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Breast Cancer Research and Treatment

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01-01-2018 | Epidemiology

Chronic pain and other symptoms among breast cancer survivors: prevalence, predictors, and effects on quality of life

Authors: Rola Hamood, Hatem Hamood, Ilya Merhasin, Lital Keinan-Boker

Published in: Breast Cancer Research and Treatment | Issue 1/2018

Abstract

Purpose

To investigate prevalence and risk factors associated with self-reported chronic pain, and other symptoms related to breast cancer or its treatment among breast cancer survivors (BCS).

Methods

A cross-sectional study of a random sample of 410 female BCS, members of “Leumit” healthcare fund, diagnosed with primary nonmetastatic invasive breast cancer in the years 2002–2012. The study questionnaire included questions on health-related quality of life, pain symptoms, and was completed by all women contacted.

Results

A total of 305 BCS (74%), with a median of 7.4 years since diagnosis reported chronic pain, of whom 84% had moderate pain, and 97% experienced pain at least 1–3 days/week. Other symptoms were paresthesia (63%), allodynia (48%), and phantom sensations (15%). Report of pain symptoms, alone or combined, was significantly associated with poorer quality of life. In multivariable analyses, chronic pain was positively associated with mastectomy compared to breast-conserving surgery [Odds ratio (OR), 3.54; 95% confidence interval (CI) 1.46–8.59; P = 0.005], radiotherapy compared to non-radiotherapy (OR 2.96; 95% CI 1.43–6.12; P = 0.003), breast cancer stage at diagnosis—regional versus localized (OR 3.63; 95% CI 2.00–6.57; P < 0.001), and inversely with age (OR per one-year increment, 0.96; 95% CI 0.94–0.99; P = 0.002), and with time since diagnosis (OR per one-year increment, 0.82; 95% CI 0.75–0.90; P < 0.001).

Conclusions

With the increasing incidence of detected breast cancer and the improvements in treatment and consequently survival, knowledge about prevalence, and factors related to treatment late effects of chronic pain is highly relevant for potential prevention or management without negatively impacting quality of life.

Miller KD, Siegel RL, Lin CC, Mariotto AB, Kramer JL, Rowland JH et al (2016) Cancer treatment and survivorship statistics. CA Cancer J Clin 66(4):271–289CrossRefPubMed

Larsson IM, Ahm Sorensen J, Bille C (2017) The Post-mastectomy pain syndrome: a systematic review of the treatment modalities. Breast J 23(3):338–343CrossRefPubMed

Vilholm OJ, Cold S, Rasmussen L, Sindrup SH (2008) The postmastectomy pain syndrome: an epidemiological study on the prevalence of chronic pain after surgery for breast cancer. Br J Cancer 99(4):604–610CrossRefPubMedPubMedCentral

Jung BF, Ahrendt GM, Oaklander AL, Dworkin RH (2003) Neuropathic pain following breast cancer surgery: proposed classification and research update. Pain 104(1–2):1–13CrossRefPubMed

Bokhari F, Sawatzky JA (2009) Chronic neuropathic pain in women after breast cancer treatment. Pain Manag Nurs 10(4):197–205CrossRefPubMed

Hamood R, Hamood H, Merhasin I, Keinan-Boker L (2016) A feasibility study to assess the validity of administrative data sources and self-reported information of breast cancer survivors. Isr J Health Policy Res 5:50CrossRefPubMedPubMedCentral

Burckhardt CS, Jones KD (2005) Effects of chronic widespread pain on the health status and quality of life of women after breast cancer surgery. Health Qual Life Outcomes 3:30CrossRefPubMedPubMedCentral

Ma AM, Barone J, Wallis AE, Wu NJ, Garcia LB, Estabrook A et al (2008) Noncompliance with adjuvant radiation, chemotherapy, or hormonal therapy in breast cancer patients. Am J Surg 196(4):500–504CrossRefPubMed

Paice JA (2011) Chronic treatment-related pain in cancer survivors. Pain 152(3 Suppl):S84–S89CrossRefPubMed

10.

Bosompra K, Ashikaga T, O’Brien PJ, Nelson L, Skelly J (2002) Swelling, numbness, pain, and their relationship to arm function among breast cancer survivors: a disablement process model perspective. Breast J 8(6):338–348CrossRefPubMed

11.

Ishiyama H, Niino K, Hosoya T, Hayakawa K (2006) Results of a questionnaire survey for symptom of late complications caused by radiotherapy in breast conserving therapy. Breast Cancer 13(2):197–201CrossRefPubMed

12.

Avis NE, Crawford S, Manuel J (2005) Quality of life among younger women with breast cancer. J Clin Oncol 23(15):3322–3330CrossRefPubMed

13.

Peuckmann V, Ekholm O, Rasmussen NK, Groenvold M, Christiansen P, Moller S et al (2009) Chronic pain and other sequelae in long-term breast cancer survivors: nationwide survey in Denmark. Eur J Pain 13(5):478–485CrossRefPubMed

14.

Juhl AA, Christiansen P, Damsgaard TE (2016) Persistent pain after breast cancer treatment: a questionnaire-based study on the prevalence, associated treatment variables, and pain type. J Breast Cancer 19(4):447–454CrossRefPubMedPubMedCentral

15.

Belfer I, Schreiber KL, Shaffer JR, Shnol H, Blaney K, Morando A et al (2013) Persistent postmastectomy pain in breast cancer survivors: analysis of clinical, demographic, and psychosocial factors. J Pain 14(10):1185–1195CrossRefPubMed

16.

Alves Nogueira Fabro E, Bergmann A, do Amaral E Silva EB, Padula Ribeiro AC, de Souza Abrahao K, da Costa Leite Ferreira MG et al (2012) Post-mastectomy pain syndrome: incidence and risks. Breast 21(3):321–325CrossRefPubMed

17.

Kehlet H, Jensen TS, Woolf CJ (2006) Persistent postsurgical pain: risk factors and prevention. Lancet 367(9522):1618–1625CrossRefPubMed

18.

Hovind IL, Bredal IS, Dihle A (2013) Women’s experience of acute and chronic pain following breast cancer surgery. J Clin Nurs 22(7–8):1044–1052CrossRefPubMed

19.

Gartner R, Jensen MB, Nielsen J, Ewertz M, Kroman N, Kehlet H (2009) Prevalence of and factors associated with persistent pain following breast cancer surgery. JAMA 302(18):1985–1992CrossRefPubMed

20.

Mejdahl MK, Andersen KG, Gartner R, Kroman N, Kehlet H (2013) Persistent pain and sensory disturbances after treatment for breast cancer: six year nationwide follow-up study. BMJ 346:f1865CrossRefPubMed

21.

Cohen R, Rabin H (2015) Membership in sick funds: a periodic survey. The National Insurance System of Israel, Jerusalem

22.

Fishler Y, Keinan-Boker L, Ifrah A (eds) (2017) The Israel National Cancer Registry—completeness and timeliness of the data. Publication #365. Israel Center for Disease Control, Israel Ministry of Health, Jerusalem, Israel

23.

RAND Health (2009) 36-Item Short Form Survey from the RAND Medical Outcomes Study. http://www.rand.org/health/surveys_tools/mos/mos_core_36item.html. Accessed 2 Jan 2017

24.

International Association for the Study of Pain (1986) Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy. Pain Suppl 3:S1–S226

25.

McCaffery M, Beebe A (1989) Pain: clinical manual for nursing practice. Mosby, St. Louis

26.

Tasmuth T, von Smitten K, Hietanen P, Kataja M, Kalso E (1995) Pain and other symptoms after different treatment modalities of breast cancer. Ann Oncol 6(5):453–459CrossRefPubMed

27.

Andersen KG, Kehlet H (2011) Persistent pain after breast cancer treatment: a critical review of risk factors and strategies for prevention. J Pain 12(7):725–746CrossRefPubMed

28.

Poleshuck EL, Katz J, Andrus CH, Hogan LA, Jung BF, Kulick DI et al (2006) Risk factors for chronic pain following breast cancer surgery: a prospective study. J Pain 7(9):626–634CrossRefPubMed

29.

Abdullah TI, Iddon J, Barr L, Baildam AD, Bundred NJ (1998) Prospective randomized controlled trial of preservation of the intercostobrachial nerve during axillary node clearance for breast cancer. Br J Surg 85(10):1443–1445CrossRefPubMed

30.

Meijuan Y, Zhiyou P, Yuwen T, Ying F, Xinzhong C (2013) A retrospective study of postmastectomy pain syndrome: incidence, characteristics, risk factors, and influence on quality of life. Sci World J 2013:159732CrossRef

31.

Jud SM, Hatko R, Maihofner C, Bani MR, Schrauder MG, Lux MP et al (2014) Comprehensive visualization of paresthesia in breast cancer survivors. Arch Gynecol Obstet 290(1):135–141CrossRefPubMed

32.

Hansen DM, Kehlet H, Gartner R (2011) Phantom breast sensations are frequent after mastectomy. Dan Med Bull 58(4):A4259PubMed

33.

Smith H, Wu S (2012) Persistent pain after breast cancer treatment. Ann Palliat Med 1(3):182–194PubMed

34.

Bokhari FN, McMillan DE, McClement S, Daeninck PJ (2012) Pilot study of a survey to identify the prevalence of and risk factors for chronic neuropathic pain following breast cancer surgery. Oncol Nurs Forum 39(2):E141–E149CrossRefPubMed

35.

Jud SM, Fasching PA, Maihofner C, Heusinger K, Loehberg CR, Hatko R et al (2010) Pain perception and detailed visual pain mapping in breast cancer survivors. Breast Cancer Res Treat 119(1):105–110CrossRefPubMed

36.

Wallace MS, Wallace AM, Lee J, Dobke MK (1996) Pain after breast surgery: a survey of 282 women. Pain 66(2–3):195–205CrossRefPubMed

37.

Gahm J, Wickman M, Brandberg Y (2010) Bilateral prophylactic mastectomy in women with inherited risk of breast cancer–prevalence of pain and discomfort, impact on sexuality, quality of life and feelings of regret two years after surgery. Breast 19(6):462–469CrossRefPubMed

38.

Sheridan D, Foo I, O’Shea H, Gillanders D, Williams L, Fallon M et al (2012) Long-term follow-up of pain and emotional characteristics of women after surgery for breast cancer. J Pain Symptom Manage 44(4):608–614CrossRefPubMed

39.

Tasmuth T, von Smitten K, Kalso E (1996) Pain and other symptoms during the first year after radical and conservative surgery for breast cancer. Br J Cancer 74(12):2024–2031CrossRefPubMedPubMedCentral

40.

Antao L, Shaw L, Ollson K, Reen K, To F, Bossers A et al (2013) Chronic pain in episodic illness and its influence on work occupations: a scoping review. Work 44(1):11–36PubMed

41.

Sun V, Borneman T, Piper B, Koczywas M, Ferrell B (2008) Barriers to pain assessment and management in cancer survivorship. J Cancer Surviv 2(1):65–71CrossRefPubMedPubMedCentral

Title: Chronic pain and other symptoms among breast cancer survivors: prevalence, predictors, and effects on quality of life
Authors: Rola Hamood
Hatem Hamood
Ilya Merhasin
Lital Keinan-Boker
Publication date: 01-01-2018
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 1/2018
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-017-4485-0

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