PURPOSE: Postoperative radiotherapy decreases breast cancer mortality. However, studies have revealed a long-lasting breast pain among some women after radiotherapy. The purpose of this study was to identify risk factors that contribute to breast pain after breast cancer radiotherapy. METHODS AND MATERIALS: We identified 1,027 recurrence-free women in two cohorts of Swedish women treated for breast cancer. The women had breast-conserving surgery and postoperative radiotherapy, the breast was treated to 48 Gy in 2.4-Gy fractions or to 50 Gy in 2.0-Gy fractions. Young women received a boost of up to 16 Gy. Women with more than three lymph node metastases had locoregional radiotherapy. Systemic treatments were given according to health-care guidelines. Three to 17 years after radiotherapy, we collected data using a study-specific questionnaire. We investigated the relation between breast pain and potential risk modifiers: age at treatment, time since treatment, chemotherapy, photon energy, fractionation size, boost, loco-regional radiotherapy, axillary surgery, overweight, and smoking. RESULTS: Eight hundred seventy-seven women (85%) returned the questionnaires. Among women up to 39 years of age at treatment, 23.1% had breast pain, compared with 8.7% among women older than 60 years (RR 2.66; 95% CI 1.33-5.36). Higher age at treatment (RR 0.96; 95% CI 0.94-0.98, annual decrease) and longer time since treatment (RR 0.93; 95% CI 0.88-0.98, annual decrease) were related to a lower occurrence of breast pain. Chemotherapy increased the occurrence of breast pain (RR 1.72; 95% CI 1.19-2.47). In the multivariable model only age and time since treatment were statistically significantly related to the occurrence of breast pain. We found no statistically significant relation between breast pain and the other potential risk modifiers. CONCLUSIONS: Younger women having undergone breast-conserving surgery with postoperative radiotherapy report a higher occurrence of long-lasting breast pain compared to older women. Time since treatment may decrease the occurrence of pain.
PURPOSE: Postoperative radiotherapy decreases breast cancer mortality. However, studies have revealed a long-lasting breast pain among some women after radiotherapy. The purpose of this study was to identify risk factors that contribute to breast pain after breast cancer radiotherapy. METHODS AND MATERIALS: We identified 1,027 recurrence-free women in two cohorts of Swedish women treated for breast cancer. The women had breast-conserving surgery and postoperative radiotherapy, the breast was treated to 48 Gy in 2.4-Gy fractions or to 50 Gy in 2.0-Gy fractions. Young women received a boost of up to 16 Gy. Women with more than three lymph node metastases had locoregional radiotherapy. Systemic treatments were given according to health-care guidelines. Three to 17 years after radiotherapy, we collected data using a study-specific questionnaire. We investigated the relation between breast pain and potential risk modifiers: age at treatment, time since treatment, chemotherapy, photon energy, fractionation size, boost, loco-regional radiotherapy, axillary surgery, overweight, and smoking. RESULTS: Eight hundred seventy-seven women (85%) returned the questionnaires. Among women up to 39 years of age at treatment, 23.1% had breast pain, compared with 8.7% among women older than 60 years (RR 2.66; 95% CI 1.33-5.36). Higher age at treatment (RR 0.96; 95% CI 0.94-0.98, annual decrease) and longer time since treatment (RR 0.93; 95% CI 0.88-0.98, annual decrease) were related to a lower occurrence of breast pain. Chemotherapy increased the occurrence of breast pain (RR 1.72; 95% CI 1.19-2.47). In the multivariable model only age and time since treatment were statistically significantly related to the occurrence of breast pain. We found no statistically significant relation between breast pain and the other potential risk modifiers. CONCLUSIONS: Younger women having undergone breast-conserving surgery with postoperative radiotherapy report a higher occurrence of long-lasting breast pain compared to older women. Time since treatment may decrease the occurrence of pain.
Authors: Li Wang; Gordon H Guyatt; Sean A Kennedy; Beatriz Romerosa; Henry Y Kwon; Alka Kaushal; Yaping Chang; Samantha Craigie; Carlos P B de Almeida; Rachel J Couban; Shawn R Parascandalo; Zain Izhar; Susan Reid; James S Khan; Michael McGillion; Jason W Busse Journal: CMAJ Date: 2016-07-11 Impact factor: 8.262
Authors: George Kyrgias; Kiki Theodorou; Anna Zygogianni; Konstantinos Tsanadis; Stefanos Zervoudis; John Tzitzikas; Michael Koukourakis Journal: Breast Cancer (Dove Med Press) Date: 2012-01-24
Authors: Robin J Bell; Penelope J Robinson; Fathima Nazeem; Mary Panjari; Pamela Fradkin; Max Schwarz; Susan R Davis Journal: J Cancer Surviv Date: 2013-08-23 Impact factor: 4.442
Authors: Eunkyung Lee; Cristiane Takita; Jean L Wright; Isildinha M Reis; Wei Zhao; Omar L Nelson; Jennifer J Hu Journal: Pain Date: 2016-05 Impact factor: 7.926
Authors: Eunkyung Lee; Cristiane Takita; Jean L Wright; Susan H Slifer; Eden R Martin; James J Urbanic; Carl D Langefeld; Glenn J Lesser; Edward G Shaw; Jennifer J Hu Journal: Hum Genomics Date: 2019-06-13 Impact factor: 4.639
Authors: Anita R Peoples; Wilfred R Pigeon; Dongmei Li; Sheila N Garland; Michael L Perlis; Julia E Inglis; Vincent Vinciguerra; Thomas Anderson; Lisa S Evans; James L Wade; Deborah J Ossip; Gary R Morrow; Julie Ryan Wolf Journal: J Pain Symptom Manage Date: 2020-08-05 Impact factor: 3.612