When former Vogue editor Alexandra Shulman revealed last month that she’d been treated for breast cancer, one fact in her account leapt out at me – as, I suspect, it did for millions of other women who read it.

Her only symptom, she wrote in The Mail on Sunday, was breast pain – something that so many of us suffer.

Alexandra was specific: it was ‘an intermittent sharp pain under my left breast, as if the wire from a bra was cutting in’.

It was not lump. There was nothing else. And she wasn’t all that worried. Friends had told her: ‘Well at least it’s not breast cancer because you don’t get a pain with breast cancer.’

They were correct in most cases. The symptoms of breast cancer, aside from a lump, are skin changes – puckering, or a rash – or changes to or a discharge from the nipple.

Sometimes, they can cause pain. They may be accompanied by pain. Breast cancer isn’t just a symptom.

Alexandra Shulman, pictured, recently revealed in the Mail on Sunday that she had been treated for breast cancer having gone to see her doctor when she suffered pain in the area - a symptom not normally linked to the disease

Alexandra Shulman, as seen in the Mail on Sunday, revealed that she was treated for breast carcinoma after she went to see her doctor because she experienced pain in her chest – something not typically associated with this disease.

Alexandra was reminded of the terrible case of Sarah Harding (pop singer), who succumbed to breast cancer in September. She decided that she would get her checked. Sarah also spoke out about her pain. It was not her fault, she thought.

And, horribly, by the time she was diagnosed – she went to the doctor after noticed bruising around her breast – her cancer was advanced, and incurable.

Alexandra Shulman had a normal mammogram and an exam. However, her doctor arranged for an extra ultrasound scan. And that’s how the small cancer was found on the bottom of her breast – where the pain had been.

Her treatment – a lumpectomy, radiotherapy, and hormone tablets which she’ll take for seven years – seems to have been a success. I have remained captivated by her story. I’ve wondered whether women who read it would be worried that breast pain, with no other symptoms, might be a sign of ‘hidden’ cancer. Because, in the vast majority of cases, it won’t be. That’s not to say there won’t be some women who notice breast pain, but find nothing else wrong, and who then go on to be diagnosed with cancer. But it’s a very unusual situation.

If a GP suspects a patient has breast cancer – according to the classic symptoms mentioned above – they will refer her for urgent assessment, which will happen within two weeks. Hospital breast clinics are now one-stop shops, where a mammogram, and possibly an ultrasound can be given, as well as a biopsy – where a needle is used to remove a small piece of tissue for testing – during a single appointment.

Former Girls Aloud singer Sarah Harding, pictured, died in September. She thought the pain in her breast was due to her guitar strap constantly rubbing the area. Unfortunately, by the time her disease was diagnosed, it was too advanced and was incurable

Sarah Harding (pictured), was a former Girls Aloud singer. She died on September. The pain she felt in her breasts was caused by her guitar strap constantly scratching the area. It was far too late and her condition was now incurable.

According to NHS guidelines, however, only pain is not enough reason for such referrals. Do you think this is the best approach? Having sat on both sides of the consulting room table, as a doctor, and as a breast cancer patient myself, I’d say yes, it is.

Let me explain. As I’ve mentioned, breast pain, or mastalgia, is very common. It is common for 70% of women to experience this at one time or another, usually during pregnancy, puberty and before menopause.

We don’t know exactly why this happens, but the changes in hormone levels at these times mean that women can develop heavy, sore, tender breast. And it’s almost always both breasts. One third of these cases might indicate that there is a non-cancerous lump behind the pain. This could be called a cyst. These small fluid-filled cysts can form within either one breast or both. They’re thought to be hormonally related, and may follow a pattern linked to the menstrual cycle. The fluid can accumulate rapidly and put the pocket surrounding it under tension – a bit like a balloon about to burst. That’s why they hurt.

Breast cancers on the other side, however, are not confined to one area. They’re just denser areas of breast tissue that don’t exert pressure. They form in the fat and tissue of the breast, and just sort of sit there, like a sixpence in a Christmas pudding, so they rarely cause pain – unless they’re lying below where a bra would sit.

It is common for breast-feeding to cause pain, inflammation and infection of the breasts. You may also experience reddening and hardening of the breasts.

These often require antibiotics, and if there’s an abscess – an infected pocket of pus – then surgery to drain it might be needed.

Consultant breast cancer surgeon Dr Liz O'Riordan, pictured, was diagnosed with breast cancer in 2015 at the age of 40. She said pain in a breast for more than a month will lead to a referral to a specialist clinic for tests

Liz O’Riordan was a breast cancer consultant. Liz was 41 when she was diagnosed. Dr Liz O’Riordan said that if a woman feels pain in her breasts for longer than one month, they should be referred to specialist clinics for testing.

However, if your breasts are still red or swollen from mastitis treatment, your GP should refer you to the breast clinic. An uncommon condition, inflammation cancer can sometimes mimic mastitis.

Pain in the breast can also be ‘referred’ – backache or neck ache, for instance, can be felt as pain in the breast, because they share the same nerve supply. It is common to feel this kind of pain at the breast’s outside edges and under the breasts. This can be felt for several months.

It’s also important to know that breast pain for any of the reasons I’ve outlined does not increase the risk of cancer. Of course, this doesn’t mean doctors should dismiss them. A referral to a breast clinic is necessary if there’s persistent pain in the breast.

This won’t be flagged as an urgent cancer referral, so patients will be seen in about four weeks, rather than two as with suspected cancer.

What can women do to relieve breast pain? It is important to wear a bra that supports your breasts. Breasts are very large. One 36C breast weighs just over a pound – that’s a bag of sugar.

Alexandra underwent an examination and a mammogram, which were both normal. But her consultant arranged an additional ultrasound scan. And that¿s how the small cancer was found on the bottom of her breast ¿ where the pain had been

Alexandra was examined and had her mammogram. Both were normal. However, her doctor arranged for an extra ultrasound scan. And that’s how the small cancer was found on the bottom of her breast – where the pain had been

Your muscles are relieved of some strain by wearing a bra. For those with large breasts it may be beneficial to use a bra nightly.

Multiple studies have proven that this is a good way to relieve pain. Have you been measured since your last measurement? What has been the weight of your body since that time? My own experience with undiagnosed breast pain was a result of poor fitting bras.

If you are unable to use paracetamol, ibuprofen or a similar painkiller can help. A good option is to rub an ibuprofen cream twice daily for several weeks. Breast pain usually gets better on its own.

While there’s no scientific evidence that changing one’s diet or cutting out caffeine and alcohol can relieve symptoms, you might feel more confident.

If you have pain in one breast, your GP should refer you to a breast clinic if simple measures such as the ones I’ve just mentioned have not worked.

And if you have breast pain in both breasts for more than three months that’s affecting your sleep or quality of life, and simple painkillers haven’t worked, then you should also be referred.

Other medications can be offered – although these target the hormone oestrogen, and can have nasty side effects, so many women choose not to take them.

A doctor should be consulted if there are any abnormalities in breasts.

Alexandra Harding and Sarah Harding found pain their sole symptom. It is possible to experience pain that’s not there.

A patient was complaining of pain in one side of her breasts. I performed a mammogram on her and found that there was cancer in her second breast.

In Alexandra’s case, the location of her lump might have meant, while it could not be felt, her bra was pressing into it, and pushing it into her chest wall.

Of course, we don’t know for sure. But ultimately, while breast pain is something always to be taken seriously, women need to know that on its own, it’s also not something to fear.