Back pain isn’t one of the hallmark symptoms of breast cancer. It’s more common to have symptoms like a lump in your breast, a change in the skin over your breast, or a change in your nipple.

While back pain isn’t typically a sign of breast cancer, it may indicate that cancer has spread. If you have back pain and other cancer symptoms, it’s a good idea to speak with a doctor.

Read on to learn more about what to know about back pain and breast cancer.

Pain anywhere, including in your back, can be a sign of breast cancer that has spread. This is called metastatic breast cancer.

When cancer spreads, it can get into the bones and weaken them. If you have pain in your back, it could be a sign that a spinal bone has fractured or that the tumor is pressing on the spinal cord.

However, it’s important to remember that back pain is a very common condition. Having back pain does not mean you have cancer. In many cases, back pain indicates something else.

Back pain much more commonly occurs from conditions such as:

If the pain is severe and you have other breast cancer symptoms or a history of breast cancer, it’s a good idea to visit a doctor to have it checked out.

When doctors diagnose breast cancer, they assign it a stage. That stage is based on whether the cancer has spread and, if so, how far it has spread.

Cancer stages are numbered 1 through 4. Stage 4 breast cancer is metastatic, which means it has spread to other parts of the body, like the lungs, bones, liver, or brain.

Breast cancer can spread in a couple of different ways:

  • cancer cells from the breast can move into nearby tissues
  • cancer cells travel through the lymph vessels or blood vessels to distant sites

The symptoms of metastatic breast cancer depend on which organs are affected. Back pain, for example, can be a sign that the cancer has spread to the bones.

Other symptoms of metastatic breast cancer include:

  • headaches, vision problems, seizures, nausea, or vomiting if it’s spread to the brain
  • yellow skin and eyes, abdominal pain, nausea and vomiting, and appetite loss if it’s spread to the liver
  • chronic cough, chest pain, and trouble breathing if it’s spread to the lungs
  • fatigue, loss of appetite, and unexplained weight loss

If you have symptoms such as a breast lump, pain, nipple discharge, or a change in the shape or look of a breast, your doctor may do some or all of the following tests to determine whether you have breast cancer:

  • Mammogram: This uses X-rays to take pictures of the breast. Mammograms can show whether there’s a tumor inside the breast.
  • Ultrasound: This uses sound waves to create a picture of the breast. Ultrasounds can help a doctor tell whether a growth in the breast is solid, like a tumor, or filled with liquid, like a cyst.
  • MRI: This uses a powerful magnet and radio waves to create detailed pictures of the breast. MRIs can help a doctor identify any tumors.
  • Biopsy: During a breast biopsy, a doctor removes a sample of tissue from your breast. The cells are tested in a lab to analyze whether they’re cancerous.

If a doctor suspects that cancer has spread, one or more of these tests can check where it is:

  • blood test for liver or bones
  • bone scan
  • X-ray or CT scan for chest or abdomen
  • MRI for the brain

Treatment depends on where the cancer has spread and the type of breast cancer.

Hormone therapy drugs

These medications are used to treat hormone receptor-positive breast cancers. They work by depriving tumors of the hormone estrogen, which they need to grow. Hormone therapy drugs include:

  • aromatase inhibitors, such as anastrozole (Arimidex) and letrozole (Femara)
  • selective estrogen receptor down regulators, such as fulvestrant (Faslodex)
  • selective estrogen receptor modulators, such as tamoxifen (Nolvadex) and toremifene
  • elacestrant (Orserdu), a new drug used for certain forms of advanced or metastatic cancer

Anti-HER2 drugs

HER2-positive breast cancer cells have large amounts of a protein called human epidermal growth factor receptor 2 (HER2) on their surface. This protein helps them grow. Anti-HER2 drugs, like trastuzumab (Herceptin) and pertuzumab (Perjeta), slow or stop the growth of these cancer cells.

Chemotherapy

Chemotherapy slows the growth of cancer cells in the body. You usually get these drugs in cycles of 21 or 28 days.

Radiation therapy

Radiation destroys cancer cells or slows their growth. Your doctor might give you radiation in addition to systemic therapies.

Targeted therapies

This form of treatment works by using drugs that specifically target proteins in the cancer cells. Examples include:

  • monoclonal antibodies
  • kinase inhibitors
  • CDK 4/6 inhibitors

Your doctor can treat breast cancer that’s spread to the bones with medications like bisphosphonates or denosumab (Prolia). These slow bone damage and prevent fractures that can cause pain. They are administered through a vein or as an injection.

To help you manage pain, your doctor might suggest one or more of the following:

  • Over-the-counter pain relievers, such as acetaminophen (Tylenol), aspirin, ibuprofen (Motrin, Advil), or naproxen (Aleve), can help with mild pain.
  • Opioid prescription drugs, like morphine (MS Contin), codeine, oxycodone (Roxicodone, Oxaydo), and hydrocodone (Tussigon), can help with more severe pain.
  • Steroid drugs, like prednisone, can help with pain caused by swelling.

You can also try alternative pain relief methods, such as breathing techniques, heat or cold, and distraction.

Back pain isn’t usually a sign of metastatic breast cancer, but it’s possible in some cases. Metastatic breast cancer isn’t curable, but you can manage it.

You can slow the progression of breast cancer with treatments like hormone therapy, chemotherapy, and radiation. These treatments can prolong and improve your quality of life.

You also can enter a clinical trial. These studies test new treatments that aren’t yet available to the public. Ask your doctor how to find a trial that matches your cancer type.