Can Shoulder Pain Be a Symptom of Breast Cancer?

Shoulder pain is one of the most common pain complaints among all people. It affects up to 26% of adults at any given time as a result of many different conditions.

Shoulder pain is not a common symptom of breast cancer. When it occurs, shoulder pain can be a symptom of metastasis. This occurs when the breast cancer cells spread from your breast to another site in your body.

Shoulder pain can involve breast cancer that has spread to your bones. It can also emerge as deferred pain from breast cancer that has spread to your liver.

Shoulder pain, stiffness, frozen shoulder, and limited mobility can occur as a result of bruising, stretching, or other damage to the nerves that can occur during radiation therapy or breast surgery.

This article describes when shoulder pain could be a symptom of breast cancer, the causes of shoulder pain, when to see your healthcare provider, and the types of treatment.

What Is Shoulder Pain?

Shoulder pain is a general term used to describe pain felt at any part of the shoulder. The feeling can range from annoying to excruciating.

Shoulder pain can originate in the joints, muscles, cartilage, tendons, or ligaments. It can also occur as referred pain from another part of the body.

Your shoulder has the greatest range of motion of any joint in your body. Because you use your shoulder in so many types of activities, shoulder pain can impact your quality of life. It can make it difficult to perform routine, work-related, and personal care tasks.

Shoulder pain can be caused by many different conditions, including the following issues:

• Tendonitis
• Bursitis
• Tendon tear
• Shoulder instability
• Osteoarthritis
• Fracture
• Tumors
• Nerve-related problems

Is Shoulder Pain a Symptom of Breast Cancer?

In rare cases, shoulder pain can be a symptom of breast cancer. When it occurs, it is often a sign that breast cancer has spread, or metastasized, to other areas of your body. Breast cancer cells can spread through the blood or lymphatic system.

The main causes of shoulder pain due to breast cancer are:

• Bone tumors: One of the most common places for breast cancer to spread is bone. In people with early stage breast cancer, bone ranks as the most common location for the first site of metastasis. Pain can occur when bones are weakened by a tumor that grows from the spread of breast cancer cells. Unlike sore muscle pain that commonly occurs with overuse or wear and tear, bone pain causes a throbbing or deep aching pain.
• Fractures: When breast cancer spreads to the bones, it can weaken them by accelerating the breakdown of normal bone tissue or the formation of too much new bone. When the breakdown of old bone tissue and/or the production of new bone tissue occurs at abnormal rates, it can make bones more susceptible to fractures with minimal stress.
• Deferred pain from breast cancer that has spread to other areas, like the liver: Breast cancer can also metastasize to the liver, which sits on the right side of your upper abdomen. When this occurs, the liver becomes enlarged and presses on nerves that also affect the right shoulder.
  

Treatment and Management of Shoulder Pain

Shoulder pain that occurs with breast cancer is handled differently from shoulder pain that occurs from an injury or musculoskeletal disease. If you have shoulder pain from breast cancer, your healthcare team will likely use an imaging test like an X-ray or magnetic resonance imaging (MRI) to identify the location and type of problem that exists.

Your treatment may involve one or more of the following therapies:

• Drugs to treat bone metastases: These drugs can help prevent bone damage and its effects, which include fractures, hypercalcemia, and spinal cord compression. They are given via intravenous (IV) therapy or as a subcutaneous (under the skin) injection once a month but may be needed less often if progress occurs. The drugs used to treat bone metastases are bisphosphonate drugs, which include Aredia (pamidronate), Zometa (zoledronic acid), and Xgeva (denosumab).
  
• Surgery for broken bones: When a broken bone occurs as a result of breast cancer, surgery is done to repair the fracture. This usually involves the use of a steel support over the break.
• Radiation therapy may be used to prevent further damage after surgery to repair fractures that occur as a result of bone metastases. It is also used to treat liver metastases that may be causing deferred shoulder pain.
• Pain medicine: Many types of pain medicine treat the pain of breast cancer that has metastasized to your shoulder. Your healthcare care team can determine the best medications for the type and source of your pain. These medicines can be administered through the mouth, a skin patch, rectal suppository, injection, or patient-controlled pump.
• Systemic therapy includes treatments that attack cancer cells anywhere in the body. These treatments include hormonal therapy, chemotherapy, and anti-HER2 targeted therapies.

When to See Your Healthcare Provider

No matter the cause of your shoulder pain, early treatment and intervention can often mean better outcomes and the prevention of further damage. This is often the case of shoulder pain linked to breast cancer.

Contact your healthcare provider if you experience shoulder pain with one or more of the following symptoms:

• Limited range of motion
• Dull or achy pain when you move your shoulder
• Shoulder pain that exists when you're at rest or asleep
• Shoulder pain that worsens over time
• Difficulty sleeping as a result of shoulder pain
• Weakness that worsens over time

Some types of shoulder care require immediate attention from an emergency room or urgent care center:

• Shoulder pain that gets suddenly worse
• Inability to move your arm
• Swelling or bruising around the shoulder
• An obvious shoulder deformity or dislocation

Summary

Shoulder pain can occur as a result of many types of problems. While it can be linked to breast cancer, shoulder pain is not a common symptom of the disease.

When this happens, shoulder pain often occurs as a result of metastasis. This occurs when the breast cancer cells spread from your breast to another site in your body.

A Word From Verywell

No matter what your current health condition is, you've probably experienced shoulder pain as a result of an injury or overuse. While shoulder pain is common, it's important to avoid dismissing it if it persists. When dealing with metastatic breast cancer, early detection and improvements in treatment can help reduce further damage and improve survival rates.

While a diagnosis of metastatic breast cancer can be devastating, there's reason to be hopeful. New breast cancer treatments mean that your prognosis is likely to include an active lifestyle, effective pain management, and increased longevity.