Bone metastases in breast cancer: pain, fractures and treatment

Bone metastases are areas where breast cancer has spread to the bones. Bone is the most common place breast cancer spreads to, especially for hormone-sensitive cancers. The spine, pelvis, ribs, hips and the long bones of the arms and legs are most often affected. Bone metastases can cause pain, weaken bones so they break more easily, raise calcium levels in the blood, and occasionally press on the spinal cord. The cancer is still breast cancer, not bone cancer, and it is treated with whole-body breast cancer treatments such as hormone therapy, targeted drugs or chemotherapy, alongside bone-protecting medicines, radiation for painful areas and sometimes surgery to strengthen bones. Many women live for years with bone metastases and keep a good quality of life.

Why outlook is often better than other sites

When cancer has spread only to bone, it often responds well to treatment and can be controlled for a long time, though every situation is individual.

What treatment aims to do

Control the cancer, relieve pain, prevent fractures and complications, and help you stay active and independent.

When to seek urgent help

Back pain with leg weakness, numbness or bladder and bowel problems, sudden severe pain after a minor injury, or confusion and extreme thirst need emergency care.

Bone metastases mean breast cancer has become metastatic, which is generally not curable. At the same time, bone-only disease is often one of the more treatable forms of metastatic breast cancer, and many women live well for years.

Pain can usually be controlled

Radiation, medicines and treatment of the cancer relieve pain for most people. Tell your team if pain is not well controlled.

Fractures can often be prevented

Bone-protecting medicines and surgery for weakened bones reduce the chance of breaks.

Staying active is encouraged

With guidance about safe movements, exercise helps strength, mood and independence.

What this page cannot tell you

It cannot predict your own course. Ask your oncologist what to expect.

Practical steps help you stay safe and active.

Safe movement

Ask which movements to avoid, such as heavy lifting or twisting if the spine is affected. A physiotherapist can guide safe exercise.

Preventing falls

Clear floors, good lighting and supportive footwear reduce fracture risk.

Around the home

A chair with arms, a raised toilet seat and grab rails make sitting, standing and bathing safer and less painful when bones in the hips or spine are affected.

Managing pain

Take pain relief regularly as prescribed rather than waiting for pain to become severe, and report side effects.

Bone-protecting medicines are an important part of treatment for most people with bone metastases.

What they do

They slow the bone breakdown that cancer triggers, lowering the chance of fractures, the need for radiation or surgery to bone, and high blood calcium.

How they are given

Usually as an infusion or an injection under the skin every few weeks, with calcium and vitamin D supplements and regular blood tests.

Dental care

Because of a rare risk of jaw bone problems, a dental check before starting and good mouth care throughout are advised.