Living with chronic pain: perceptions of breast cancer survivors

Breast Cancer Res Treat. 2018 May;169(1):133-140. doi: 10.1007/s10549-018-4670-9. Epub 2018 Jan 19.

Abstract

Purpose: Breast cancer treatments may lead to chronic pain. For some breast cancer survivors (BCS), this experience can develop into the perception of living with chronic pain. The majority of BCS are postmenopausal and have hormone receptor-positive (HR+) breast cancer requiring aromatase inhibitors (AIs). Neither the prevalence nor risk factors associated with the perception of living with chronic pain among this population are well defined.

Methods: We conducted a cross-sectional survey among postmenopausal, HR+ BCS who previously took or were currently taking AIs. The primary outcome was patients' perception of living with chronic pain over the past 6 months. We measured pain and demographic and clinical variables. Multivariable logistic regression analysis was performed to evaluate risk factors associated with the perception of chronic pain.

Results: Among 1280 participants, 167 (13%) reported having the perception of living with chronic pain before their breast cancer diagnosis; 426 (34%) reported this perception after completion of non-hormonal cancer treatment. Seventy-eight percent of BCSs reported experiencing at least one type of treatment-related pain within the past 7 days, with 23% experiencing at least three types. The most common types of pain were AI-induced musculoskeletal pain (49%) and pain at the surgery or radiation site (31%). Younger age (< 56), BMI > 25, and the perception of living with chronic pain before diagnosis were risk factors associated with the perception of living with chronic pain.

Conclusions: One in three postmenopausal, HR+ BCS considered themselves to be living with chronic pain. Effective interventions to reduce chronic pain are needed.

Keywords: Aromatase inhibitors; Breast cancer; Chronic pain; Musculoskeletal pain.

MeSH terms

  • Aged
  • Aromatase Inhibitors / adverse effects
  • Aromatase Inhibitors / therapeutic use
  • Breast / drug effects
  • Breast / physiopathology
  • Breast Neoplasms / complications
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / physiopathology*
  • Cancer Survivors*
  • Chronic Pain / epidemiology
  • Chronic Pain / etiology
  • Chronic Pain / physiopathology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Middle Aged
  • Musculoskeletal Pain / epidemiology
  • Musculoskeletal Pain / etiology
  • Musculoskeletal Pain / physiopathology*
  • Risk Factors

Substances

  • Aromatase Inhibitors