Is Breast Cancer Painful?

Breast pain is sometimes associated with breast cancer, but it’s not a common symptom. Breast lumps and visual changes to the breasts or nipples are more typical signs.

While some people with breast cancer may experience breast pain, it’s not a typical sign or symptom of breast cancer. Treatment for breast cancer and any breast cancer that has spread from the breast may cause pain in other parts of the body.

This article discusses how and when breast cancer causes pain, common symptoms of breast cancer, and other reasons for breast pain.

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Does breast cancer cause pain?

Breast pain, also called mastalgia, is not a common symptom of breast cancer.

When breast pain is related to breast cancer:

• it’s confined to one breast or nipple
• it’s in a specific area rather than an all-over pain
• there’s no variation related to the menstrual cycle

Pain when cancer has spread to other areas in the body

Metastatic breast cancer — cancer that has spread to areas beyond the breast — can cause pain, depending on where it spreads.

Examples of this include:

• Bones: Bone metastasis tends to affect the ribs, spine, pelvis, and long bones in the arms and legs. Pain may come on suddenly and feel like exercise strain or arthritis. However, resting doesn’t relieve it and it keeps getting worse. Bones can become fragile and easily fractured.
• Lungs: Pain in the affected lung may be accompanied by shortness of breath and other breathing problems.
• Liver: Liver metastasis can cause pain under the ribs, midsection, or near the right shoulder. Other symptoms include yellowing of the skin (jaundice) and dark urine.
• Brain: Head pain is one sign of brain metastasis. It can also affect vision, speech, and memory.

Pain due to breast cancer treatments

Pain can sometimes be a side effect of breast cancer treatments such as: 

• surgery
• radiation therapy
• chemotherapy
• hormonal and targeted therapies
• immunotherapy

What other breast conditions can cause pain?

About two-thirds of women experience breast pain at some point, usually during their reproductive years. If you have unexplained breast pain, it’s a good idea to see a doctor just in case.

Hormonal changes

Cyclic breast pain is related to hormonal variations in the menstrual cycle. It tends to affect both breasts, causing swelling and tenderness.

Pain increases about 2 weeks before your period and begins to fade once you start. Hormone levels can also vary with puberty, pregnancy, and menopause.

Breastfeeding

According to researchers in 2019, over 90% of women who breastfeed experience pain.

Engorged breasts can feel hard and tight. And it’s not unusual to have sore or cracked nipples while breastfeeding. It may be helpful to speak with a lactation consultant or doctor if this is happening to you.

Mastitis

Mastitis is painful inflammation in the breast. Other symptoms include:

• redness
• skin that’s warm to the touch
• generally feeling unwell

Because mastitis can involve infection, it’s important to seek medical help for treatment.

Abscesses

A breast abscess is a collection of pus due to infection. Other symptoms can include redness, swelling, and skin that’s warm to the touch.

Untreated infections can lead to serious complications, so it’s important to reach out to a doctor.

Cysts

Breast cysts are fairly common, and most are benign. Symptoms can also include lumps or nipple discharge. A doctor can make the diagnosis and determine if you need treatment.

Gynecomastia

Gynecomastia can cause breast pain in males. It’s a condition in which the breasts enlarge, likely due to medications or hormonal changes. Gynecomastia can be treated, but it sometimes resolves on its own.

Injury or surgery

You might have breast pain due to a recent injury or surgery on or near the chest.

Medications

Breast pain can be a side effect of certain medications, such as:

• oral contraceptives
• hormone therapy
• psychotropic agents
• some cardiovascular medicines

Referred pain

Breast pain can also be referred pain. This is when pain originates somewhere else, such as the chest wall, gallbladder, or stomach, but you feel it in the breast. 

What are the screening recommendations for breast cancer?

Although an update to their guidelines is currently in progress, the 2016 screening recommendations from the U.S. Preventive Services Task Force are that women ages 50 to 74 with an average risk of breast cancer receive mammography screening every 2 years.

The recommendations also state that for women ages 40 to 49, mammography screening should be based on an individual decision. Earlier screening may be more beneficial to people with a higher-than-average risk.

American Cancer Society guidelines recommend:

• women between ages 40–44 can choose to start yearly mammography screening
• women ages 45–54 should get yearly mammograms
• women ages 55 and older should continue yearly screening or switch to every other year
• screenings should continue as long as you’re in good health and can expect to live at least 10 more years

If you have a higher risk of developing breast cancer, you may want to screen earlier or more often than recommended.

Breast cancer risk factors include:

• a personal history of cancer or benign breast conditions
• a family history of breast cancer
• carrying certain gene mutations

It’s also helpful to be familiar with how your breasts normally look and feel so you can spot changes right away. One way to do this is by performing breast self-exams.

Frequently asked questions about breast cancer pain

What percentage of breast cancers are painful?

About 2–7% of people with breast cancer report pain as the primary symptom at the outset.

Is pain associated with a particular type of breast cancer?

Inflammatory breast cancer is rare and presents differently than other types of breast cancer. There’s usually no lump, but it can be painful.

Other symptoms include:

• swelling
• a large area of redness
• dimpled, thickening skin that resembles an orange peel

Is back pain a sign of breast cancer?

Back pain is not typically associated with early-stage breast cancer but could be a symptom of metastatic breast cancer that has reached the bones. Of course, back pain can be due to many other conditions, including arthritis and muscle strain.

What can I do about pain during breast cancer treatment?

First, let your oncology team know that you’re in pain. It may help to keep a pain journal, noting where it occurs and how long it lasts.

Your healthcare team’s pain management strategy may include medications, physical therapy, and relaxation techniques.

In metastatic breast cancer, tumors can press on nerves and organs. In these cases, surgery or radiation therapy can remove or shrink tumors to relieve pain. 

Takeaway

Breast cancer can cause breast pain, but it’s not common. Breast lumps and visual changes to the breast or nipple are more frequent signs of breast cancer.

Pain in other areas of the body can be a sign that breast cancer has spread. Pain can also be a side effect of breast cancer treatment.

If you have breast pain or other changes to your breasts, consider seeing a doctor. Without treatment, even benign breast conditions can lead to complications. And like all cancers, breast cancer is easier to treat in the earlier stages.