Life after Breast Cancer

A recent article that got my attention was published in the Journal of the American Medical Association by a group of researchers from Denmark. In it, over 3,200 breast cancer survivors who are 2-3 years out from treatment were surveyed to determine how often these women experienced and continued to suffer from pain. Pain was reported by nearly half of respondents, and 13% rated it as severe. Factors associated with chronic pain reports were age below 40, use of adjuvant radiation, and axillary node surgery (vs. sentinel node surgery). Interestingly, chemotherapy was not associated with increased report of severe pain. Of note, pain in the breast tracked with pain experienced in other parts of the body. Yet, while a significant proportion of women reported pain, only 20% had discussed it with their doctor in the prior three months.

This article again cites the challenges women with breast cancer face as they look towards the future. As more and more women can expect to be cured, we as their doctors must forge a stronger alliance to ensure the quality of their lives after treatment. What is missing is evidence-based guidelines on evaluation, work-up, and most importantly, treatment. We must commit resources in to evaluations and therapeutic modalities that can assist breast cancer survivors. It will remain important that advocates in the cancer community team with investigators to ensure that these investigations continue.

For more information:

Rune Gärtner, MD; Maj-Britt Jensen, MSc; Jeanette Nielsen, RN; Marianne Ewertz, MD, DMSc; Niels Kroman, MD, DMSc; Henrik Kehlet, MD, PhD. Prevalence of and Factors Associated With Persistent Pain Following Breast Cancer Surgery. JAMA. 2009;302(18):1985-1992. The abstract available at: http/jama.ama-assn.org/cgi/content/short/302/18/1985.