Is Breast Cancer Painful?

A breast cancer diagnosis can feel scary and overwhelming at the beginning. And while the diagnosis and treatment process may present unexpected challenges, the good news is that pain is often not one of those challenges. 

Unlike other types of cancer, breast cancer is not typically painful, particularly in the earlier stages. However, someone with stage 4 metastatic breast cancer might have pain when the cancer spreads to other parts of the body. So here we will review why this pain happens and how it can be treated. 

How does breast cancer cause pain?

Pain is not a common symptom for people diagnosed with breast cancer. But there are some exceptions to this, which may include:

• Large tumors that put pressure on surrounding tissue

• Tumors that are near the skin surface 

• Rare types of breast cancers that cause inflammation surrounding the tumor

If you're not having pain at the time breast cancer is diagnosed, you probably won't end up having pain from the cancer itself as you progress through treatment.

Are more advanced stages of breast cancer more painful?

Stage 4 breast cancer is advanced, which means the cancer has spread (metastasized) to other parts of the body. The spread can be painful if the additional tumors (metastases, referred to as “mets”) press on surrounding tissues or nerves. Breast cancer most commonly metastasizes to:

• Bone: This is the most common location of breast cancer mets, and they can cause a persistent, nagging pain in the bone. About 3 out of every 4 people with bone metastasis will have pain associated with it.

• Brain: About half of people who have brain metastases have headaches.

• Lung: Metastases in a lung rarely cause pain, though some people can feel them when they take a deep breath.

• Liver: Liver tumors are also less likely to cause any pain. Sometimes these tumors lead to a build-up of fluid in the abdomen (called “ascites”), which can make someone feel uncomfortable and bloated. 

Sometimes, surgery or radiation therapy can be helpful if a metastatic tumor is causing pain. These treatments can either remove or shrink the tumor for treatment. But we’ll discuss other options for pain relief below.

How does breast cancer treatment cause pain?

While breast cancer itself does not often cause pain, some of its treatments can cause discomfort. The good news is that any pain associated with treatment is often temporary and short-lived:

• Surgery: This treatment can lead to postoperative pain at the site of the tumor (or lymph nodes). But the pain resolves as the incision heals.

• Radiation therapy: This treatment can cause mild pain in the skin and breast where the radiation is given. However, the pain usually goes away a few weeks after the treatment is completed.

• Chemotherapy: After this treatment, there’s more likely to be nausea and vomiting than pain. But some side effects are painful. Examples include sores in the mouth, skin rashes, or damage to nerves (called “neuropathy”). 

• Hormone therapy: Headaches, muscle aches, or bone and joint pain can be caused by hormone therapy. But, like chemotherapy, these symptoms don’t happen to everyone who receives this treatment.

How is breast cancer pain treated?

There are many options and ways to treat the different types of pain related to breast cancer. 

Some people are surprised to learn that over-the-counter medications like ibuprofen (Motrin) or acetaminophen (Tylenol) work quite well in a lot of cases. And they can provide full pain relief. 

But if these medications do not adequately treat someone’s pain, stronger pain medications are available. There are several different types of prescription pain medications that can help, including:

• Hydrocodone with acetaminophen 

• Oxycodone or oxycodone with acetaminophen

• Oxycontin

• Morphine or morphine ER

• Methadone

• Fentanyl patches

• Tramadol

Prescription pain medications carry risks for side effects and even the possibility of an overdose, so it is best to discuss the risks and benefits of these medications with your provider before using them.

Of course, pills and medication are not the only ways to treat pain. Other therapies, such as acupuncture, hypnotherapy, and massage therapy, can be helpful. 

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Written by:

Michael Dreis, MD

Dr. Dreis is an emergency medicine physician currently practicing in Milwaukee, Wisconsin. He went to medical school at the University of Wisconsin – Madison and completed his residency at Henry Ford Hospital in Detroit, Michigan.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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