Pain and other symptoms after different treatment modalities of breast cancer.
OBJECTIVE
The aim of this study was to analyse the risk factors that predispose women to chronic symptoms related to the treatment of breast cancer.


METHODS
A questionnaire was sent to 569 women who had undergone modified radical mastectomies with axillary evacuation (MRM) or breast resection with axillary evacuation (BCT).


RESULTS
Pain, paraesthesias and strange sensations were reported by half of the patients. The chronic pain slightly affected the daily lives of about 50% of the patients and moderately or more the daily lives of about 25% of the patients. Pain was reported significantly more often after BCT than after MRM both in the breast scar (BS) and in the ipsilateral arm (IA). The patients with chronic pain were significantly younger and had larger primary tumours. Postoperative complications increased the incidence of chronic pain in the IA. The highest incidence of pain in the IA was reported by patients who had had both radio- and chemotherapy. The fact that the incidence of pain (IA) had a significant correlation with the incidence of paraesthesias, oedema, strange sensations and muscle weakness may be an indication of nerve injury.


CONCLUSIONS
Chronic pain was more common after breast-conserving surgery than after radical surgery. Surgical complications and postoperative radiotherapy and chemotherapy increased the risk of chronic pain and other symptoms. Modifications in the treatment protocol and preclusion of postoperative complications may be necessary in order to minimize chronic treatment-related symptoms.
Tasmuth
T
T
Department of Anaesthesia, Helsinki University Central Hospital, Finland.
von Smitten
K
K
Hietanen
P
P
Kataja
M
M
Kalso
E
E
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001499:Bayes Theorem; D001941:Breast Diseases / Q000209:etiology; D001943:Breast Neoplasms / Q000534:rehabilitation / Q000601:surgery / Q000628:therapy*; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003131:Combined Modality Therapy; D004487:Edema / Q000209:etiology; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects; D015411:Mastectomy, Modified Radical / Q000009:adverse effects; D008875:Middle Aged; D015999:Multivariate Analysis; D009123:Muscle Hypotonia / Q000209:etiology; D010146:Pain / Q000209:etiology*; D010292:Paresthesia / Q000209:etiology; D011788:Quality of Life; D012307:Risk Factors; D012678:Sensation Disorders / Q000209:etiology