Sometimes we feel concerned about chronic pain after breast cancer treatment. The fear of recurrance comes up because we’re told to report any pain lasting more than two weeks. What if the pain lasts for months, or even years?  Current research is showing that lingering pain can be a common problem for women who have had breast cancer.

A Survey of Joint and Muscle Aches, Pain, and Stiffness Comparing Women With and Without Breast Cancer

Fenlon D, Addington-Hall JM, O’Callaghan AC, Clough J, Nicholls P, Simmonds P
J Pain Symptom Manage. 2013;46:523-535

Study Summary

The purpose of this study was to determine the prevalence of joint and muscle aches, pain, and stiffness in women after completing adjuvant breast cancer treatment, in comparison with women of a similar age without breast cancer. The study participants were 247 women attending breast cancer follow-up clinics. The comparison group of 274 women of similar age was drawn from women attending breast screening and other (benign) breast clinics. The prevalence and severity of pain were compared between the 2 groups.

The mean age of all women in the study was 59 years (range, 30-86 years). The median time since diagnosis of cancer was 28 months (range, 2-184 months). Adjuvant treatments included radiation therapy (79%), chemotherapy (45%), and hormone therapy (81%).

Sixty-two percent of women with breast cancer reported pain “today,” compared with 53% of women without breast cancer (P=.023). Significant predictors of pain in both patient groups were cancer, age, and arthritis. For the women with cancer, significant predictors of pain were age, arthritis, taxane chemotherapy, aromatase inhibitors, and tamoxifen. Quality of life (measured by the Short Form-36) was significantly worse for women with breast cancer than for controls and was significantly worse in the women with breast cancer who reported pain.

The main conclusion was that treatment with tamoxifen, taxane chemotherapy, and aromatase inhibitors for breast cancer is predictive of joint pain, which may have an impact on women’s lives for some years after breast cancer.

Viewpoint

There are currently 2.9 million breast cancer survivors in the United States, many of whom have been treated with chemotherapeutic agents, now known to be associated with long-term effects. Nurses will increasingly care for women who have survived breast cancer but who will be seen in primary care clinics or for other chronic illnesses.

A thorough assessment of symptoms that persist in survivorship is vital to quality of life for these survivors. Nurses should document the history of breast cancer, as well as all previous treatments. Symptom assessment should include reports of not only pain but also muscle ache, joint stiffness, or other discomfort that could be underreported or minimized by patients. Assessment should also determine the impact that these symptoms have on quality of life, such as decreased function; psychological responses, including anxiety or depression; and impaired roles and relationships.