Ribs and back pain - mets?
Hi,
I was diagnosed with triple negative BC September 2015 aged 30. 22mm tumour, no nodes involved, I had an MRI but no other scans at diagnosis. I immediately began AC chemo followed by right mastectomy, I achieved a pathologic complete response to the AC. Post surgery I completed 12 taxols and finished 6 weeks ago. I have decided against radiation as its deemed unnecessary by my doctors. 4 months ago I started getting a sharp and rather constant pain at the bottom of my ribs on the front left, opposite side to my cancer. I had a chest X-ray and bone scan both of which were clear. I was treated with antibiotics but the pain never went away and I showed no signs of infection. The doctors thought whatever the pain was, it would subside post chemo, it hasn't. I also have upper back pain, sort of between my shoulder blades. It doesn't feel muscular and I'm terrified it's my lungs. I sometimes feel like my chest is heavy and there's a weird fluttering in there, I can't tell if it's caused by anxiety or if it's real.I feel now treatment is finished I should be excited and happy but the anxiety is crippling me. I am seeing my surgeon tomorrow. Does any one have any advice? I feel like my doctors have brushed me off a little as I responded so well to the chemo. Did anyone have similar pain that was nothing sinister? I've never been so scared. Thank you
Comments
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I have costochondritis, which has somewhat similar symptoms. For example:
- The pain, which may be dull, usually will be sharp and located on your front chest wall. It may radiate to your back or abdomen and is more common on your left side.
- There can be pain with a deep breath or cough.
- The most common sites of pain are your fourth, fifth, and sixth ribs. This pain increases as you move your trunk or take deep breaths. Conversely, it decreases as your movement stops or with quiet breathing.
- The reproducible tenderness you feel when you press on the rib joints (costochondral junctions) is a constant feature of costochondritis. Without this tenderness, a diagnosis of costochondritis is unlikely.
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I only now saw this and agree with Lou10. I have costochondritis too - my oncologist said it's fairly common after mastectomy and it's different than "regular" costochondritis that normally goes away by itself. Due to all the areas traumatized during the surgeries we get the ribs can remain permanently tender. It doesn't make it easier to figure out if you get any pain out of the ordinary. But yes, it can be really bad. Last time I had an ultrasound done to my kidneys, when the tech touched that little scanner to my lower ribs I almost screamed it was so painful. And it's not like they press hard on that area.
The back pain sounds more like issues with the spine (some pinched nerve) or muscle spasms.
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It's good your bone scan was clear, but perhaps you could ask for a PET or CT scan, since you've never had one, just to ease your mind. It's totally normal to feel anxiety when you end active tx, but any pain that lasts for 3 or more weeks needs to be investigated and an explanation found to give you total peace of mind. In addition to costochondritis, you might have some truncal lymphedema (fluid build up) going on, which can also cause weird shooting pain and discomfort in your chest, back and/or sides. And as you pointed out, anxiety can absolutely cause physical pain.
If you are happy with your onc, discuss it with him or her -- or your BS -- and see if a PET or CT might ease your mind. Otherwise, if you are doubting your docs for any reason, it could be a good time to reach out and get a second opinion. You will have an ongoing relationship with your onc for several years of monitoring, so it's never too late to switch if this one is brushing you off or you feel isn't taking your concerns seriously. But hopefully, explaining how much anxiety this pain is causing will prompt whatever imaging he/she feels is appropriate to ease your mind.
Good luck, and keep us posted! Deanna
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