Painful breasts with hard lumps are most likely to be associated with cystic hyperplasia of the breast, which is most common in women aged 30-50 and may be associated with ovarian dysfunction.
The pain and size of the lump are often associated with the menstrual cycle, increasing before menstruation and decreasing afterwards. The diagnosis is usually made by ultrasound of the breast. It is important to note that many breast cancer patients have only a lump with no pain or mild pain and should be aware of early detection.