Breast cancer and pain: understanding the physical burden

For many women, the journey through breast cancer is filled with unknowns, and pain is one of the most complex pieces of the puzzle. While breast pain isn’t always a direct sign of cancer, it often becomes part of the experience, whether from the disease itself or from the treatments used to fight it. And that pain? It’s not just physical, it can carry emotional weight too.

Is breast pain always a symptom of cancer?

Short answer: no, not always.

Breast pain can be caused by many things: hormonal changes, cysts, even tight clothing. But during cancer treatment, new pain or persistent discomfort shouldn’t be ignored. Pain that occurs in just one breast (especially if accompanied by a lump, changes in skin texture, or nipple discharge) should always be evaluated by a healthcare provider.

Even though pain isn’t the most common early symptom of breast cancer, it can still show up in different ways throughout the cancer journey.

Breast bone pain: when cancer spreads to the bones

In advanced stages of breast cancer, the disease can spread (or metastasize) to bones, especially the sternum (breastbone) or ribs. This leads to deep, aching pain that might get worse with movement or even small activities.

Sometimes, the pain radiates into the shoulders, upper back, or chest wall. It can feel dull or sharp, and in cases where the bones are weakened, it might even lead to fractures.

If you're experiencing this type of pain, you're not being dramatic. It’s real, and there are ways to treat it, from bone-strengthening medications to targeted therapies and supportive care.

Pain in one or both breasts: what does it mean?

Pain can be unilateral (in one breast) or bilateral (in both). It may:

• Radiate to the armpit, chest, or upper back

• Feel sharp, dull, burning, or throbbing

• Come and go depending on activity or hormone levels

While bilateral pain is more often hormonal, persistent, localized pain in one breast should always be checked out, especially if it feels different from your usual cycle-related discomfort.

Hormone therapy and breast pain: a double-edged sword

For many breast cancer patients, hormone therapy is a powerful tool, but it often comes with uncomfortable side effects, including pain.

Treatments like tamoxifen or aromatase inhibitors work by blocking estrogen, which fuels many breast cancers. But less estrogen can mean:

• Tenderness or pain in the breasts

• Menopausal symptoms (hot flashes, dryness, fatigue)

• Increased joint or muscle pain

It’s okay to talk to your doctor if the side effects feel unbearable, there are often ways to adjust your treatment or support you with additional medication, physical therapy, or complementary options like acupuncture.

What can help with breast cancer-related pain?

Pain management is never one-size-fits-all, but here are a few things that may help:

• Over-the-counter medications (always under medical supervision)

• Physical therapy for mobility and muscle tension

• Mindfulness techniques like meditation or breathing exercises

• Heat or cold packs depending on the type of pain

• Support groups to share experiences and learn from others

And perhaps most importantly: don’t downplay your pain. If something doesn’t feel right, speak up. You deserve comfort, not just survival.

Breast cancer pain - whether from the tumor, the treatment, or the emotional toll - can affect every part of life. But it doesn’t define you. With the right support, tools, and care team, you can manage the pain and continue moving forward.

Your body has already carried you through so much. This pain has a voice, but so do you.