Long-term course of pain in breast cancer survivors: a 4-year longitudinal study
- 9 June 2011
- journal article
- research article
- Published by Springer Science and Business Media LLC in Breast Cancer Research and Treatment
- Vol. 130 (2), 579-586
- https://doi.org/10.1007/s10549-011-1614-z
Abstract
After successful treatment of early breast cancer, many women still report pain symptoms, and attribute them to the previous illness or its treatment. However, knowledge about the long-term course of pain in breast cancer is limited. Baseline assessment included 3,088 women who received a breast cancer diagnosis on average 2 years prior to enrollment, and who completed typical medical treatments. After 4 years, a subsample of 2,160 recurrence-free women (70%) was re-assessed. The major outcome variable was the composite index for general pain symptoms. Over the 4-year course, a slight but significant increase in pain was reported. If only medical variables were examined, a triple interaction between surgery type, breast cancer stage, and time indicated that pain scores increased in most subgroups, while they decreased in stage II women after mastectomy and stage III women after lumpectomy. Using a regression analytical approach, psychological and other variables added significantly to the prediction of pain persistence. Regression analysis revealed that pain symptoms increased in those women taking tamoxifen at baseline, in those reporting depression at baseline or stressful life events during the first 12 months after enrollment. Exercise at baseline had a beneficial effect on pain recovery. The persistence or increase of pain symptoms in women surviving breast cancer is associated with some medical factors (surgery type, tamoxifen use), but also with psychological factors. Pain should be a standard outcome variable in the evaluation of cancer treatment programs.Keywords
This publication has 55 references indexed in Scilit:
- Physical activity, additional breast cancer events, and mortality among early-stage breast cancer survivors: findings from the WHEL StudyCancer Causes & Control, 2010
- Somatic Symptoms in Patients With Cancer Experiencing Pain or DepressionArchives of Internal Medicine, 2010
- A prospective study of aromatase inhibitor‐associated musculoskeletal symptoms and abnormalities on serial high‐resolution wrist ultrasonographyCancer, 2010
- Effect of Telecare Management on Pain and Depression in Patients With CancerJama-Journal Of The American Medical Association, 2010
- Depression and cancer mortality: a meta-analysisPsychological Medicine, 2010
- Quality of life after successful treatment of early-stage Hodgkin's lymphoma: 10-year follow-up of the EORTC–GELA H8 randomised controlled trialThe Lancet Oncology, 2009
- Development of a Novel Location-Based Assessment of Sensory Symptoms in Cancer Patients: Preliminary Reliability and Validity AssessmentJournal of Pain and Symptom Management, 2009
- The relative importance of specific risk factors for insomnia in women treated for early‐stage breast cancerPsycho‐Oncology, 2007
- Influence of a Diet Very High in Vegetables, Fruit, and Fiber and Low in Fat on Prognosis Following Treatment for Breast CancerJama-Journal Of The American Medical Association, 2007
- Pain, Depression, and Fatigue in Community-Dwelling Adults With and Without a History of CancerJournal of Pain and Symptom Management, 2006