Chronic pain in breast cancer survivors: comparison of psychosocial, surgical, and medical characteristics between survivors with and without pain.
BACKGROUND
According to the literature, 25%-60% of women treated for breast cancer, regardless of the stage, experience pain. Many risk factors have been suggested, with many possible confounding factors.


OBJECTIVE
The aim was to investigate psychosocial, surgical, and medical factors associated with chronic pain by comparing breast cancer survivors with chronic pain with survivors without chronic pain. In addition, we investigated the prevalence, intensity, and body location of chronic pain after breast cancer treatment nationwide.


METHODS
A nationwide postal survey of 1332 women who received surgery and adjuvant therapy for breast cancer in Norway two to six years before the onset of this study.


RESULTS
A total of 832 women (63%) returned the questionnaires, and 41% reported pain, of which 51% had mild, 41% moderate, and 8% severe pain. Among the women who experienced pain, 33.8% reported symptoms and signs of neuropathic pain. Young age (odds ratio [OR], 0.95; 95% CI, 0.93-0.98; P < 0.0001), axillary lymph node dissection with subsequent chemotherapy and radiotherapy (OR, 1.69; 95% CI, 1.07-2.67; P = 0.02), other illness that caused pain (OR, 2.37; 95% CI, 1.72-3.26; P < 0.0001), depression (OR, 2.07; 95% CI, 1.25-3.40; P = 0.004), and anxiety (OR, 1.83; 95% CI, 1.26-2.66; P = 0.002) were associated with chronic pain.


CONCLUSIONS
Young age, previous comorbidities (such as back pain, arthritis, arthrosis, and fibromyalgia), and combined treatment with axillary lymph node dissection, chemotherapy, and radiotherapy were risk factors for chronic pain. Whether depression or anxiety is a risk factor for chronic pain remains unclear.
Oslo University Hospital, Oslo, Norway; University of Oslo, Oslo, Norway. Electronic address: i.s.bredal@medisin.uio.no.
Inger
I
Schou Bredal
University of Oslo, Oslo, Norway.
Nina A
NA
Smeby
Oslo University Hospital, Oslo, Norway; University of Oslo, Oslo, Norway.
Stig
S
Ottesen
Oslo University Hospital, Oslo, Norway.
Torhild
T
Warncke
Oslo University Hospital, Oslo, Norway.
Ellen
E
Schlichting
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D059350:Chronic Pain / Q000453:epidemiology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009437:Neuralgia / Q000453:epidemiology; D009664:Norway / Q000453:epidemiology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017741:Survivors
Adjuvant therapy; anxiety; breast cancer; chronic pain; depression; surgery