The bra band area, or the upper back, can be a sore spot for people with breast cancer. “I had my double mastectomy on Wednesday and came home Thursday,” wrote one MyBCTeam member. “My chest and upper back hurt a lot. Is there any advice that could help?”

There are many possible reasons for pain around the bra band area, sometimes called postmastectomy pain syndrome (PMPS) or iron bra syndrome. Some reasons are related to cancer or cancer treatment, while others could happen to anyone. Understanding what’s normal and what’s not can help you decide when it’s time to reach out for help.

Here’s how members of MyBCTeam have experienced upper back pain and potential causes to look out for.

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Chest Tightness After Mastectomy

With breast cancer, chest pain is a known side effect of radiation therapy, surgery, and expanders for breast reconstruction.

Members of MyBCTeam have described a specific type of pain in the bra band area. “After having a mastectomy, my biggest complaint is the extreme tightness I feel around my chest area. It’s almost unbearable at times,” explained one member.

Another responded, saying they’d had the same symptom. “I called that tightness across my chest a ‘vice.’ I can feel the mechanism tighten, and I wondered what I was being prepared for, as in a tool shop. Many people experience it, some for years.”

Managing Tightness

Some MyBCTeam members have said massages help, but they’re not right for everyone. Only consider massage if your surgical or rehabilitation team says it’s safe, since timing depends on wound healing and reconstruction.

“I was told to periodically gently massage the entire chest, avoiding the suture line, until it fully closes. After a few weeks, it stopped happening, although I continue to massage a couple of times a day. Massaging with pure coconut oil helps moisturize the skin and makes rubbing more pleasant,” said one member.

Another member explained, “The tightness is fascial pain — the layer over the muscle. It gets sticky and doesn’t slide, like scar tissue. I get a massage every other week. It helps a little.”

Persistent tightness could be related to nerve pain, scar tissue, or postmastectomy pain syndrome. How you manage it depends on your unique situation, including your healing process and future reconstruction plans.

Ask your doctor about pain medication, massages, and the use of cold packs to reduce pain after a mastectomy or lumpectomy.

Delayed Cancer Treatment Side Effects

Breast cancer treatment side effects, including pain, can develop long after you’ve completed treatment.

“Radiation therapy can cause swelling in that area years down the road,” explained one member. “My doctor advised me to take an anti-inflammatory. And if in a week, I don’t feel better, I’ll go for an X-ray.”

Breast or chest wall lymphedema (swelling) may be to blame for your symptoms. In some cases, lymphedema happens months or years after finishing treatment.

Another member said, “I go through the same pains, even being four years out from my surgery. My doctor and I kid each other, and I call it ‘canceritis.’ Not to make light of this, but every new pain I get, I jump to the conclusion that it’s from my breast cancer, surgery, and/or radiation. Just keep your doctors totally informed, and they’ll reassure you and do the proper testing if needed,” they advised.

Contact Your Care Team

If your pain is new or isn’t getting better, reach out to your healthcare team. They can check for physical causes, such as treatment effects and health issues related to cancer and its treatment.

For example, breast cancer surgery and other treatments may affect your posture or the way you use your arms and lift things, ultimately leading to a sore or painful upper back.

Getting help to fix these issues is important. You can ask your cancer care team for a referral to a physical therapist or occupational therapist for a physical exam and treatment options.

Pain Related to Wearing Bras

Several members of MyBCTeam have reported pain when wearing a bra. Some have found brands that work better for them, and others choose to wear a bra as seldom as possible.

One member wrote, “I still hurt three years later. No bra for this girl. It’s tanks or nothing, even at school. I feel sorry for my coworkers and students, but being as comfortable as I can is more important.”

Another member shared, “Since my surgery, I rarely wear a bra. After shopping around, I found an inexpensive and comfortable bra. I bought it in my size, and a bra extender, and it worked! When home alone, I don’t wear one. But I can’t do that when someone comes over, or when I go out. So, I had to find something comfortable.”

Do everything possible to give yourself breaks during cancer treatment. Consider different options, such as sports bras, tank tops with built-in bras, or loose tops that you feel comfortable wearing. If you can’t wear a bra, or don’t want to wear one, don’t force yourself.

When To Call Your Doctor About Bra Band Pain

It’s always a good idea to inform your healthcare provider if you’re experiencing worse or new unexplained pain. They may recommend testing to ensure nothing’s wrong related to your cancer or healing process.

“I found my latest tumor because I had pain in an area that had been painful after the first surgery,” said a member of MyBCTeam.

Certain types of breast cancer are associated with pain, including metastatic breast cancer that’s spread to other areas. If breast cancer spreads to the lungs or the bones, it may cause pain in other parts of the body, including the bra band area or ribcage.

During breast cancer treatment, you should have frequent contact with your healthcare team, so be sure to bring up any concerns. Sudden bra band pain during remission (after cancer treatment) could be related to breast cancer or another issue that would benefit from treatment.

Common Causes of Upper Back Pain

Apart from breast cancer or its treatments, there are also common causes of back pain that might cause strains, sprains, or pinched nerves for anyone. In some cases, pain in the chest and upper back may also be a sign of a serious health issue.

Spinal Cord Compression

The area between the bottom of the neck and the base of the ribcage is known as the thoracic spine. It contains twelve bones, called vertebrae, stacked one by one with a shock-absorbing disk between each bone.

Each vertebra is attached to one set of ribs. Finally, a network of ligaments and muscles provides structure and support to the area.

For the general population, lower back pain and neck pain are more common than pain in the upper back. However, it’s still possible to injure this area by lifting awkwardly, picking up something that’s too heavy, standing with poor posture, or arthritis-related damage.

During an accident or injury, you may experience a bone fracture, a slipped disk, or a herniated disk that pinches a nerve and causes pain.

Severe back pain that comes with leg weakness or numbness could be caused by a compressed spine. If you have trouble walking or loss of bowel or bladder control, seek emergency medical attention.

Heart Attack Risk

Other unrelated causes of chest pain and tightness include heartburn or a heart attack. Some signs of a bigger problem include back pain with tingling or numbness in your lower body, muscle spasms, bowel or bladder problems, and/or fever.

If you experience a racing heartbeat, cold sweats, nausea, pain that radiates to the jaw, arm, back, or neck, or shortness of breath, call 911 or go to the emergency room right away.