scholarly journals Breast pain in a diverse population of breast cancer patients

2020 ◽  
Author(s):  
Jami Fukui ◽  
Erin Bantum ◽  
Madison Meister ◽  
Shannon Lim ◽  
Ashley Davidson Marumoto ◽  
...  

Abstract Background Breast cancer is the most common cancer in women. The majority of women with breast cancer present with early stage disease requiring surgical management. Post-operative breast pain has been reported to be anywhere from 25–60%. Racial disparities in cancer treatment-related symptom burden are known and linked to worse treatment outcomes. There is sparse data regarding racial/ethnic differences in breast pain among breast cancer patients. We evaluated the prevalence of breast pain in breast cancer patients and characterized the pain using a modified short-form McGill pain questionnaire in our diverse population. Methods We performed a cross sectional study, including 237 patients from various outpatient oncology clinics and breast cancer survivorship groups on Oahu and Maui. Participants had the option to complete the survey in person at the clinic or online. Results Eight-four respondents (35.4%) reported breast pain. There were no statistical differences seen in breast pain likelihood according to racial/ethnic group. On multivariate analysis, we did however find significant racial/ethnic differences in the amount of breast pain, where Chinese, Native Hawaiian and Mixed Asian participants reported significantly less pain compared to White participants (1.36, 2.16 and 2.22 vs 2.92, p = < 0.0001, 0.03 and 0.05) on a 10-point pain scale. We found differences in breast pain according to age, chemotherapy, radiation therapy and endocrine therapy use as well as survey location. No differences were seen according to the type of breast or axillary surgery. The most common descriptors of breast pain were sensory compared to affective characteristics. The average self-reported pain score found was 3/10. Overall, in women with breast pain, 33.4% reported the breast pain affected their sleep with 16.7% reporting it affected their work and 15.4% reporting it affected their sexual activity. Conclusions Breast pain is a significant problem in our breast cancer community. This survey assessment has informed our understanding of breast pain in our diverse population. In turn we are developing culturally appropriate pain management strategies to treat this challenging symptom common in breast cancer survivors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24085-e24085
Author(s):  
Jami Aya Fukui ◽  
Madison Meister ◽  
Ian Pagano ◽  
Erin Bantum

e24085 Background: Breast cancer is the most common cancer in women. Prevalence rates for persistent pain following breast cancer surgery are reported to be up to 60%. Younger age, radiation, more invasive surgery, and acute post-operative pain have been identified as predictors of chronic pain after surgery. Several studies have looked at factors predicting breast pain, but to our knowledge none of these studies have reported on perceived pain among ethnic groups beyond white and non-white comparisons. Methods: Participants were asked to complete an anonymous breast pain questionnaire based on the McGill pain questionnaire, either online or face-to-face in a clinical setting. Incidence and type of breast pain, common risk factors (age, type of surgery, treatment: chemotherapy, radiation and endocrine therapy), and race/ethnicity was collected and analyzed through descriptive and multivariate analysis. Results: 238 responses were collected and analyzed. About 36% of participants reported breast pain, where 82% reported these symptoms for more than a year. More than 71% identified as non-white, with the majority identifying as Asian (50%) followed by White (11%), Multi-ethnic (9%) and Native Hawaiian (8%). The majority of participants were older than 60 years of age (57%), with 30% being older than 70. Japanese, Filipino and Native Hawaiian participants reported significantly more pain compared to White participants (p < .0001). The majority of participants reported a 3/10 pain level on a pain scale and described overall breast pain as mild. The most common descriptor of mild pain was aching and represents the dullness pain characteristic. The most common descriptor of moderate pain was sharp characterizing an incisive pressure, and the most common descriptors of severe pain were heavy, tender, shooting and throbbing, representing various pain characteristics. Participants who were undergoing radiation (p < .0001) or chemotherapy (p < .05) reported statistically higher breast pain, although there were no differences in breast pain according to the type of surgery (mastectomy vs lumpectomy). Participants who completed the survey online also reported more pain (p < .0001) than participants who completed the survey face-to-face. Conclusions: Breast pain is a significant problem in our breast cancer community. This questionnaire has informed our understanding of the type of pain our multi-ethnic breast cancer patients are experiencing and in turn we are developing culturally appropriate pain management strategies to treat this challenging symptom for breast cancer survivors.


2021 ◽  
Vol 3 (3) ◽  
pp. e055
Author(s):  
Jami Fukui ◽  
Erin Bantum ◽  
Madison Meister ◽  
Shannon Lim ◽  
Ashley Davidson Marumoto ◽  
...  

Author(s):  
Marilot C. T. Batenburg ◽  
Wies Maarse ◽  
Femke van der Leij ◽  
Inge O. Baas ◽  
Onno Boonstra ◽  
...  

Abstract Purpose To evaluate symptoms of late radiation toxicity, side effects, and quality of life in breast cancer patients treated with hyperbaric oxygen therapy (HBOT). Methods For this cohort study breast cancer patients treated with HBOT in 5 Dutch facilities were eligible for inclusion. Breast cancer patients with late radiation toxicity treated with ≥ 20 HBOT sessions from 2015 to 2019 were included. Breast and arm symptoms, pain, and quality of life were assessed by means of the EORTC QLQ-C30 and -BR23 before, immediately after, and 3 months after HBOT on a scale of 0–100. Determinants associated with persistent breast pain after HBOT were assessed. Results 1005/1280 patients were included for analysis. Pain scores decreased significantly from 43.4 before HBOT to 29.7 after 3 months (p < 0.001). Breast symptoms decreased significantly from 44.6 at baseline to 28.9 at 3 months follow-up (p < 0.001) and arm symptoms decreased significantly from 38.2 at baseline to 27.4 at 3 months follow-up (p < 0.001). All quality of life domains improved at the end of HBOT and after 3 months follow-up in comparison to baseline scores. Most prevalent side effects of HBOT were myopia (any grade, n = 576, 57.3%) and mild barotrauma (n = 179, 17.8%). Moderate/severe side effects were reported in 3.2% (n = 32) of the patients. Active smoking during HBOT and shorter time (i.e., median 17.5 vs. 22.0 months) since radiotherapy were associated with persistent breast pain after HBOT. Conclusion Breast cancer patients with late radiation toxicity reported reduced pain, breast and arm symptoms, and improved quality of life following treatment with HBOT.


2015 ◽  
Vol 26 ◽  
pp. ix16
Author(s):  
A. Deniel ◽  
N.A. Hakim ◽  
N.A. Md Nordin ◽  
T.M.I. Tg Abu Bakar Sidik ◽  
S. Subramanian ◽  
...  

Author(s):  
C. T. Sánchez-Díaz ◽  
S. Strayhorn ◽  
S. Tejeda ◽  
G. Vijayasiri ◽  
G. H. Rauscher ◽  
...  

Abstract Background Prior studies have observed greater levels of psychosocial stress (PSS) among non-Hispanic (nH) African American and Hispanic women when compared to nH White patients after a breast cancer diagnosis. We aimed to determine the independent and interdependent roles of socioeconomic position (SEP) and unmet support in the racial disparity in PSS among breast cancer patients. Methods Participants were recruited from the Breast Cancer Care in Chicago study (n = 989). For all recently diagnosed breast cancer patients, aged 25–79, income, education, and tract-level disadvantage and affluence were summed to create a standardized socioeconomic position (SEP) score. Three measures of PSS related to loneliness, perceived stress, and psychological consequences of a breast cancer diagnosis were defined based on previously validated scales. Five domains of unmet social support needs (emotional, spiritual, informational, financial, and practical) were defined from interviews. We conducted path models in MPlus to estimate the extent to which PSS disparities were mediated by SEP and unmet social support needs. Results Black and Hispanic patients reported greater PSS compared to white patients and greater unmet social support needs (p = 0.001 for all domains). Virtually all of the disparity in PSS could be explained by SEP. A substantial portion of the mediating influence of SEP was further transmitted by unmet financial and practical needs among Black patients and by unmet emotional needs for Hispanic patients. Conclusions SEP appeared to be a root cause of the racial/ethnic disparities in PSS within our sample. Our findings further suggest that different interventions may be necessary to alleviate the burden of SEP for nH AA (i.e., more financial support) and Hispanic patients (i.e., more emotional support).


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