Different breast cancer treatments can cause different types of pain. Surgery with mastectomy and lumpectomy can damage tissues and nerves. So can radiation therapy. Sometimes the scars from surgery may hurt. If you have breast reconstruction, you could have pain from

• removing tissue in other areas of your body
• stretching the skin for an implant
• internal scarring or hardening of the skin

Lymph node removal can lead to pain in the armpit, arm or chest. Taking out nodes or cutting lymphatic vessels may result in lymphedema, which can cause pain as well as swelling. Other sources of pain:

• Some people feel phantom pain after a breast is removed. Phantom pain is pain you feel in the breast that is no longer there. This pain is real, coming from signals in your spinal cord and brain
• Chemotherapy and some targeted therapies may cause pain from mouth sores, hand-foot syndrome, or neuropathy
• Hormonal therapy, especially aromatase inhibitors, may cause bone, joint, and muscle pain. Tamoxifen also may cause these types of pain

Good pain treatments exist. You may need to try several ways, or a combination of methods, to find what is best for you.

Keep a pain journal, noting when and where you have pain, what it feels like, how intense it is, and what makes the pain worse. Write down which symptoms you have and how long you’ve had them. Rate your pain on a scale of 1 (not at all uncomfortable) to 10 (the most uncomfortable you have ever been). Note where you have the pain, and whether the pain comes or goes or is persistent. Be as specific as possible, and let your team know how much pain impacts your life. Take the journal with you when you talk with healthcare providers about your pain.

Your providers might refer you to a cancer pain specialist. Palliative care specialists work to prevent and manage pain and discomfort. Team members can be nurses, social workers, spiritual care professionals, pharmacists, or other medical providers. If you do not have access to palliative care specialists where you get care, your regular care team can help you.

There are medical and nonmedical ways to get relief from pain. If your providers give you medicine to keep pain from starting or getting worse, do not wait to use it until your pain is intense. It’s easier to prevent pain than it is to manage it once it starts.

Here Are Some Medical Methods to Manage Pain

• over-the-counter medicines, for mild to moderate pain, such as aspirin, ibuprofen (Advil, Motrin), and acetaminophen (Tylenol)
• antidepressants and anticonvulsants, for nerve pain
• corticosteroids,  for inflammatory pain
• physical therapy, for pain caused by damage to muscle or tissues

It’s also possible to take opioid or narcotic medicines for ongoing and breakthrough pain. These include medicines like the fentanyl patch, morphine (MS Contin) and oxycodone. Taken as prescribed for cancer pain, you are unlikely to become addicted to these medicines. Talk with your providers about your concerns.

Complementary, or nonmedical, methods can help relieve pain and may be used even while taking pain medicines. Cancer centers may offer classes in some of these techniques. Some methods to try are:

• Acupuncture
• Yoga
• Gentle massage
• Meditation
• Hypnotherapy
• Guided imagery
• Relaxation exercises
• Tai Chi

Pain, especially chronic pain, can be trying. It can affect your mood, your outlook, and your relationships. You may wish to seek emotional support along with other methods. Counselors, support groups, religious or spiritual communities, and trusted people can help.  

If you have metastatic breast cancer learn more about ongoing treatment and pain.