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.
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Acknowledgments
The authors wish to thank the study participants and the members of our Study Advisory Group: Dr. Jacquie Chirgwin, A/Professor John Collins, Professor Graham Giles, Mr. Peter Gregory, Mr. Stewart Hart, Miss Suzanne Neil and Mrs. Avis McPhee. The authors also wish to thank members of the research team of the Health and Wellbeing After Breast Cancer study, without whose hard work this large cohort study would not be possible (Maria La China and Jo Bradbury). Finally, we thank Ms. Helen Farrugia, Director of Information Systems, and Professor Graham Giles, Director of the Victorian Cancer Registry, for their ongoing support of this study.
This work was supported by the Bupa Health Foundation (previously the Medical Benefits Fund of Australia Limited Foundation) (to SRD and RJB), the National Health and Medical Research Council of Australia (grant nos. 219279 to SRD and RJB, 490938 to SRD, 1034977 to MP), Novartis Oncology Australia, the L.E.W. Carty Trust, the Jack and Robert Smorgon Families Foundation, Connie and Craig Kimberley and Roy Morgan Research (all to SRD and RJB). This research project was also supported by the Victorian Government through a Victorian Cancer Agency Research Fellowship (to RJB). None of the funding agencies had any role in determining study design; in the collection, analysis and interpretation of data; in the writing of the manuscript or in the decision to submit the manuscript for publication.
Conflict of interest
None of the authors consider that they have any conflict of interest that could inappropriately influence or bias this work.
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Bell, R.J., Robinson, P.J., Nazeem, F. et al. Persistent breast pain 5 years after treatment of invasive breast cancer is largely unexplained by factors associated with treatment. J Cancer Surviv 8, 1–8 (2014). https://doi.org/10.1007/s11764-013-0306-6
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DOI: https://doi.org/10.1007/s11764-013-0306-6