Breast Cancer and Pain
Pain happens when nerves or tissues are damaged or inflamed. Pain can be sharp, dull, throbbing, stabbing, achy, tingling, or pinching, and can be described in many other ways. Pain may come and go or it may be steady.
Pain can be a symptom of breast cancer itself or a side effect of breast cancer treatment. Pain also can cause many other side effects, including nausea, dizziness, weakness, depression, and mood swings.
Does breast pain mean cancer?
Breast pain, also called mastalgia, usually isn’t a symptom of breast cancer. Most of the aches or burning feelings in one or both breasts are caused by changes in hormone levels in your body. Still, if you’re concerned about breast pain, it makes sense to talk to your doctor.
Types of pain
Doctors consider pain acute, chronic, or breakthrough.
Acute pain usually comes on suddenly because of a known cause, like disease, injury, or inflammation. Acute pain is usually severe and short-lived, such as the intense pain you feel if you break a bone. Acute pain usually doesn’t last longer than a month or so. Most of the time, acute pain goes away when the underlying cause of the pain goes away (for example, after the broken bone heals, it’s no longer painful). But sometimes acute pain can turn into chronic pain.
Chronic pain, also called persistent pain, is ongoing, usually lasting longer than three months. It can be mild or intense and can come and go or be constant. Chronic pain can have a cause, like a disease or cancer treatment, or the reason may not be known.
If there is a known cause, chronic pain can continue even after the injury or illness that caused the pain has healed or gone away. Some people have chronic pain even when there is no past injury or damage to the body.
Breakthrough pain is a sudden, brief and intense spike in pain that happens while you’re taking medicine or using other techniques to manage chronic pain. Breakthrough pain can happen even if you’re taking the right amount of pain medicine. A number of people report breakthrough pain when their current pain medicine is wearing off, but it’s not time to take the next dose.
Causes of pain in people with breast cancer
There are different reasons why someone diagnosed with breast cancer might feel pain. Pain is also very personal. Even if two people have the same cause of pain in the same area — joint pain from an aromatase inhibitor, say — they will experience the pain in different ways.
In some cases, pain can be a symptom of breast cancer itself, particularly inflammatory breast cancer or metastatic breast cancer. Cancer that is metastatic has spread to a part of the body away from the breast and may cause pain there. For example, breast cancer that has spread to the bones or spine may cause pain in the back, hips, legs, or other bones that have cancer cells in them. Breast cancer in the brain may cause headaches and breast cancer in the liver may cause pain in the upper right part of the abdomen.
Pain can also be caused by breast cancer treatments. For example, after breast cancer surgery, you’re likely to have pain at and around the surgery site.
Where can breast cancer treatment cause pain?
Depending on the treatments you’re receiving, pain can vary in intensity and affect different parts of the body.
Joint and bone pain may be caused by aromatase inhibitors, chemotherapy, targeted therapies, or medicines used to reduce the risk of infection during chemotherapy, such as Neulasta or Neupogen.
Back pain may be caused by hormonal therapy or other treatments.
Chest tightness or pain may be caused by breast cancer surgery, breast reconstruction, or radiation.
Abdominal or stomach pain can be caused by nearly all breast cancer treatments. It also may be a sign that breast cancer, especially lobular breast cancer, has metastasized and spread to the stomach.
Muscle pain also may be caused by nearly all breast cancer treatments, as well as by medicines used to treat osteoporosis and medicines used to reduce the risk of infection during chemotherapy.
Arm pain may be caused by surgery, radiation therapy, chemotherapy, aromatase inhibitors, and targeted therapies.
Talking to your doctor about pain
As with other symptoms, the earlier you tell your health care team about any problems you’re having with pain, the sooner they can work on determining the cause and developing a plan to treat it. Telling your doctor about your pain doesn’t mean you’re complaining or that you’re a bad patient.
If you’ve already completed treatment for breast cancer, it can be scary to feel pain in either the affected or unaffected breast. Breast pain is usually not related to cancer, but new and persistent discomfort in only one breast may be of concern. This is especially true if the pain gets worse without any clear explanation.
Keeping a pain diary can help you give your medical team detailed information about the pain you’re feeling. It’s a good idea to keep the diary on your phone or in a small notebook.
Start by listing any breast cancer treatments you’re receiving. Then list any pain medicines, including the dose and how often you take them, and any other techniques you may be using to control pain.
Each time you feel pain, write down:
the date and time
where the pain is located
what the pain feels like; for example, whether it’s dull, sharp, shooting, stabbing, or achy or more like a spasm
the intensity of the pain on a scale of zero (no pain at all) to 10 (the worst pain imaginable)
how long the pain lasts
any activities associated with the pain, for example, whether a particular activity makes the pain better or worse
the name and dose of any pain medicine you took to relieve the pain, as well as the time you took the medicine and whether the medicine worked
anything else about the pain you think is important
Take the pain diary to your doctor’s appointments so you remember to keep your medical team updated.
Pain management
Pain management — which may include medicines, exercise, and complementary therapies — should be part of the discussion as you and your medical team develop a treatment plan for breast cancer. A plan should be in place to treat any pain you have before, during, and after treatment. You need to tell your doctor right away if the pain isn’t getting better or if the medicines or other techniques don’t work as quickly or for as long as your doctor said they would.
It’s also important to be aware of the scrutiny that now surrounds opioid pain medicines. A dramatic increase in opioid overdose deaths led the U.S. Department of Health and Human Services to declare opioid abuse a public health emergency in 2017. According to the National Cancer Institute, efforts by states to reduce opioid prescriptions have unintentionally made it harder for people with cancer to get the pain medicines they need.
If you don’t feel like you’re getting the pain relief you need, ask for a referral to a pain physician, a doctor who specializes in treating pain. Many hospitals and cancer centers have pain management departments that include doctors, nurses, physical therapists, social workers, psychiatrists, complementary medicine practitioners, pharmacists, nutritionists, dietitians, and chaplains.
— Last updated on March 29, 2025 at 6:36 PM
