering whether you’ll feel accepted once you walk through the door.

That changes how you experience care.

People are far more likely to ask questions, seek support, and return for follow-up care when they feel emotionally safe and respected.

Inclusive care is not about having all the perfect words. It’s about:
• listening without assumptions
• respecting how people identify
• creating space without judgment
• helping people feel safe in their body and care experience

No one should have to explain or defend who they are in order to receive respectful care.

A Helpful Reminder

You do not need to understand every term perfectly to treat people with kindness and respect.

Most people are learning as they go. I know I still am too.

Curiosity, openness, compassion, and willingness to listen go a long way in helping people feel safe and welcomed.

Additional Resource

If you’d like to explore the Genderbread Person resource yourself, you can find it here:
The Genderbread Person v4

JUNE BLOG – PRIDE GROWS HERE – SEPHIRA HEALING

A Guide to Breast and Chest Health for Women, Men, Trans, and Nonbinary People in Canada

Pam Fichtner, RMT | Breast and Chest Health Educator | Founder, Sephira Healing | Saskatoon, Saskatchewan

TL;DR – Key Takeaways

✓ Breast and chest health applies to every body – women, men, trans, and nonbinary people. Most people were never taught how to understand theirs.
✓ The biggest barrier to care for many Canadians, especially LGBTQ+ people, is fear of being judged when seeking it.
✓ Breast and chest tissue changes throughout life because of hormones, surgery, binding, and aging. Familiarity with your own body matters more than matching a textbook.
✓ This guide includes a simple, pressure-free starting point for getting to know your body. Research shows 96% of breast cancers are first identified by the person themselves – which is exactly why body familiarity matters.
✓ Sephira Healing in Saskatoon offers breast and chest massage therapy, lymphatic drainage, post-surgical recovery support, and educational programs for every kind of body.

 

A lot of people have questions about their breast or chest health, but they don’t ask. Sometimes they sit on those questions for years. And sometimes they wait until they can’t anymore.

When I’ve asked why, the answer is usually some version of the same thing. At some point, they felt judged, or they were afraid they would be. They felt like they didn’t know enough, like they had the wrong kind of body, or like they were a problem. A nuisance. An inconvenience. Too much to deal with.

There’s research on this. Studies looking at cancer screening across 2SLGBTQI+ communities keep coming back to the same finding. The strongest predictor of whether someone seeks care is whether they feel safe with their provider. Not how informed they are. Not how close the clinic is. 

I believe every body deserves care that feels safe, respectful, and accessible. With Pride Month here, it felt like the right time to speak more openly about some of my own experiences and why this matters so much to me personally.

As someone who identifies as bisexual while also being in a heterosexual relationship, I know what it feels like to carry parts of yourself that are not always immediately visible to other people. I also have a nonbinary child, which deepened my learning and understanding even further in ways that became both personal and important to me.

The more I learned about gender identity, expression, attraction, and the experiences many LGBTQ+ people have within healthcare spaces, the more intentional I became about creating an environment where people feel safe, respected, and able to show up fully as themselves without fear of judgment or assumptions.

You don’t have to fit a particular profile or explain your body to deserve care.

Breast Cancer in Canada: An Inclusive Look at the Numbers

Breast and chest health is something many people put off. It doesn’t always feel urgent. But these numbers might make you reconsider waiting.

According to the Canadian Cancer Society’s 2026 projected estimates:

• An estimated 32,400 women in Canada will be diagnosed with breast cancer in 2026 – roughly 89 per day. 
• 300 men in Canada will also be diagnosed with breast cancer this year. Most will not have known they were at risk.
• About 1 in 8 people with breasts will develop breast cancer at some point in their lifetime. 
• The 5-year survival rate for breast cancer in Canada is approximately 89%. That number is tied to how early changes get noticed. 

Those numbers only count the people currently being counted, which is its own issue. The Canadian Cancer Society has acknowledged that data on breast and chest cancer in transgender, non-binary, and gender-diverse people is not being collected in a way that reflects the real world. 

What research does show is that 2SLGBTQI+ people face more barriers to screening. Screening rates are lower, which means cancers are often caught later. And when people can’t safely access the system, they often aren’t counted by it either. That’s part of why the data gaps exist in the first place. 

Closer to home, Saskatchewan has been expanding access to screening without a doctor’s referral. As of January 2026, women aged 43 and older can now self-refer. That age is expected to drop to 40 by the end of this month, June 2026. 

 

Why Feeling Safe Enough to Ask Is the Real Barrier

If you’ve been putting this off, you’re not alone.

People come to this late for a lot of reasons. Body shame that started young. A past healthcare experience that left them feeling dismissed. Language that never reflected their body. Or simply never being given clear, usable information in the first place.

Research across 2SLGBTQI+ communities is consistent on this. Screening rates are lower, and discrimination in healthcare is a major factor. What makes the biggest difference is having a provider who communicates well and makes people feel respected. 

In practice, that means the barrier for many people is the relationship. Whether someone in that space makes them feel like they belong there.

For a lot of people in the 2SLGBTQI+ community, that hasn’t been their experience. They’ve had to assess safety before accessing care. They’ve had to explain their bodies to receive basic information. They’ve been misgendered, rushed, or made to feel like their needs were inconvenient.

When people can’t safely access care, they often aren’t counted by it either. That is part of why there are still gaps in the data. 

Sephira Healing in Saskatoon was built with this in mind. Care where consent is explicit from the start, where no explanation is required, and where the people walking through the door don’t have to fit a particular picture to be welcomed.

 

Get to Know What Normal Breast And Chest Feels Like For You

I’ve found most people were never really taught how to understand their own breast or chest health. What they did learn was often clinical, fear-based, or built around a very narrow idea of what a body is supposed to look like. So they’re left trying to make sense of it on their own.

The questions I hear most often are things like:

• What should this actually feel like?
• What is normal for my body specifically?
• If I bind, or I’ve had surgery, or things have changed a lot, does any of this still apply to me?
• Is there a space where I can ask this without having to explain myself first?

Breast and chest tissue varies from person to person. It can feel soft or firm, lumpy or smooth, more sensitive at certain times, and different from one side to the other. All of that can fall within a normal range.

What matters most is getting familiar with your own body as it is right now.

Bodies change over time, and hormones play a big role in that. Pregnancy, postpartum, perimenopause, menopause, hormonal therapy, and aging all affect how tissue feels. A lot of the fear people carry comes from noticing something different and not knowing what it means. Change does not automatically mean something is wrong.

For people who bind or have had surgery, the picture is different again. Scar tissue can feel firm or tight and often changes for months or even years. Understanding what your body feels like now helps you make sense of those changes. There is no textbook version to match.

 

How to Do a Visual and Physical Breast and Chest Self-Exam

Here’s something worth knowing before anything else. Research looking at 462 breast masses found that 96% of cancers and 81% of ultrasound findings were first identified by the person themselves, not by a clinical exam or mammogram. 

The approach I teach at Sephira Healing is simple and sustainable. The goal is to build a relaxed familiarity with your body so you can notice when something changes.

There are two important parts to this: a visual check and a physical check.

The visual check

Standing in front of a mirror, look at your breast or chest area with your hands on your hips, then with arms raised overhead. You’re simply looking for anything that seems new or different: changes in shape or symmetry, skin dimpling or puckering, or any change around the nipple. If you’ve had surgery, get familiar with what your body looks like now so you’ll notice when something changes.

The physical check

You can do this lying down or in the shower. The water and soap in the shower lets your fingers move more easily across the skin, which some people find helpful. Just make sure you’re feeling relaxed and ease when before you start.

1. Use the pads of your fingers to get a feel for your breast or chest tissue. Note – don’t use the tips of your fingers. The pads cover more surface area and are more sensitive to texture changes.
2. Work through the whole area in a spiral pattern, starting at the nipple and moving outward. Cover from your collarbone down, across to your armpits, and all the way to the lower edge of your breast or chest tissue. Put one arm over your head to access the side near the armpit.
3. Use varying pressure (light, medium, and firm) as you go. Different pressures pick up different things.
4. Gently check your nipples for any discharge.
5. Notice what you feel. Not to diagnose anything. Just to get a sense of what’s normal for you right now. Soft spots, firmer areas, any tenderness. This is just information.

Timing

If you menstruate, the best time to do this is a few days after your period ends, when hormonal changes have settled and tissue is in a more typical state. If you don’t menstruate, choosing a consistent day each month works well.

A few things worth knowing as you go
•  One side feeling slightly different from the other is common and usually normal.
•  Tenderness that comes and goes with your cycle or with hormonal changes is usually not a concern.
•  If you have scar tissue from surgery, it can feel quite firm or dense. Getting to know how yours feels specifically is important.
•  If you bind, checking on days you’re not binding is easiest, but even a quick check through lighter fabric gives you a sense of what’s there.
•  If you find something that feels harder than the surrounding tissue, that’s worth noting. A lump will usually feel harder than other parts of the area, though people with dense or cystic tissue may experience lumps that feel different.

If you’ve never done anything like this before, or if the idea of touching that part of your body brings up difficult feelings, that’s worth knowing about yourself too. A lot of people carry complicated relationships with their breast or chest area. That’s not unusual, and it’s part of what the work that Sephira Healing addresses.

If you’d rather be guided through this, you can learn more about hands-on and educational support here: https://www.sephirahealing.ca/treatment-options.

 

What to Watch for in Breast and Chest Health

When you know what your body normally feels like, you'll notice when something is genuinely different.

Things to pay attention to:
•  A new lump or thickened area that wasn’t there before
•  Changes in shape, size, or how one side compares to the other
•  Skin dimpling or changes in texture
•  Nipple changes or discharge
•  Persistent pain in one area that doesn’t go away on its own

If something feels different and doesn’t settle, it’s worth following up with a healthcare provider. Most changes turn out to be nothing. And for the ones that do need attention, catching them earlier means having more options. Canada’s breast cancer 5-year survival rate of approximately 89% reflects that. Knowing your body is just the practical part of it. 

You don’t need to be certain something is wrong to ask about it.

 

Breast and Chest Health Questions for Specific Situations

What do lumps in the breast or chest area mean?

A lot of lumps are completely benign. Many are related to normal tissue changes, hormonal shifts, or cysts. What’s worth paying attention to is whether something is new or changing, and whether it resolves on its own. Getting familiar with your body over time is more useful than trying to evaluate any single moment against a checklist.

What should people know about breast and chest health after surgery?

Scar tissue from mastectomy, lumpectomy, top surgery, or reconstruction can feel firm, tight, or quite different from what’s around it. It often keeps changing for a year or more after surgery. Gentle care and body awareness matter here. Breast and chest massage therapy and lymphatic drainage support can make a real difference in both physical comfort and feeling reconnected to that part of the body. Pam works with post-surgical bodies regularly and understands the specific ways tissue changes after different procedures.

Does breast and chest health apply to people with implants?

Yes. Having implants changes how tissue feels, and staying familiar with your body still matters. You can learn what’s normal for you specifically and notice when something shifts. That familiarity is part of good self-care regardless of surgical history.

Is binding bad for breast and chest health?

Binding is an important part of daily life for a lot of people, and breast and chest health care needs to include that without judgment. There are things worth being mindful of: breath restriction, skin irritation, and muscle tension. Giving the body breaks when possible and paying attention to discomfort helps. Pam addresses binding specifically as part of her practice because it’s part of the real picture of breast and chest health for many people she works with.

How do hormones affect breast and chest tissue?

Hormones have a significant effect on breast and chest tissue throughout life, through menstrual cycles, pregnancy, perimenopause, menopause, and hormonal therapy. If tissue feels different than it used to, more tender or dense or active, that often has a hormonal explanation. Having language for that shift can replace a lot of unnecessary worry. Pam’s Healthy Breast Foundations program covers hormonal changes as a core thread, because it’s one of the things most people were never taught clearly. Contact for details.

Can men get breast cancer?

Yes. In Canada, an estimated 300 men will be diagnosed with breast cancer in 2026. Most will not have known they were at risk. Men have breast tissue, and male breast cancer is underdiagnosed largely because awareness is so low. Body familiarity matters for anyone with tissue in that area. 

 

Where to Start

Breast and chest health doesn’t have to be something you approach with dread or obligation.

A lot of people have avoided this part of their body for a long time, for reasons that make complete sense. Body shame, past experiences, language that left them out, or simply never having had a useful conversation about it. That's a really common place to be.

Getting started doesn’t require having it figured out. It can just look like:
• Trying the simple check-in described in this guide
• Reading through the program options at Sephira Healing to see what resonates
• Reaching out to ask a question, even if you’re not sure what you need yet

Sephira Healing is showing up at Pride this month in Saskatoon. We’ll be doing some demonstrations and would be happy to answer more questions there.

Additional Resource

One resource that really helped me better understand the differences between gender identity, gender expression, biological sex, and attraction was the Genderbread Person. I found it to be a simple and approachable visual explanation for concepts that can sometimes feel overwhelming or confusing when the language is new.

The resource explains that:
• gender identity is how someone experiences themselves internally
• gender expression is how someone presents themselves outwardly
• biological sex refers to physical characteristics someone is born with or develops over time
• attraction refers to who someone is emotionally, romantically, or physically drawn to

One thing I appreciated about the resource is that it recognizes these experiences can exist on spectrums rather than rigid boxes. Language and understanding continue to evolve over time, and most people are learning as they go.

You do not need to understand every term perfectly to treat people with kindness and respect. Curiosity, openness, compassion, and willingness to listen go a long way in helping people feel safe and welcomed.

I’ve added more about this on my website if you’d like to explore it further.
https://www.sephirahealing.ca/the-hub/my-blog/what-ive-learned-about-gender-identity-expression-and-attraction

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Frequently Asked Questions About Breast and Chest Health in Canada

Does breast cancer affect 2SLGBTQI+ people differently?

LGBTQ+ people aren’t at higher biological risk, but they face more barriers to screening and care, so cancers tend to get caught later. The Canadian Cancer Society has acknowledged that data on breast and chest cancer in transgender, non-binary, and gender-diverse people is currently incomplete. 

What is breast and chest health, and is it different from breast health?

Breast and chest health is a broader term that covers everyone with tissue in that area, regardless of gender identity, surgical history, or anatomy. It was intentionally expanded in clinical settings to include trans and non-binary people, people who have had mastectomies, and anyone who doesn’t identify with the word “breast.” Sephira Healing uses this language as standard.

What is the survival rate for breast cancer in Canada?

Approximately 89% at five years, according to the Public Health Agency of Canada. That number is higher when changes are caught early, which is why body familiarity and timely follow-up matter. 

What should someone do if they notice a change in their breast or chest?

Follow up with a healthcare provider. Most changes won’t be cancer, but early awareness gives you more options if something does need attention. You don’t need to wait until you’re certain something is wrong.

Can people in Saskatchewan self-refer for a mammogram?

As of mid-2025, Saskatchewan women aged 45 and older can self-refer for a screening mammogram without a doctor’s requisition. The province is working toward lowering that age to 40 by June 2026. Awareness of the change has been low, and health advocates have called on the government to communicate eligibility more actively. 

What does breast and chest massage therapy involve?

Breast and chest massage therapy is specialized, consent-based therapeutic work that supports the health of breast and chest tissue. It can address pain, tightness, lymphatic congestion, scar tissue, and disconnection from the body after surgery or trauma. At Sephira Healing, it is always paired with education and body awareness so clients leave understanding their own body better.

Where can I find inclusive breast and chest health care in Saskatoon?

Sephira Healing, founded by Pam Fichtner, RMT, offers specialized, trauma-aware breast and chest massage therapy, lymphatic drainage, oncology massage care, and post-surgical recovery support in Saskatoon, Saskatchewan. The practice welcomes people of all genders and identities. No explanation or justification is required to receive care. See all services at https://www.sephirahealing.ca/treatment-options

Sources

All statistics and claims in this post can be verified through the sources listed below. If any information has been updated since publication, please contact us so we can keep this resource accurate.

1. Canadian Cancer Society – Breast Cancer Statistics (2026 Projected Estimates) cancer.ca/en/cancer-information/cancer-types/breast/statistics
2. Public Health Agency of Canada – Breast Cancer
   canada.ca/en/public-health/services/chronic-diseases/cancer/breast-cancer.html

3. Canadian Cancer Survivor Network – LGBTQ+ People and Breast Cancer
   survivornet.ca/cancer-type/breast-cancer/lgbtq-information

4. ScienceDirect (2023) – Participation, Barriers, and Facilitators of Cancer Screening Among LGBTQ+ Populations
   doi.org/10.1016/j.ypmed.2023.107451

5. CBC News Saskatchewan (January 2026) – Experts Shocked by Mammogram Misinformation in Saskatchewan
   cbc.ca/news/canada/saskatchewan/experts-shocked-mammogram-misinformation-saskatchewan-9.7041168

6. CMAJ Open (2019) – Breast Cancer Risk and Breast Screening for Trans People: An Integration of 3 Systematic Reviews
   cmajopen.ca/content/7/3/E598

7. CA: A Cancer Journal for Clinicians (2025) – Breast Cancer in a Transgender Man
   acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.70021

8. Canadian Medical Association Journal (2026) – Projected Estimates of Cancer in Canada in 2026
   cmaj.ca/content/198/14/E526

9. Huang N, et al. (2022) – The Efficacy of Clinical Breast Exams and Breast Self-Exams in Detecting Malignancy or Positive Ultrasound Findings
   ncbi.nlm.nih.gov/pmc/articles/PMC8942605

10. Healthline – Breast Self-Exam: Preparation, Procedure, and Risks (medically reviewed by Valinda Riggins Nwadike, MD, MPH; updated July 2024)
    healthline.com/health/breast-lump-self-exam

Pam Fichtner, RMT | Breast and Chest Health Educator | Founder, Sephira Healing | Saskatoon, Saskatchewan

TL;DR

• Body shame is learned and can begin as early as age six
• How adults talk about their bodies shapes how children relate to their own for decades
• Consent education is body education
• Body shame can make it harder to seek care, including breast and chest health care
• Therapeutic touch, done with consent and care, can help people reconnect with a part of their body they've been avoiding

Most of us didn't choose our first feelings about our bodies. They came from the world around us.

I'm Pam Fichtner, a Registered Massage Therapist, breast and chest health educator, and court-recognized expert witness in breast massage therapy in Saskatchewan. I founded Sephira Healing in Saskatoon in 2004, and in nearly 30 years of clinical practice, I've supported women, trans, and non-binary people at every stage of their breast and chest health journey — from general wellness and self-care to post-surgical recovery and life with or beyond cancer.

I grew up with large breasts as a teenager, and I spent years hiding them under oversized shirts. When I reflect back now, I don’t think I did that because I chose to. It’s because somewhere along the way, I got the impression that my body needed to be made smaller and I should cover up anything that might draw attention to it. It’s taken years of study and practice to fully understand what had happened.

The shame I carried wasn't mine to begin with. It was taught.

And I'm not alone in that.

May 4–10 is Mental Health Week in Canada and this year, I want to talk about something that sits right at the intersection of mental health and body health.  The messages we perceive about our bodies from childhood onward, and what it actually takes to change them.

 

 

 

 

 

 

 

 

Is body shame something we're born with or something we learn?

We learn it. And research shows it can start surprisingly early.

A 2023 study published in Sex Roles found that body shame appears in children as young as six, and is directly linked to how parents pay attention to their children's appearance. (Bouderbala et al., 2023)

Children notice how the adults around them talk about their bodies. They notice what gets talked about openly and what gets said behind closed doors, hushed or avoided.   

Breasts and chests are a good example. They tend to get treated one of two ways: either too sexual to mention, or too medical to relate to.

By the way, breast and chest tissue is not exclusive to women. Let’s normalize that. People assigned male at birth have breast tissue too. So do transgender women, transgender men, and non-binary people.

The silence and avoidance around this part of the body affects anyone who has a chest, regardless of how they identify or what their body looks like.

That silence has a cost.

People grow up not knowing what their own breast or chest tissue feels like. They avoid touching that area because it feels awkward, embarrassing, or somehow inappropriate — even when they're alone.

What does consent have to do with breast and chest health?

So much!  Consent education often gets framed as a safety conversation for teenagers. But it starts (or should start) much earlier.

At its core, it's about a very simple message. Your body belongs to you.

Teaching children that their body belongs to them helps them build confidence in advocating for themselves throughout life.

When a child is told they don't have to hug someone if they don't want to, that's not just about manners. It's the beginning of a much longer lesson. It teaches them that how something feels in their body is important information. That they have the right to say what does and doesn't feel okay and that their comfort matters.

Research shows that children are more aware of body ownership and autonomy than we often give them credit for.  Teaching consent early has lasting effects on how they navigate healthcare, relationships, and their own sense of safety. (Alderson, 2024, PMC)

That foundation shapes whether a young person can:

• speak up during a medical appointment when something doesn't feel right
• ask questions about their body without shame
• feel safe enough to access breast or chest health care later in life

I've worked with clients who came to me after years of avoidance. No one had really ever taught them that this part of their body was worth paying attention to with regard to their whole person health and wellbeing.

Consent isn't a grown-up topic. It's the earliest lesson in body respect.

 

Does how we speak about our own bodies affect our children?

Yes. Children learn from what they see and hear every day.

A meta-analysis of 42 studies found that criticizing children's weight leads to negative self-perception and disordered eating. But it’s not only direct criticism that affects them. When a parent speaks badly about their own body, children draw their own conclusions about whether bodies like theirs are acceptable. (Slate / Virginia Sole-Smith, 2019, citing meta-analysis)

Before I became a massage therapist, I worked in social services — including time at the Downtown Eastside Women's Centre in Vancouver, one of the most demanding frontline environments in Canada. I worked alongside women living with poverty, addiction, and trauma. I watched what happened when they didn’t believe their body deserved respect or care.

I also watched what happened when they finally did.

A respectful hand on a shoulder or hug impacted them in a way words never could. That's what brought me to this work. And it's why I believe so strongly that safety, consent, and body respect need more conversations, and that what we model matters.

We need to:

• treat a health appointment as normal rather than with fear, shame or avoidance
• name body parts clearly and without embarrassment
• take care of whole selves and include breast or chest health without apologizing for it

 

 

 

 

 

 

 

 

Does body shame actually affect your health?   

Yes. And this connection is important.

Body shame doesn’t just affect your self-image.  It’s associated with higher rates of anxiety, depression, and poorer quality of life. (Rodgers et al., 2023, Global Mental Health / PMC).

Studies also show that shame can lead people to conceal symptoms, avoid disclosing concerns to their doctor, and delay treatment altogether. (Dolezal et al., 2017, PMC)

This is especially true for breast and chest health.

People assigned female at birth are most often the focus of breast health conversations, but people assigned male at birth can also develop breast conditions, including breast cancer, and they are far less likely to catch it early because the topic is so often treated as though it doesn't apply to them.

Transgender and non-binary people face their own distinct barriers, including care settings that weren't designed with them in mind.

Knowing what your breast or chest tissue normally feels like, noticing when something seems different, and being able to talk about it with a practitioner without embarrassment can protect you.  You’ll be more likely to speak up early, get the support you need, and feel confident doing it.

Body image is a health issue. It deserves to be treated like one.

 

Can therapeutic touch help you reconnect with your body?

For many people, yes.

Part of what I do at Sephira Healing is help people develop a different relationship with their breast or chest, often for the very first time. For many clients, this is a genuinely new experience. It’s not a cold or clinical experience you have to get through. It’s slow, attentive, and consent is clear.  Questions are welcome, and it’s a place where you as a whole person can be present, not just the body part.

One client told me she had never once touched her own chest with kindness before coming to see me. She was in her 50s.

I wasn't surprised. I've heard versions of that story hundreds of times.

But after that, she was able to start some self-care for her breasts.  She has more confidence and the therapeutic benefits of breast and chest massage therapy are long.

That’s what this work is about. And it doesn't start in a treatment room. It starts in the messages we receive, the silences we inherit, and the conversations we choose to have differently.

Questions to Ask Yourself About Your Breast and Chest Health

Whether you're a parent, a person navigating your own relationship with your body, or someone who works with others in any capacity, it’s a good time to ask yourself:

• What messages did you pick up on about your own body growing up? And which ones are you still carrying?
• How do you speak about your own body in front of other people?  In front of yourself?
• Is there a part of your body (breast or chest included) that you've been avoiding, ignoring, or disconnecting from?

You don't have to have any of this figured out. It starts with awareness.  And then, you can go from there.

You Don't Have to Navigate This Alone

Body shame is common. So is the disconnection that follows it. But common doesn't mean permanent — and it doesn't mean you have to figure it out on your own.

At Sephira Healing, my goal is to help you feel more at ease in your body and more confident in what it's telling you. Whether you're looking for education, self-care tools, or hands-on breast and chest massage therapy, care that feels safe, informed, and respectful is available to you.

You don't have to wait for a crisis to come see me.  Many clients tell me they didn't know how much they needed this kind of support until they experienced it.

[Explore Classes] [Book a Session]

FAQ: Body Image, Consent, and Breast and Chest Health

What does consent have to do with breast and chest health care?

Quite a lot. Research suggests that body shame can make it harder to seek care — people may skip self-exams, delay appointments, or stay quiet about pain or changes they notice. Not because they don't care, but because the discomfort and avoidance get in the way. Building a more aware, comfortable relationship with your breast or chest is part of whole-body health — not separate from it.

Is it normal to feel disconnected from your breast or chest tissue?

Very. Many people go years — sometimes their whole lives — without ever touching that part of their body with curiosity or care. This is especially common for people who carry body shame, have experienced trauma, or grew up in environments where the chest and breast area was treated as off-limits, sexual, or simply never discussed. That disconnection is understandable. It's also something that can change.

How do I talk to kids about bodies and consent without making it awkward?

The most effective approach is usually also the simplest: use accurate body part names, respond to questions calmly and without embarrassment, and model that your own body deserves respect and care. You don't need a formal script. Children pick up far more from what they observe than from what they're told directly. If you respond to a child's question about their body with ease and honesty, you're already teaching them something important.

Does breast and chest health apply to people of all genders?

Yes. Breast tissue exists in people of all genders — including people assigned male at birth, transgender women, transgender men, and non-binary people. People assigned male at birth can develop breast conditions including breast cancer, though they are far less likely to be screened or diagnosed early because it's so rarely discussed. At Sephira Healing, breast and chest care is available to everyone, regardless of gender or identity.

What is breast and chest massage therapy and what is it used for?

Breast and chest massage therapy is a legitimate, evidence-informed area of massage therapy practice. It can support lymphatic drainage, ease muscle tension in the chest wall, help with scar tissue healing after surgery or injury, and support general breast and chest tissue health. At Sephira Healing, it is always offered with explicit, ongoing consent and within a trauma-aware framework. It is not a trend, and it is not a cure-all — it is skilled therapeutic care.

Can therapeutic touch really change how you feel about your body?

Many clients tell me it does. For people who have spent years avoiding a part of their body, being cared for in a way that is slow, respectful, and consent-based can shift something that goes beyond the physical. Clients often leave feeling more comfortable doing their own self-care, more confident about noticing changes, and more at ease in their body than they expected. I'm not promising a particular outcome — but I have seen this shift happen hundreds of times.

What does a session at Sephira Healing involve?

Every session begins with a conversation. I want to understand what you're experiencing, what feels concerning, and what you're hoping to get from your care. Consent is explicit, ongoing, and never assumed. From there, sessions may include breast and chest massage therapy, lymphatic drainage massage therapy, craniosacral therapy, or trauma-aware somatic bodywork, depending on what your body needs. Many clients also leave with simple self-care practices they can use at home. My goal is never to create dependence — it's to help you feel more informed, more comfortable, and more at ease in your own body.

Pam Fichtner, RMT | Breast and Chest Health Educator | Founder, Sephira Healing | Saskatoon, Saskatchewan

Sources

1. Bouderbala et al. (2023). Body shame in 7–12-year-old girls and boys: The role of parental attention to children's appearance. Sex Roles. https://pubmed.ncbi.nlm.nih.gov/37360900/
2. Mental Health Foundation. Body image report — executive summary. https://www.mentalhealth.org.uk/explore-mental-health/articles/body-image-report-executive-summary
3. Sole-Smith, V. (2019). How to talk to kids about weight and body shaming. Slate. https://slate.com/human-interest/2019/01/child-body-image-advice-weight-shaming.html  (citing 2016 meta-analysis of 42 studies)
4. Alderson, P. (2024). Bodily integrity and autonomy of the youngest children and consent to their healthcare. PMC / PubMed. https://pmc.ncbi.nlm.nih.gov/articles/PMC11606759/ 
5. Reichel, L. (2020). To teach young kids the concept of consent, focus on bodily autonomy. WHYY. https://whyy.org/articles/to-teach-young-kids-the-concept-of-consent-focus-on-bodily-autonomy/
6. Rodgers, R. F. et al. (2023). Body image as a global mental health concern. Cambridge Prisms: Global Mental Health / PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC9970735/
7. U.S. Office on Women's Health. Body image and mental health. https://womenshealth.gov/mental-health/body-image-and-mental-health/body-image 
8. Lamont, E., Flynn, M., & Stewart, T. (2024). Body shame predicts healthcare discomfort and avoidance in college women. International Journal of Behavioral Medicine. https://link.springer.com/article/10.1007/s1 2529-024-10341-y
9. Dolezal, L. et al. (2017). Health-related shame: An affective determinant of health? PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC5739839/

Pam Fichtner,
RMT | Breast and Chest Health Educator | Founder, Sephira Healing | Saskatoon, Saskatchewan

TL;DR "Breast pain is one of the most common things I see in my practice — and it's almost never what you're afraid it is."

• Most breast pain is not cancer — up to 70% of women experience it at some point
• The most common causes are hormonal changes, fibrocystic tissue, lymphatic congestion, and muscle tension
• Cyclical pain that follows your menstrual cycle is very common and usually not a concern
• Gentle movement, deep breathing, and lymphatic drainage massage therapy can help ease many types of breast discomfort
• See a doctor if you notice a new lump, skin changes, nipple discharge, or pain that doesn't improve or feels unusual for your body

Could this be breast cancer?

Breast pain (mastalgia) can be scary and we almost immediately fear that any pain there could be a sign of cancer.  But breast pain alone is rarely a symptom of breast cancer.  In fact, the majority of breast discomfort is caused by hormones, muscle tension, or lymphatic congestion — all very manageable and very common.

I'm Pam Fichtner, a Registered Massage Therapist, breast and chest health educator, and a court-recognized expert witness in breast massage therapy for Saskatchewan. I founded Sephira Healing in Saskatoon in 2004, and over 30 years of clinical experience, I've had the privilege of supporting women, trans, and nonbinary people across Canada, including many navigating surgery, recovery, and life with or beyond cancer.

 

Studies suggest that up to 70% of women will experience breast pain at some point in their lives, which is very much in line with what I see in my practice.

Breasts are living tissue. They respond to hormones, stress, posture, movement, and even how we breathe.

So, the key to understanding your breast health is noticing changes in your own body.  When you become familiar with how your breasts normally feel, it becomes much easier to notice when something changes.

Before we look at some of the common causes of breast pain, remember that articles like this are meant to provide education, not a diagnosis.

If something in your breast or chest area feels different from what is normal for you, trust that instinct and speak with your healthcare provider.

Hormonal Changes: What Does Hormonal Breast Pain Feel Like?

Hormonal fluctuation is one of the most common causes of breast pain, and it usually shows up as tenderness or swelling 1–2 weeks before your period.  That’s often when estrogen and progesterone can cause breast tissue to hold more fluid.

This type of breast pain is cyclical, meaning it tends to follow the same pattern each month and usually improves once menstruation begins and hormone levels shift again.

You might feel:

• Heaviness
• Soreness
• Swelling
• sensitivity to touch

Some people I treat at Sephira Healing also notice that the discomfort spreads into the armpit or upper chest area, which can feel alarming but is also common with hormonal breast pain.

Hormonal breast pain can also happen during:

• perimenopause
• pregnancy
• hormone therapy
• certain birth control methods

During these transitions, the body is adjusting to new hormone levels, and the breast tissue may respond differently than it has in the past.

For many people, this type of discomfort settles as hormone levels stabilize.  However, if breast pain feels unusual for your body, persists beyond your normal cycle, or is concentrated in one specific area, it’s always a good idea to speak with your healthcare provider.

Fibrocystic Breast Tissue: Is Lumpy or Tender Breast Tissue Normal?

Yes, in most cases it is. Up to 50% of women between the ages of 20 and 50 experience fibrocystic breast changes at some point in their lives.  It’s a very common and non-cancerous condition. 

Fibrocystic breast changes happen when fibrous tissue thickens or small fluid-filled cysts develop within the breast.

Breast tissue is not meant to feel perfectly smooth. It's naturally dense, with areas that may feel lumpy or rope-like. Because breast tissue responds to hormones, these changes often become more noticeable before menstruation, when estrogen and progesterone cause the breast tissue to swell and hold more fluid.

People with fibrocystic breast tissue may notice:

• areas that feel lumpy or rope-like
• tenderness or sensitivity
• swelling or fullness
• breast discomfort that changes during the menstrual cycle

These sensations can feel concerning, especially if you’re not familiar with how your breast tissue normally feels. But in many cases, the discomfort improves once menstruation begins and hormone levels shift again.

When you know what is normal for your body, it becomes much easier to notice when something truly changes.

At Sephira Healing, I often encourage clients to do a breast self-exam at the same time each month, ideally a few days after their period when breast tissue is not as sensitive or tender.

If you ever feel a new lump does not move, continues to grow, or even just feels different from the rest of your breast tissue, it’s always a good idea to speak with your healthcare provider.

Lymphatic Congestion: Can Slow Lymph Flow Cause Breast Tenderness?

Yes. And it's more common than most people realize!  The breasts are part of the lymphatic system, which helps move fluid, waste, and immune cells throughout the body. Unlike your heart, the lymphatic system has no pump, so it relies entirely on movement, breath, and muscle activity to keep fluid circulating.

That’s why lymph fluid can sometimes move more slowly, especially when we’re sitting a lot, holding tension in our chest and shoulders, or not moving as much as usual.

When that lymph flow slows, some women experience:

• fullness
• tenderness
• swelling
• heaviness in the chest

Gentle movement, breath, and massage therapy can really help and support that healthy lymphatic flow.

Lymphatic drainage massage is something many of my clients at Sephira Healing now ask for specifically.  It’s a very gentle technique that encourages lymph fluid to move through the body and toward nearby lymph nodes, where it can be filtered and returned to circulation. This can help improve lymph circulation, reduce swelling, and ease discomfort after surgery, injury, or lymphedema.

Because the lymphatic system relies on movement to function well, I also help my clients with some gentle stretching, breathing, and yoga poses that support healthy lymph flow. These four are the ones I recommend most often for the upper body:

4 Yoga Poses to Support Lymphatic Flow in the Chest

1. Seated neck stretch — helps encourage lymph movement through the neck, shoulders, and upper chest. Sit upright and gently lower your head toward your chest or shoulder, holding the stretch for about 30 seconds.

2. Supine reclined twist — helps stimulate circulation through the torso and chest. Lie on your back and gently bring one knee across your body into a soft twist while keeping your shoulders relaxed.

3. Child's pose — gently stretches the back, shoulders, and chest while encouraging slow, deep breathing. From hands and knees, sit your hips back toward your heels and rest your torso forward.

4. Cat–cow pose — helps mobilize the spine and rib cage while supporting breath and movement through the chest. Alternate slowly between arching and rounding your back.

For the full list of 8 poses with detailed instructions, [see this post.]

These movements don’t need to be intense. Slow, gentle motion and steady breathing are usually enough to help support your body’s natural lymphatic flow.

Stress and Muscle Tension: Can Stress and Tight Muscles Cause Breast Pain?

Yes.  Breast pain doesn’t always come from breast tissue. Muscles in the chest, ribs, and shoulders can also refer pain into the breast area.

Even when the breast tissue itself is healthy, stress and poor posture can create tension in the muscles of the chest, shoulders, and rib cage, which may make the breasts feel sore or sensitive.

When these muscles become tight, they can create pressure and pulling sensations through the chest wall, which may be felt as soreness, tenderness, or sensitivity in the breasts.

Many people spend long hours sitting at desks, leaning forward, or looking down at phones. This position can tighten the chest muscles while weakening the muscles in the upper back, creating imbalance and tension through the chest and rib cage.

When we are stressed, breathing often becomes short and shallow, which limits movement in the rib cage and chest. Over time this can contribute to tightness and discomfort in the surrounding muscles and connective tissue.

This tension can show up in a few different ways, including:

• tight chest muscles
• shallow breathing
• shoulder tension
• fascial restriction

In many cases, gentle movement, stretching, massage therapy, and mindful breathing can help release this tension and allow the chest to relax again.

However, if breast pain persists, worsens, or feels different from what is normal for your body, it’s important to speak with your healthcare provider to rule out other causes.

Improper Support: Can a Poor-Fitting Bra Cause Breast Pain?

Yes.  And it is one of the most overlooked causes of breast and chest discomfort.

Wearing a poorly fitting or unsupportive bra can place ongoing strain on the muscles, ligaments (often called Cooper’s ligaments), and connective tissue of the chest, shoulders, and upper back. Over time, that strain can show up as tenderness, achiness, or a general heaviness in the breast and chest area.

This is especially common during exercise, when breast tissue needs adequate support to reduce excessive movement, and for people with larger breasts, where the weight of unsupported tissue can place constant pull on the chest wall and surrounding muscles.

At Sephira Healing, bra fit is something I bring up regularly with clients.  Here’s a few questions that can help you determine if it’s your bra that’s contributing to discomfort:

• Does your bra feel tight across the chest band or dig into your shoulders?
• Are you relying on the straps for most of the support rather than the band?
• Does your bra fit differently at different times of the month as your breast tissue changes?

If breast and chest discomfort seems to worsen during activity or by the end of the day, I’d recommend visiting a professional bra fitter to ensure your bra is providing the right support for your body.

7 Simple Daily Habits That Can Help Ease Breast Discomfort

Because the breasts are influenced by hormones, circulation, muscle tension, and lymphatic flow, small daily habits can sometimes make a big difference in how your chest feels.  At Sephira Healing, these are the ones I recommend most often.

• Gentle movement throughout the day – walking, stretching, or light yoga helps support circulation and lymphatic flow.

• Taking breaks from sitting – standing up, rolling the shoulders, or stretching the chest can relieve tension that builds in the rib cage and shoulders.

• Slow, deeper breathing – diaphragmatic breathing helps the rib cage expand and contract, which naturally supports lymph movement.

• Rebounding or light bouncing – gentle bouncing on a mini trampoline can help stimulate lymphatic circulation because the lymphatic system responds well to rhythmic movement and changes in gravity.

• Supporting lymphatic flow with massage therapy – gentle self-massage or professional lymphatic drainage massage therapy can help encourage fluid movement through the lymphatic system.

• Staying hydrated – I remind my clients that the lymphatic system is largely fluid, and drinking enough water throughout the day is one of the simplest things you can do to support it.

• Wear a well-fitting, supportive bra - Breast size and shape changes over time. So, make sure you’re routinely fitted for the correct bra size.

When Should Breast Pain Be Checked by a Doctor?

As I often remind my clients, the most important part of breast health is knowing what is normal for your own body. When you become familiar with how your breasts normally feel, it becomes much easier to recognize when something changes.

Most of the time, breast pain is related to hormones, muscle tension, lymphatic flow, or other non-serious causes.  But if you notice a change that feels unusual for you, it’s always a good idea to speak with a healthcare provider.

Here are 6 clear signs of breast pain or changes you should get checked by your healthcare provider:

• a new lump that feels different from the surrounding tissue
• a lump that does not move or continues to grow
• skin dimpling, puckering, or changes in the texture of the skin
• nipple discharge that is new or unusual
• redness, warmth, or swelling in the breast
• pain that persists or does not improve over time

If you’re experiencing breast or chest discomfort and would like support understanding what your body might be telling you, you don’t have to navigate that alone.

You Don't Have to Navigate This Alone

Even though breast and chest pain is common, and in most cases has a straightforward explanation, I also know that "common" doesn't make it any less scary when it's happening in your own body.

My goal at Sephira Healing is to help you feel more at ease in your body and more confident in what it's telling you.

If you're curious about breast and chest health, or looking for evidence-based support that feels comfortable and safe, I invite you to book a session or sign up for a class.

Many clients tell me they didn't know how much they needed this kind of support until they experienced it. For a lot of people, it's the first time they've ever stopped avoiding this part of their body. You don't have to wait for pain or a crisis to happen before you start caring for your whole body.

[Explore Classes]  [Book a Session]

 

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FAQ’S:

Frequently Asked Questions About Breast Pain

Is breast pain a sign of cancer?

In most cases, no. Breast pain is actually one of the less common symptoms of breast cancer. Most breast pain is related to hormonal changes, fibrocystic breast tissue, lymphatic congestion, or muscle tension — all very common and manageable causes. That said, if you notice pain accompanied by a new lump, skin changes, nipple discharge, or anything that feels unusual for your body, it's always worth speaking with your healthcare provider. Knowing your own body is the most important tool you have.

Why do my breasts hurt before my period?

This is one of the most common questions I hear at Sephira Healing, and the answer is usually hormones. In the 1–2 weeks before your period, estrogen and progesterone levels rise and cause breast tissue to swell and hold more fluid. This can create tenderness, heaviness, and sensitivity that typically improves once your period begins and hormone levels shift again. If the discomfort feels more intense than usual or is concentrated in one specific area, it's a good idea to check in with your healthcare provider.

Is it normal to feel lumps in my breast tissue?

Yes — breast tissue is not meant to feel perfectly smooth. It's naturally dense, and many people have areas that feel lumpy, rope-like, or uneven. Up to 50% of women between the ages of 20 and 50 experience fibrocystic breast changes, which can make the tissue feel more pronounced at certain times of the month. What matters most is knowing what is normal for your own body so that you can notice when something truly changes. If you feel a new lump that doesn't move, continues to grow, or feels different from the surrounding tissue, speak with your healthcare provider.

Can massage therapy help with breast pain?

For many people, yes. Breast and chest massage therapy can help support lymphatic flow, ease muscle tension in the chest wall, and reduce the heaviness or fullness that comes with hormonal fluid retention. It can also help people reconnect with a part of their body they may have been avoiding. At Sephira Healing, breast and chest massage therapy is offered as evidence-based therapeutic care — not a trend, and not a cure-all. Our goal is to support your body in doing what it's already designed to do.

What is lymphatic drainage massage therapy and how does it help?

Lymphatic drainage massage therapy is a very gentle, specialized technique that encourages lymph fluid to move through the body toward the lymph nodes, where it can be filtered and returned to circulation. Unlike regular massage therapy, it uses light, rhythmic strokes specifically designed to stimulate the lymphatic vessels just beneath the skin. It can help reduce swelling, ease breast and chest tenderness, support post-surgical recovery, and improve overall circulation through the chest. I have been certified with the Dr. Vodder School for nearly 30 years and it is one of the most requested services at Sephira Healing.

Can stress really cause breast pain?

Yes — and this surprises a lot of people. Breast and chest pain doesn't always originate in the breast tissue itself. When we are stressed, breathing becomes shallow, the chest tightens, and muscles in the rib cage and shoulders can refer pain directly into the breast and chest area. Poor posture from long hours at a desk or looking down at a phone adds to this tension over time. Gentle movement, deeper breathing, and massage therapy can all help release that tension and ease the discomfort it creates.

Can a poorly fitting bra cause breast pain?

Yes — and it's more common than people realize. A bra that doesn't fit well can place ongoing strain on the muscles, ligaments, and connective tissue of the chest, shoulders, and upper back. This shows up as tenderness, achiness, or heaviness that often worsens during activity or by the end of the day. It's especially common for people with larger breasts, where unsupported tissue places constant pull on the chest wall. If you notice your discomfort increases during exercise or correlates with how long you've been wearing your bra, fit may be a contributing factor. I recommend visiting a professional bra fitter — it's a simple step that can make a surprisingly big difference. At Sephira Healing, bra fit is something I bring up regularly because the right support is genuinely part of breast and chest health care.

When should I see a doctor about breast pain?

Most breast and chest pain doesn't require urgent medical attention, but there are specific signs that mean it's time to see your healthcare provider. Reach out if you notice a new lump that feels different from the surrounding tissue, a lump that doesn't move or continues to grow, skin dimpling or puckering, nipple discharge that is new or unusual, redness, warmth, or swelling in the breast or chest, or pain that persists and doesn't improve over time. Trust your instincts. If something feels different from what is normal for you, that's reason enough to get it checked.

What can I do at home to ease breast discomfort?

Quite a bit, actually. Start with your bra.  It's one of the most overlooked contributors to breast and chest discomfort, and getting properly fitted can make a surprising difference. From there, gentle movement throughout the day, slow diaphragmatic breathing, staying hydrated, and taking regular breaks from sitting can all make a meaningful difference. Gentle self-massage to support lymphatic flow is something I teach many of my clients at Sephira Healing — you don't always have to come in to get relief. Light bouncing on a mini trampoline, yoga poses that open the chest and upper body, and reducing prolonged shoulder tension are all simple, accessible tools. The more you understand what your body is responding to, the more confident you feel managing it.

What does a session at Sephira Healing involve?

Every session at Sephira Healing begins with a conversation. I want to understand what you're experiencing, what feels concerning, and what you're hoping to get from your care. Consent is explicit, ongoing, and never assumed. From there, sessions may include breast and chest massage therapy, lymphatic drainage massage therapy, craniosacral therapy, or trauma-aware somatic bodywork depending on what your body needs. Many clients also leave with simple self-care practices they can use at home. My goal is never to create dependence — it's to help you feel more informed, more comfortable, and more at ease in your own body. If you're not sure whether a session is right for you, you're welcome to reach out before booking.

Pam Fichtner, RMT | Breast and Chest Health Educator | Founder, Sephira Healing | Saskatoon, Saskatchewan

Medical References

• Canadian Cancer Society. Breast pain (mastalgia).
  https://cancer.ca/en/cancer-information/cancer-types/breast/what-is-breast-cancer/non-cancerous-conditions/breast-pain
• Island Health (British Columbia). Breast Pain (Mastalgia).
  https://www.islandhealth.ca/sites/default/files/2019-06/breast-pain.pdf
• Mayo Clinic. Fibrocystic Breasts: Symptoms and Causes.
  https://www.mayoclinic.org/diseases-conditions/fibrocystic-breasts/symptoms-causes/syc-20350438
• Breastcancer.org. Breast Pain (Mastalgia).
  https://www.breastcancer.org/benign-breast-conditions/mastalgia
• Tahir, M.T. Mastalgia. StatPearls Publishing.
  https://www.ncbi.nlm.nih.gov/books/NBK562195/
• Healthline. Breast pain: Premenstrual tenderness and swelling.
  https://www.healthline.com/health/breast-premenstrual-tenderness-and-swelling
• Healthline. Breast massage: Benefits and risks.
  https://www.healthline.com/health/breast-massage
• Healthline. Aging changes in the breast.
  https://www.healthline.com/health/aging-changes-in-the-breast
• Cleveland Clinic. Breast Pain (Mastalgia).
  https://my.clevelandclinic.org/health/diseases/15469-breast-pain-mastalgia