1. Pain and discomfort after breast cancer treatment
It’s normal to have some pain or discomfort in the weeks or months after breast surgery, lymph node removal or radiotherapy. Usually, this pain will improve within about 3 months.
Ongoing pain and discomfort
Some people continue to have pain and discomfort in their breast, chest, upper back, arm or armpit for months or sometimes years after surgery or radiotherapy.
Ongoing pain and discomfort can develop some time after treatment has finished.
Ongoing pain or discomfort can happen after any type of breast surgery, including a lumpectomy (wide local excision), a mastectomy, lymph node removal and breast reconstruction. It can also happen after radiotherapy.
What does ongoing pain feel like?
The pain may be in your scar, breast, armpit, arm or shoulder.
The pain may feel burning, shooting, tingling or throbbing.
You might also have sensitivity, a dull ache, intermittent stabbing or numbness.
It’s important to talk to your GP or treatment team if your pain changes or a new pain develops.
2. Causes of ongoing pain or discomfort
Nerve damage
Most ongoing pain or discomfort is caused by bruising, stretching or damage to nerves during surgery or when scar tissue forms.
The upper, outer part of the breast and the armpit are more likely to have nerve injury from surgery.
Some types of chemotherapy may make nerve damage worse.
One common type of nerve damage is phantom breast and nipple pain. This is pain that feels as if it’s coming from the breast and nipple that have been removed. It can feel like pressure, itching, throbbing or pins and needles.
Phantom pain can happen straight after surgery or sometimes a year or more later.
Musculoskeletal pain
Breast cancer surgery and radiotherapy can cause musculoskeletal pain. Musculoskeletal pain is pain that affects the muscles, joints and bones.
Lasting musculoskeletal pain or discomfort can be the result of reduced movement in the shoulder joint or general pain and inflammation in a single muscle or muscle group after surgery or radiotherapy.
Exercises after breast surgery can help you regain arm and shoulder movement.
Lymphoedema
Some people develop a long-term condition called lymphoedema after having breast cancer treatment.
Lymphoedema is swelling caused by a build-up of fluid in the body’s tissues.
It can cause stiffness and discomfort in your arm. Swelling can also happen in the breast, chest, shoulder or the upper, outer back behind the armpit and hand.
Find out more about the causes, symptoms and treatment of lymphoedema.
Who is most likely to have ongoing pain and discomfort?
Ongoing pain and discomfort are more likely to affect people who have had surgery to the upper, and the armpit. This is because these areas are more likely to have nerve injury.
Research suggests ongoing pain is also more common in people who:
- Had all their lymph nodes removed (rather than just one or two, as in a sentinel lymph node biopsy)
- Had severe pain straight after surgery that was not well controlled
- Had issues with pain before surgery, whatever the cause and wherever in the body
- Had radiotherapy to the area where the scar is or the lymph nodes under the arm
- Had chemotherapy
- Are overweight
3. Managing pain
Tell your GP or treatment team about any ongoing pain or discomfort, especially if it’s new or different from what you have had before.
For some people, it may not be possible to be completely pain free, but the pain can be managed.
It may be useful to keep a pain diary, which you can show to your GP or treatment team. This may help with finding the best ways of managing your pain.
The Pain Support website has further tips on getting the most out of your discussion with a health care professional about your pain.
The NHS website has information about getting help with ongoing pain.
Pain relief medication
Regularly taking simple pain relief, such as paracetamol or ibuprofen, may help. This could be as a tablet or applied to the skin. Always follow the instructions on the medication.
If taking simple pain relief does not control your symptoms, let your GP or treatment team know.
They may suggest stronger medication such as codeine-based medication.
Your GP or treatment team may prescribe drugs that are usually used to treat depression or epilepsy, which can also be used to relieve nerve pain. These may include amitriptyline, duloxetine, pregabalin and gabapentin.
Exercise and physiotherapy
Depending on the causes, some forms of regular exercise have been shown to ease lots of types of pain, as well as improve general wellbeing.
Some people may be referred to a physiotherapist. A physiotherapist can help work out an exercise plan for you to improve movement and build up strength.
Speak to your GP or treatment team about how physical activity may help, and if referral to a physiotherapy service would be of benefit.
In some areas you can self-refer to physiotherapy
Activities such as swimming, walking, yoga or Pilates may be suggested.
You may also find our Exercises after breast cancer surgery leaflet helpful.
Wearing a well-fitting bra
Wearing a well-fitting bra may help reduce your pain.
You may need to try different styles. You could look in your nearest supermarket, department or lingerie store. Or you may prefer to use specialist suppliers of bras for women who have had breast surgery.
Complementary therapies
Some studies show acupuncture may help reduce pain after breast cancer surgery.
Complementary therapies such as massage, reflexology and reiki may also help improve your general sense of wellbeing.
Speak to your treatment team before trying a complementary therapy.
Talking therapies and self-help techniques
Talking therapies include counselling and cognitive behavioural therapy (CBT).
They can help you find new ways to think about pain and the impact it has. They may also help to reduce the worry and anxiety you have about your pain.
Some people practise self-help techniques such as relaxation, meditation, mindfulness and distraction. These can help you manage pain and improve your general wellbeing.
Find out more about talking therapies and self-help techniques.
You can find information about CBT on the NHS website.
Pain clinics
If your pain cannot be controlled you may benefit from going to a specialist pain clinic. You can ask your GP or treatment team to refer you.
At the pain clinic, you may see a doctor with a special interest in pain. Or you might see a range of different healthcare professionals such as a doctor, nurse, physiotherapist and occupational therapist.
Some pain clinics run a pain-management programme (sometimes called a PMP). The programme aims to help improve your quality of life by developing ways of living with pain. This may help if pain continues after you have tried other treatments.
4. Support if you're in pain
Managing pain can be difficult, and there may be times when you feel unable to cope.
If you want to talk things through, you can call our free helpline to speak to one of our specialist nurses.
You can also speak to someone who has had a similar experience with ongoing pain through our Someone Like Me service.
See the bottom of this page for ways to get in touch.
