Mechanisms In Bone Metastases
The primary extracellular matrix components and cell-surface receptors which aid in metastasis are:
Metastatic breast-cancer cells excrete lysophosphatidic acid which binds to receptors on tumor cells, inducing cell proliferation and release of cytokines and stimulating bone resorption. After the breast-cancer cells have left the primary tumor, they interact with the bone microenvironment and secrete osteolytic factors capable of osteoclast formation and bone resorption. Apart from the breast tumor cells, the resident stromal cells also contribute to tumor survival. Growth factors such as epidermal growth factor , fibroblast growth factor and transforming growth factor beta are implicated in the development and progression of metastatic breast cancer.
- Matrix metalloproteinases
Diagnosing Chest Wall Pain
See your GP if your breast pain is new and carries on.;
Your GP will examine your breasts and take a history of the type of pain you have and how often it occurs. To check how long the pain lasts for, how severe the pain is or if the pain may be linked to your menstrual cycle, your GP may ask you to fill in a simple pain chart.;
If your GP thinks you may have chest wall pain, they may ask you to lean forward during the examination. This is to help them assess if the pain is inside your breast or in the chest wall.;
Your GP may refer you to a breast clinic where youll be seen by specialist doctors or nurses for a more detailed assessment.
What Should You Know About Breast Cancerpain
Breast cancer usually does not cause pain, but it can. A tumor in the breast can create pain by pushing up against other breast tissue.
Breast cancer that has spread to other parts of the body is known as metastatic breast cancer. It is also called advanced breast cancer or Stage IV breast cancer. This form may trigger pain in the areas to which it has spread, such as bones, brain, lungs, or liver. An estimated 70 to 90 percent of people with metastatic cancer have chronic pain.
While some cancer pain is related to the disease, you might also find that some pain is related to treatment. Breast cancer treatments include chemotherapy, surgery, and/or radiation therapy. For many people being treated for breast cancer, pain from therapy is temporary. However, some degree of pain can be lasting and affect your ability to function and your quality of life.
There are different types of pain, including:
- Breakthrough pain
How To Communicate Your Pain Level With Your Doctor
There are several terms that doctors use to describe cancer-associated pain. Learning about these descriptions, as well as how to describe and rank your pain, will help you communicate with your doctor so they can have a better grasp on how to best control your pain.
- Acute pain comes on rapidly. It may last only a few moments or go on for days at a time.
- Chronic pain is pain that is ongoing and usually lasts for longer than six months.
- Breakthrough pain is pain that you feel despite your pain treatment regimen.;
- Referred pain is pain that is felt in an area away from the actual source of the painfor example feeling shoulder pain during a gallbladder attack.
- Phantom pain;is pain that is felt in a region of the body that isn’t there. For example, feeling pain where your leg used to be after an amputation for sarcoma, or feeling pain where your breast used to be after a mastectomy.
Other ways that pain is characterized include the:
- Severity: Is the pain barely there, or is it the worst pain imaginable?
- Quality: What does the pain feel like?;Is it achy, sharp, dull, gnawing, stabbing, or burning?
- Frequency: How often does the pain occur, or is it constant?
- Location: Where do you feel the pain?
- Modifying factors: What makes it worse and what makes it better?
- Effect on quality of life: How does the pain affect your daily activities?
- Effect on sleep: How does the pain affect your sleep? Do you have difficulty falling asleep, or does the pain awaken you during the night?
What Do Lumps In My Breast Mean
Many conditions can cause lumps in the breast, including cancer. But most breast lumps are caused by other medical conditions. The two most common causes of breast lumps are fibrocystic breast condition and cysts. Fibrocystic condition causes noncancerous changes in the breast that can make them lumpy, tender, and sore. Cysts are small fluid-filled sacs that can develop in the breast.
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Coping With Chest Wall Pain
Any type of breast pain can be very distressing, and many women worry they may have breast cancer. However, in most cases pain in the breast isnt a sign of breast cancer.;;
Having breast pain doesnt increase your risk of breast cancer. However, its still important to be breast aware and go back to your GP if the pain increases or changes, or you notice any other changes in your breasts.;
Men And Breast Cancer Warning Signs
Breast cancer isnt typically associated with people who were assigned male at birth. But male breast cancer can occur in rare instances at any age, although its more common in older men.
Many people dont realize that people assigned male at birth have breast tissue too, and those cells can undergo cancerous changes. Because male breast cells are much less developed than female breast cells, breast cancer isnt as common in this part of the population.
The most common symptom of breast cancer in people assigned male at birth is a lump in the breast tissue.
Other than a lump, symptoms of male breast cancer include:
- thickening of the breast tissue
- nipple discharge
- redness or scaling of the nipple
- a nipple that retracts or turns inward
- unexplained redness, swelling, skin irritation, itchiness, or rash on the breast
Most men dont regularly check their breast tissue for signs of lumps, so male breast cancer is often diagnosed much later.
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The Good News Breast Pain
One of the very first signs of pregnancy is swelling and soreness in your breasts. You may experience these symptoms as early as the first week of pregnancy.
A sure telltale early sign of pregnancy is the darkening of your areola with tiny bumps. You may also experience a little fatigue.
And if you miss your period when its due, you should take a pregnancy test the following week to be sure whether or not you are pregnant.
Cramping Between Both Breasts
Some women may feel a certain cramping feeling between both breasts or just below the breasts. Very often, wearing tight underwire bras may be the culprit.
On the other hand, when the pain is where your ribs and breastbone connect, it may be a condition known as costochondritisa type of arthritisthat is not related to the breast. This burning pain may sometimes be confused with actual breast pain.
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You’re Getting Your Period
Two-thirds of breast pain is caused by the predictable surges of estrogen and progesterone around your monthly period.
Hormonal breast pain can happen to any woman that is menstruating, Dr. Swain says. It doesnt matter if theyre 14 or 44, as long as theyre still menstruating they have the risk of having cyclic breast pain.
Youll usually feel period-related boob pain in both breasts at once and all over your breasts. Most people describe the pain as achy rather than sharp.
For some women, its enough just to know that the pain will go away, usually in a week to 10 days. Other women seek relief from over-the-counter pain medications. There is one FDA-approved prescription drug for breast pain, called danazol, but it can have serious side effects.
Tweaking your diet may limit menstrual breast pain as well: Eating more flaxseed might help, as can sticking to a low-fat diet thats rich in complex carbs, says Dr. Swain.
Caffeine And Breast Pain
Your morning brew might be the culprit behind your breast pain, but unfortunately, were still not sure why.
What do we know so far?;In a study on women with pain associated with fibrocystic breast disease, a;reduction in the amount of caffeine consumed led to less breast pain.
How can I use this information?;Trialling a few less coffees a day or week could yield beneficial results. If the idea of not having coffee is a terrifying prospect, switching to decaf or a strong, black tea could be a satisfactory substitute.
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Signs Of Inflammatory Breast Cancer
Another type of breast cancer, known as inflammatory breast cancer , will only rarely cause lumps or symptoms. This type of breast cancer does not show up on a mammogram. Symptoms of inflammatory breast cancer may include:
- Red, swollen, itchy breast
- Tenderness of the breast when touched
- A pitted or ridged appearance of the surface of the breast
- Aching, burning, heaviness in one breast
- One breast that is significantly larger than the other breast
- A nipple that faces inward
- Swollen lymph nodes under the arm
- Swollen lymph nodes above the collarbone
- Other symptoms that do not go away after you take a course of antibiotics
It is important to remember that several other conditions besides cancer can cause these changes. Eczema can cause changes to the texture of the skin on your breasts, for example, and many illnesses can cause swollen lymph nodes. Breasts may change size during your menstrual cycle, inverted or flat nipples throughout life are common, and milk leaks are very normal during pregnancy or shortly after you have had a baby.
If you notice changes in the size of only one breast, skin changes not associated with eczema, changes in the size or shape of only one breast, or have nipple discharge when you are not pregnant or during postpartum, however, you should seek a medical opinion. Other signs to look for are nipples that invert or flatten suddenly or a feeling of warmth inside your breast.
How Cancer Causes Pain
There are several ways that cancer or its treatments can cause pain. You can have pain for one or more of these reasons at different times during your cancer care.
- Growth of a Tumor: Cancer can cause pain by compressing organs and nerves adjacent to the tumor.
- Metastases: Metastases of cancers to other regions of the body can cause pain.
- Bone metastases: The spread of cancer to bones can be very painful. Pain that’s related to bone metastases is often treated with radiation or bone-modifying medications.
- Substances Secreted by the Tumor: Some cancers secrete proteins, and the effects can lead to pain.;Examples include some of the paraneoplastic syndromes that can develop due to small cell lung cancer and squamous cell lung cancer.
- Neuropathic pain: Neuropathic pain is usually severe pain, and may occur due to nerve damage from chemotherapy or may be caused by the pressure of a tumor on nerves. There is currently a lot of research looking at treatments for peripheral neuropathy caused by chemotherapy.
The interventions used to control pain can vary depending on the type of pain. For example, neuropathic pain may not improve with medications that are used to treat pain that’s caused by tumor growth. And bone pain is treated with specific medications that will not reduce pain due to other causes.
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When To See A Doctor
In a majority of breast pain as described above, there is usually no cause for alarm. However, if you notice something unusual about the pain or appearance of your breast, and have cause for concern, it may be good to speak with a doctor.
Breast pain is rarely indicative of breast cancer, even though that may be the first thought that many women might fear. Make an appointment with the doctor, if you notice:
- New lumps or existing lumps increase in size or change in skin color
- Swelling of all or part of a breast
- Skin dimpling
- Change in the size or shape of your breast
- Itchy, scaly sore or rash on the nipple
- Nipple turning inward
- Discharge from the nipple, especially if the discharge is brown or bloody
- Breast pain that is severe and that bothers you
- Hard lumps that occur only in one breast.
Pain In Left Breast On Upper Left Side Towards Armpit
Over a month ago I noticed that my breast was really sore on the left side toward my armpit. I didn’t think much of it first as I have lupus so I seem to always have aches and pains. But one day I was feeling it and I noticed that there seemed to be a lot more “tissue” in that area than on the other side. It seems to only have gotten more sore the longer I’ve waited for answers. I’ve beent to the doctor a few times and to be quite honest I am just not impressed with Ireland’s healthcare . First doctor told me that he could not feel anything in my breast unusual at all, while poking around in the very painful area and clearly seeing me in pain. He said it was probably just an inflammation of chest wall, which seemed ridiculous to me as I can feel that it does not seem like it is in my chest wall. I told him I feel lumpiness but he wouldn’t listen.;
Second doctor told me that she could feel no cancerous lump but that it seems to be glandular – indicating she could feel something there but not a lump necessarily. She agrees with me that it is in my breast, however, so referred me to a breast clinic which she says could take 6-8 weeks to hear back from.;
I’m really worried as it is so sore and I can very clearly feel something there. Then I was reading about Inflammatory Breast Cancer and how it doesn’t usually present with a lump and spreads rapidly and is virtually incurable and now I’ve seriously freaked myself out and feel that I get zero answers from doctors here.;
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Breast Lumps Or Lumpiness
Many women find their breasts feel lumpy. Breast tissue naturally has a bumpy texture.
Some women have more lumpiness in their breasts than others. In most cases, this lumpiness is no cause to worry.
If the lumpiness can be felt throughout the breast and feels like your other breast, then its likely normal breast tissue.
Lumps that feel harder or different from the rest of the breast or that feel like a change should be checked. This type of lump may be a sign of breast cancer or a benign breast condition .
See a health care provider if you:
- Find a new lump that feels different from the rest of your breast
- Find a new lump that feels different from your other breast
- Feel something thats different from what you felt before
If;youve had a benign lump in the past, dont assume a new lump will also be benign. The new lump may not be breast cancer, but its best to make sure.;
What Causes Pain And Tenderness
Breast pain or sharp throes in the breast is very rarely the first noticeable symptom of breast cancer. Several other factors that are likely to contribute to the pain:
Consumption of birth control pills
The fluctuation of hormones caused by menstruation
Large breasts, which may be accompanied by neck, shoulder, or back pain stress
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Stage Of Breast Cancer
When your breast cancer is diagnosed, the doctors will give it a stage. The stage describes the size of the cancer and how far it has spread.
Ductal carcinoma in situ is sometimes described as Stage 0. Other stages of breast cancer describe invasive breast cancer .
- Stage 1 the tumour measures less than 2cm and the lymph nodes in the armpit aren’t affected. There are no signs that the cancer has spread elsewhere in the body.
- Stage 2 the tumour measures 2-5cm or the lymph nodes in the armpit are affected, or both. There are no signs that the cancer has spread elsewhere in the body.
- Stage 3 the tumour measures;2-5cm and may be attached to structures in the breast, such as skin or surrounding tissues. The lymph nodes in the armpit are affected. However, there are no signs that the cancer has spread elsewhere in the body.
- Stage 4 the tumour is of any size and the cancer has spread to other parts of the body .
This is a simplified guide. Each stage is divided into further categories: A, B and C. If you’re not sure what stage you have, ask your doctor.
Metastatic Breast Cancer Symptoms
Metastatic breast cancer symptoms depend on the part of the body to which the cancer has spread and its stage. Sometimes, metastatic disease may not cause any symptoms.
- If the breast or chest wall is affected, symptoms may include pain, nipple discharge, or a lump or thickening in the breast or underarm.
- If the bones are affected, symptoms may include pain, fractures, constipation or decreased alertness due to high calcium levels.
- If tumors form in the lungs, symptoms may include shortness of breath or difficulty breathing, coughing, chest wall pain or extreme fatigue.
- If the liver is affected, symptoms may include nausea, extreme fatigue, increased abdominal girth, swelling of the feet and hands due to fluid collection and yellowing or itchy skin.
- If breast cancer spreads to the brain or spinal cord and forms tumors, symptoms may include pain, confusion, memory loss, headache, blurred or double vision, difficulty with speech, difficulty with movement;or seizures.
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