Persistent breast pain 5 years after treatment of invasive breast cancer is largely unexplained by factors associated with treatment

J Cancer Surviv. 2014 Mar;8(1):1-8. doi: 10.1007/s11764-013-0306-6. Epub 2013 Aug 23.

Abstract

Purpose: The aim of our study was to establish the prevalence of breast pain persisting 5 years after the initial treatment of breast cancer (BC) and the relationship between those persistent symptoms and general well-being.

Methods: The study involved women from Victoria, Australia, who had survived at least 5 years from diagnosis, remained free from recurrence or new BC and completed the fifth annual follow-up questionnaire. Analysis involved both multivariable logistic and linear regression.

Results: Of 1,205 women, 45 % reported breast pain which persisted for at least 3 months following initial treatment, and of these, 80 % reported pain persisting for at least 5 years. The factor contributing most to the likelihood of persistent breast pain was current lymphedema; however, a full multivariable model explained <10 % of the likelihood of breast pain persisting for 5 years. The presence of breast pain at 5 years was associated with only a modest reduction in general well-being.

Conclusions: Breast pain persisting for at least 5 years after treatment for BC is common. As the pain is largely unexplained by factors associated with the characteristics of the cancer or its treatment, the contribution of patient expectations to persistent breast pain may be considerable.

Implications for cancer survivors: Where persistent pain occurs, referral for the management of pain and, where appropriate, lymphedema is warranted.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents, Hormonal / adverse effects
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Breast Neoplasms / complications*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery
  • Carcinoma, Ductal, Breast / complications*
  • Carcinoma, Ductal, Breast / drug therapy
  • Carcinoma, Ductal, Breast / radiotherapy
  • Carcinoma, Ductal, Breast / surgery
  • Chemotherapy, Adjuvant / adverse effects
  • Combined Modality Therapy
  • Female
  • Humans
  • Lymph Node Excision / adverse effects
  • Lymphedema / etiology
  • Lymphedema / physiopathology*
  • Mastectomy / adverse effects
  • Mastodynia / etiology*
  • Mastodynia / physiopathology
  • Mastodynia / psychology
  • Pain Clinics / statistics & numerical data
  • Pain Management
  • Pain, Postoperative / etiology
  • Pain, Postoperative / physiopathology
  • Pain, Postoperative / psychology
  • Paresthesia / etiology
  • Paresthesia / physiopathology
  • Paresthesia / psychology
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Quality of Life
  • Radiotherapy, Adjuvant / adverse effects
  • Surveys and Questionnaires
  • Survivors / psychology
  • Time Factors

Substances

  • Antineoplastic Agents, Hormonal