Persistent Pain After Breast Cancer Treatment, an Underreported Burden for Breast Cancer Survivors

Bo T M Strijbos*, Loes Janssen, Adri C Voogd, Willem A R Zwaans, Rudi M H Roumen, Adriana J G Maaskant-Braat

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Many patients who have undergone surgery experience persistent pain after breast cancer treatment (PPBCT). These symptoms often remain unnoticed by treating physician(s), and the pathophysiology of PPBCT remains poorly understood. The purpose of this study was to determine prevalence of PPBCT and examine the association between PPBCT and various patient, tumor, and treatment characteristics. PATIENTS AND METHODS: We conducted a questionnaire-based cross-sectional study enrolling patients with breast cancer treated at Máxima Medical Center between 2005 and 2016. PPBCT was defined as pain in the breast, anterior thorax, axilla, and/or medial upper arm that persists for at least 3 months after surgery. Tumor and treatment characteristics were derived from the Dutch Cancer Registry and electronic patient files. RESULTS: Between February and March 2019, a questionnaire was sent to 2022 women, of whom 56.5% responded. Prevalence of PPBCT among the responders was 37.9%, with 50.8% reporting moderate to severe pain. Multivariable analyses showed that women with signs of anxiety, depression or a history of smoking had a higher risk of experiencing PPBCT. Women aged 70 years or older at diagnosis were significantly less likely to report PPBCT compared with younger women. No significant association was found between PPBCT and treatment characteristics, including type of axillary surgery and radiotherapy. CONCLUSIONS: A considerable percentage of patients with breast cancer experience PPBCT. Women with signs of anxiety or depression and women with a history of smoking are more likely to report PPBCT. Further research is required to understand the underlying etiology and to improve prevention and treatment strategies for PPBCT.
Original languageEnglish
Pages (from-to)6753-6763
Number of pages11
JournalAnnals of Surgical Oncology
Volume31
Issue number10
Early online date28 Jun 2024
DOIs
Publication statusPublished - Oct 2024

Keywords

  • Breast cancer
  • Breast cancer treatment
  • Pain
  • Persistent pain
  • Postoperative
  • Surgery breast

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