Chronic pain in breast cancer survivors: comparison of psychosocial, surgical, and medical characteristics between survivors with and without pain.
Open accessAbstract
Context 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.Objectives 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.Conclusion 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.
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Both CPSP and chronic fatigue are common consequences of breast cancer surgery, with disabling effects on recovery outcomes and quality of life.
“Even though both CPSP and chronic fatigue are common consequences of breast cancer surgery [7,52], with disabling effects on recovery outcomes and quality of life, hardly any studies have looked at preventive interventions from a psychological perspective.”
From Pre- and post-operative psychological interventions to prevent pain and fatigue after breast cancer surgery (PREVENT): Protocol for a randomized controlled trial (2022) · cites this paper as [7]
The Pain Prevalence, Intensity, and Body Location section reports that 41% of survivors still had pain at the time of investigation and that pain often interfered severely with daily activities. The Discussion also reports disability due to pain. The paper does not establish that chronic fatigue is a common consequence of surgery or assess its effects on recovery or quality of life. (LLM, conf=0.85)
Experimental — accuracy not yet measuredMore than 40% of women treated for breast cancer continue to have pain 2-6 years after surgery.
“In a recent Norwegian study, more than 40% of women treated for breast cancer continued to have pain 2–6 years after surgery [7]”
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- Authors
- Schou Bredal, I., Smeby, N. A., Ottesen, S., Warncke, T., & Schlichting, E.
- Affiliations
- University of Oslo (NO)
- Oslo University Hospital (NO)
- ORCID
- Schlichting, Ellen
- Venue
- Journal of Pain and Symptom Management
- Publisher
- Elsevier BV
- Published
- 2014-11
- Volume
- 48
- Issue
- 5
- Pages
- 852-862
- ISSN
- 0885-3924 (ISSN-L)
- OpenAlex
- W2004781910
- Cited by
- 123
- References
- 50
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 5 · 2023: 15 · 2022: 16 · 2021: 13 · 2020: 14 · 2019: 9 · 2018: 16 · 2017: 8 · 2016: 5 · 2015: 8
- FWCI
- 3.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain and Symptom Management (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- chronic pain, breast cancer survivors, neuropathic pain, risk factors, axillary lymph node dissection, chemotherapy, radiotherapy, depression, anxiety, comorbidities, pain prevalence, pain intensity, psychosocial factors, surgical factors
- MeSH terms
- Adult, Aged, Anxiety, Breast Neoplasms, Depression, Female, Humans, Middle Aged, Neuralgia, Norway, Pain Measurement, Pain, Postoperative, Postoperative Pain, Surveys and Questionnaires, Risk Factors, Comorbidity, Chemotherapy, Adjuvant, Survivors, Chronic Pain
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