Abstract P5-13-08: The perception of chronic pain among breast cancer survivors
Authors: Bao T , Seluzicki C , Li Q , Mao J 
Published: March 2017

Introduction: Breast cancer treatments may result in acute pain that, if untreated or undertreated, may lead to chronic pain. Twenty to thirty percent of patients who undergo mastectomy experience post-mastectomy pain syndrome, and up to 50% of breast cancer survivors taking aromatase inhibitors (AI) report aromatase inhibitor associated arthralgia (AIAA). The rates, experiences, and risk factors of the effects of breast cancer treatment on breast cancer survivors' perceptions of chronic pain are not well defined.

Methods: We conducted a cross-sectional survey among postmenopausal, hormone receptor-positive, breast cancer survivors who were currently taking or had previously taken an AI. The main outcome variable was the patient's perception of living with chronic pain. Variables including breast cancer treatment, socioeconomic and clinical factors, symptom burden, pain (measured by the Brief Pain Inventory [BPI]), and pain-related coping (measured by the Pain Catastrophizing Scale [PCS]) were measured. Univariate and multivariate logistic analyses were performed to identify the risk factors associated with patients' perceptions of living with chronic pain.

Results: Among 561 participants, 62 (11.1%) reported that they perceived themselves as living with chronic pain prior to their breast cancer diagnosis and 172 (30.8%) reported living with chronic pain during the past 6 months at the time of the survey. Compared with patients who did not perceive chronic pain, patients with the perception of chronic pain had significantly higher pain severity (4.15±0.17 vs. 1.54±0.09) and interference (3.47±0.2 vs. 0.97±0.08); higher pain medication usage (percentage of patients taking at least one pain medication over the past 7 days: 85.47% vs. 57.36%); and higher levels of negative coping with pain, including rumination (4.08±0.31 vs. 2.28±0.16), magnification (2.27±0.2 vs. 1.15±0.08), and helplessness (4.63±0.37 vs. 1.64±0.13). Among participants, 369 (65.78%) reported taking at least one pain medication over the past 7 days. In a multivariate analysis, age (&lt;56 or &gt;70), higher BMI (&gt;30), prior chemotherapy, currently experiencing AIAA, and the presence of chronic pain before cancer diagnosis were identified as risk factors associated with the perception of living with chronic pain.

Conclusion: One in three breast cancer survivors considered themselves to be living with chronic pain, and two-thirds developed such perceptions following their cancer diagnosis. Both chemotherapy and AI use were risk factors for perceptions of chronic pain. Those women who had chronic pain experienced greater pain severity, daily interference, and more negative coping. Better understanding of the risk factors and symptom burden associated with chronic pain perceptions among this population may allow for more targeted interventions to reduce chronic pain and its negative sequelae, including premature termination of AI treatment.

Citation Format: Bao T, Seluzicki C, Li Q, Mao J. The perception of chronic pain among breast cancer survivors [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-13-08.