Breast Cancer and Bone Pain

This year, more than 211,000 women in the United States will learn they have invasive breast cancer.1 They join more than 2 million patients living with the disease.

Early detection and improved treatment lets breast cancer patients live longer, healthier lives. In fact, if cancer is caught before it spreads beyond the breast, 97 percent of patients survive at least five years.2

Breast cancer spreads, or metastasizes to the bone in 65 percent to 75 percent3 of patients with advanced disease. This may begin as a dull, continuous ache, then will worsen over time. It may seem more intense at night or with activity. Patients also may experience muscle spasms.

As part of our body's natural regeneration, bones constantly break down and rebuild. Cancer upsets that normal process. Cancer cells may cause bone to erode or to build up too quickly.

Breast cancer usually causes small areas of bone to deteriorate. The bones become fragile and may break. It also may prompt abnormal bone cell growth, which can lead to further complications including bone weakness.

Breast cancer cells typically spread to the spinal vertebrae, pelvis, ribs, skull or thighbones. If cancer locates in the spine, it may press on nerve roots. Numbness and tingling in the arms or legs, weakness, paralysis or difficulty with urination or bowel movements may result. Anytime you develop a new symptom, even if it seems unrelated to your cancer, talk to a member of your health care team.

If you develop bone pain, your physician may order tests to check for cancer in your skeleton. These may include X-rays, computed tomography or magnetic resonance imaging, and a bone scan. A bone scan involves injecting a radioactive substance that localizes in areas of bone activity. If the scan detects a "hot spot," the doctor may biopsy the area or use an additional imaging test to check for cancer cells since arthritis and other conditions can cause similar images.

Treatment goals include killing cancer cells, controlling pain, improving quality of life and prolonging survival. The physician may order external beam radiation to affected bone, chemotherapy or hormonal therapy. Procedures may be recommended to prevent or repair fractures and drugs may be prescribed to slow bone destruction. Pain medications are usually ordered and a special type of pain relieving radiopharmaceutical therapy may be employed. This therapy is a radioactive agent that travels to the bone and provides a high local dose of radiation to the cancer cells. This treatment is especially helpful if the cancer has spread to many sites.

Your doctor will monitor your progress and determine whether your pain has abated. Accurately reporting symptoms and how they affect your daily activities will aid your health care team in caring for you and improving your quality of life.

  1. American Cancer Society. Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_ statistics_for_breast_cancer_5.asp?sitearea=.
    Last accessed April 12, 2005.
  2. Cancer Facts & Figures 2004. American Cancer Society. Atlanta, GA. 2004: 10.
  3. Coleman RE. Cancer Treat Rev. 2001; 27:165-176.

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