Breast Cancer Pain

Overview

What should you know about breast cancer pain?

Breast cancer usually does not cause pain, but it can. A tumor in the breast can create pain by pushing up against other breast tissue.

Breast cancer that has spread to other parts of the body is known as metastatic breast cancer. It is also called advanced breast cancer or Stage IV breast cancer. This form may trigger pain in the areas to which it has spread, such as bones, brain, lungs, or liver. An estimated 70 to 90 percent of people with metastatic cancer have chronic pain.

While some cancer pain is related to the disease, you might also find that some pain is related to treatment. Breast cancer treatments include chemotherapy, surgery, and/or radiation therapy. For many people being treated for breast cancer, pain from therapy is temporary. However, some degree of pain can be lasting and affect your ability to function and your quality of life.

There are different types of pain, including:

  • Chronic (long-lasting)
  • Acute (new, or sudden pain)
  • Breakthrough pain (pain that happens even though you are being treated)

Management and Treatment

What should you know about pain management for breast cancer?

It is important that you always tell your doctor or other healthcare provider if you are having pain. Do not wait for them to ask you about pain.

Managing pain from breast cancer surgery

Breast cancer treatment often includes surgical procedures such as lumpectomy, breast removal, or breast reconstruction. Your doctor may remove one or more lymph nodes from your axillary area, which tends to be painful. The cuts from surgery may cause pain in the skin, breast nerves, or muscle. Degrees of pain or discomfort after surgery is to be expected. During surgery, the surgeon may inject a pain medicine into your surgical area to help decrease the amount of post-operative pain you experience.

Your doctor may also give you a prescription for opioid pain relievers to take for severe pain. He or she will suggest over-the-counter pain medicines such as ibuprofen, acetaminophen, or naproxen to take as a first measure. They will also discuss applying ice to the surgical area for comfort. Make sure that you check with your healthcare provider before taking any kind of medicine, even non-prescription items.

Post-operatively, wearing a soft bra that fastens in the front is comforting. After lymph node surgery, keeping the arm elevated on a pillow when sitting and placing a small lap pillow between your upper arm and lateral chest wall will help with arm pain and healing.

Activity after surgery, such as walking and starting slowly the arm range of motion exercises, once cleared by your surgeon, helps to improve healing and pain. The limitations on activity and exercise will be discussed with you by your surgical team. Pain that is new or worsening in the days after surgery should be brought to the surgeon’s attention to make sure there is no infection or problem with the surgical area.

Managing pain from radiation therapy for breast cancer

If you have radiation therapy, it is likely to affect your skin. The results are similar to a sunburn in some cases, where skin gets red, tender, blisters and then peels, like a bad sunburn. Your doctor will recommend a topical cream or lotion to rub on the skin area daily. A few recommendations can include ucerin cream, aquaphore, and alove vera. The lotions make the skin feel better. You may also take an over-the-counter pain aid as needed. You may experience some pain inside your breast while you are having radiation or even up to the year after radiation as the tissues heal. The recommendation for best results is to continue to rub the lotion onto your skin, even after treatment is complete, to keep the skin soft as radiation will dry it out. Also you should continue range of motion exercises of your arm and shoulder area to prevent scar tissue from forming.

Managing pain from chemotherapy for breast cancer

Some drugs that treat breast cancer can also cause nerve damage in the hands and feet in certain people. This type of pain, called neuropathy, is usually a shooting or burning pain. It can also cause numbness. It usually affects fingers and toes. Your doctor might suggest that you take a mild pain reliever. Other options for nerve and muscle pain include medications normally used for other conditions, including antidepressants, anticonvulsants, anti-anxiety drugs, and steroids. Some women have had success with acupuncture. Most of this pain improves after completion of chemotherapy, with time, but some numbness unfortunately can be chronic.

Are there alternative ways to treat breast cancer pain?

An accurate diagnosis of the cause of pain can be challenging, and effective pain management can be complex. Pain management specialists employ an interdisciplinary approach to ease suffering and improve quality of life of those living with pain.

In addition to medications, a specialist might recommend:

  • Physical therapy
  • Exercise
  • Ice or heat application
  • Psychological tools, like biofeedback, cognitive behavioral therapy, or support groups
  • Complementary methods like massage, reiki, acupuncture, hypnosis, meditation and yoga

Last reviewed by a Cleveland Clinic medical professional on 02/09/2019.

References

  • Breastcancer.org. Accessed 2/12/2019.Treatments for Pain. (https://www.breastcancer.org/treatment/pain/causes/cancer)
  • American Cancer Society. . Accessed 2/12/2019.Cancer-Related Pain (https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/pain.html)
  • National Cancer Institute. Accessed 2/12/2019. Pain Control: Support for People with Cancer. (https://www.cancer.gov/publications/patient-education/paincontrol.pdf)
  • National Breast Cancer Foundation. Accessed 2/12/2019.Breast Pain. (https://www.nationalbreastcancer.org/breast-pain)
  • Costa WA, Monteiro MN, Queiroz JF, Gonçalves AK. . Clinics (Sao Paulo). 2017;72(12):758-763. Accessed 2/12/2019.Pain and quality of life in breast cancer patients (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738557/)
  • Metastatic Breast Care Alliance. Accessed 2/12/2019.Changing the Landscape for People Living with Metastatic Breast Cancer. (https://www.icrpartnership.org/library/file/7276/MBCA_Full_Report_Landscape_Analysis.pdf)
  • Susan G Komen. Accessed 2/12/2019.Managing Pain Related to Treatment. (https://ww5.komen.org/BreastCancer/ManagingPainRelatedtoTreatment.html)

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