OBJECTIVES: To examine bone pain and BTA treatment patterns in patients with BMs from BC in real-world setting in Europe. METHODS: The study was conducted using the Adelphi Breast Cancer Disease-Specific Programme (DSP) 2015 database, a multi-country cross-sectional survey of 385 oncologists from 6 European countries (UK, Germany, France, Italy, Spain, and Belgium). Each physician completed a patient record form (PRF) for 10 patients being treated for advanced BC that captured the following information: presence of BMs, current pain state, current analgesic use, BTA treatment, and reasons behind BTA treatment decisions.  RESULTS: A total of 1376 patients with BM from BC were identified. At the time of survey (an average of 11 months after diagnosis of BMs), 47% of the patients experienced mild pain; and 20% had moderate/severe pain. The majority of the patients (96%) with pain took analgesic drugs to manage pain, which included 28% (n=260) patients treated with strong opioids (e.g. morphine, oxycodone etc.). Of them, 59% (154/260) still experienced moderate/severe bone pain. Among the patients with BMs, 88% (n=1210) were treated with a BTA. Of them, 81% (n=979) received treatment within 3 months of BMs diagnosis. Reasons for BTA treatment initiation within 3 months of BMs were “bone pain” (34%), “high risk of bone complications” (31%), “number of BMs” (13%), “location of BMs” (8%) and “prior history of bone complications” (7%). Reasons for not treating patients with BTAs were “recent diagnosis” (40%), “low bone complication risk” (17%), “focus on treating primary tumor” (10%), and “short life expectancy” (10%).  CONCLUSIONS: Bone pain is the main symptom encountered by patients with BMs from BC. Most of these patients treated with strong opioids still experienced moderate/severe bone pain. The majority of patients with BMs received BTAs; primary treatment goals were reductions of bone pain and risk of bone complications.