Women who have suffered the indignity of breast cancer often have the added insult of breast tenderness or pain. The causes of this are multifactorial:

• The tumour itself and surgery would have disrupted the normal architecture of the breast disturbing the flow of fluid around it. Not only will this cause a throbbing aching discomfort in itself it makes the breast heavier and hotter straining the adjacent muscles.

• Surgery also cuts the minor nerves in the breast and under the arm, when these try the repair themselves the usual numbness gives way to a burning over sensitive pain (hyperaesthesia) which can last for several years. On top of all this, the disrupted nerves not infrequently send sharp lightening jabbing pains into the breast – these neuralgic pains may only last a few seconds but they are enough to make your toes curl!

• During radiotherapy the skin can become red and itchy and in the long term it can contribute to the underlying thickening and fibrosis of the tissues.

How can you help:

It’s important to gently break up the scar (fibrous) tissues which have accumulated in the breast tissue itself, between the breast tissue the skin and the underlying muscle and ribs. At first moving the arm or upper chest is often associated with an aggravation of the pain because the tissues do glide smoothly across each other – sometimes even a tearing sensation is felt.

To ease the pain try to obey the following rules:

• exercise -  exercise is an excellent way to break down the scar tissues particularly those which affect the shoulder and armpit, follow the instructions in the “exercise and the breast section”.

• massage - local gentle massage has also produced some excellent results some of the worse effected women I have encountered. It is particularly good on the breast itself and the surrounding skin which may have stuck down onto the ribs. Put some extra virgin olive oil on the fingers and gently try to roll the skin over the ribs – be as firm as possible but do not cause any pain or bruising as this will be counter productive. At first you will not notice an improvement but with daily persistence the mobility will improve along with the pain. As an added bonus, let you partner to assist you.

• Evening primrose supplements - If exercise and massage do alleviate the pain some patients have reported a benefit from oral evening primrose supplements. There is very little proof that this works but it is unlikely to do any harm. Remember to eat less calories otherwise whilst on these oils as they can be fattening.

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.