pain

I am 1 year post mastecomy, with 28 lump nodes removed. I was diagonised as invasive ductal carcinoma stage 4, with 25 positve nodes and spread to skin. I have had full chemo and 35 radiation treatments. I have severe pain below breast line in front and also in my back, like pain wraps around. Pain increases with sitting up, until I can't stand it. Am on Perocet 5 mg/325 q 4. Pain worsened with radiation treatments. Doctor says it's chest wall pain. My question- Should I still be having pain. It wasn't bad right after surgery, but has worsened with time, instead of getting better. I also have frozen shoulder on mastecomy side. I have read about post breast therapy pain syndrome. Is this a possibility? I am very worried that my cancer has spread, because Doctor told me that from the condition of the lump nodes my body did not resist or fight the cancer at all, and they were worried that the cancer was in my blood stream. They also said there is no test to check and see if breast cancer was in the blood. Is this true?

[CCF-RN,MSN-rf]

Dear artisticvicky:  It is possible that your pain is related to the treatment, both surgery and radiation therapy and the development of scar tissue.  However, it is not impossible that the cancer could have spread.  If x-rays or scans of your chest and back have not been done, it may be worthwhile to rule out any progression of the disease and help to address proper treatment of the pain.

[surgeon]

It's true that there's not a specific way to test for cancer in the blood stream. And if cancer has gotten into the blood, it eventually shows up in some location -- cancer cells don't stay in the blood for long; they get somewhere downstream and start growing there. That's why chemo is used; it gets in the blood and goes wherever the cancer cells would go.

Pain as you describe could be due to various things, including a problem in the spine where the nerves exit: a pinched nerve in the back could give pain like you are having. Tests for it might include CT scan, or bone scan. Treatment would depend on the cause, which could be arthritis in the spine, disc problems, or tumor growing there.