A study in the November 11 issue of
JAMA says that nearly 50 percent of women surveyed indicate they experience pain symptoms 2 to 3 years after breast cancer treatment, with women who were younger or who received supplemental radiation therapy more likely to have pain.
Persistent postsurgical pain has been shown to be clinically relevant in many patients undergoing various common operations, including breast cancer surgery. With breast cancer, the pathogenic mechanisms are multiple, including nerve damage related to surgical technique, according to background information in the article. Different types of sensory disturbances (e.g., aftersensations, burning, or sensory loss) can occur after other surgical procedures and may be an important part of the pain characteristics in breast cancer. "Pain has also been reported to be associated with adjuvant [supplemental] therapy, such as chemotherapy and radiotherapy," the authors write.
Rune Gärtner, M.D., of the University of Copenhagen, Denmark, and colleagues examined the prevalence, associated factors, and severity of chronic pain and sensory disturbances an average of 26 months after surgery for breast cancer of 3,754 women, ages 18 to 70 years, who received a questionnaire between January and April 2008. By June 2008, 87 percent (3,253) of eligible women returned the questionnaire.
The researchers found that a total of 1,543 patients (47 percent) reported pain in 1 or more areas, of which 13 percent reported severe pain, 39 percent reported moderate pain, and 48 percent reported light pain. Among women reporting severe pain, 77 percent experienced pain every day, whereas only 36 percent of women experiencing light pain had pain every day. Adjuvant radiation therapy, but not chemotherapy, increased the risk of reporting pain. Axillary lymph node dissection was associated with increased likelihood of pain or sensory disturbances, compared with sentinel lymph node dissection.