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Breast Cancer and Pain

One common symptom post breast cancer treatment is pain. Sometimes this has been described as sharp shooting pain that happens with movement, and sometimes more of a constant dull ache.

Is pain something you learn to live with?

Constant pain brings on fatigue.

Pain that lasts and lasts, after breast cancer surgery has been estimated to affect 60% of women. This is m ore than half of the women that go through diagnosis, treatment and work towards returning to a full life with breast cancer in the rear view mirror, tend to have pain as a backseat driver, constantly reminding them of their journey. Constant pain has also been shown to increase irritability and fatigue. Sometimes, women report living with this pain for so long, that they can’t even imagine not having the pain.

But does that mean that learning to live with the pain is the only option? Researchers have been studying that question, to come up with an answer. Providers do not want to treat the issue (cancer) and leave emotional and psychological scars in its place. So, a group of physicians and PhD studied what women who have pain for several years after treatment have in common. They looked at the types of surgery involved. Some women had lumpectomies, and other women had full mastectomies. Could one surgery lead to the possibility of having more pain down the road? The aftereffects of gaining weight were examined, as well as the treatment types such as chemotherapy, radiation, axillary lymph node dissection and age. Women who are younger, tend to have more aggressive types of breast cancer and typically require more aggressive treatment. So, what were the findings? Younger age, radiation therapy and axillary lymph node dissection did have a higher incidence of women having more persistent pain after their breast cancer surgery. Axillary lymph node dissection is the type of surgery associated with the highest pain level of pain reported. Axillary lymph node dissections involve removing lymph nodes from the axillary or underarm area. There are three different layers of lymph nodes in this small space. The need for removing these lymph nodes is determined after a sentinel lymph node dissection, which usually means that eight or fewer lymph nodes are removed and checked for cancer migration. If more lymph nodes are involved, then the decision may be made to go further in the underarm and remove lymph nodes. So, what is the point of the study? Well, pain may have such negative effects on women, emotionally and physically. Knowing the amount of risk of persistent pain, a procedure may cause is important, as that is part of the conversation with women prior to undergoing any treatment. As with nearly every research article, it ends stating that further research should establish to true correlation of pain and with treatment type. Every bit of information is helpful for the providers charged with organizing the best treatment plan, and for women looking to move forward in life—pain free.

Reference: Wang L, Guyatt GH, Kennedy SA, Romerosa B, Kwon HY, Kaushal A, Chang Y, Craigie S, de Almeida CPB, Couban RJ, Parascandalo SR, Izhar Z, Reid S, Khan JS, McGillion M, Busse JW. Predictors of persistent pain after breast cancer surgery: a systematic review and meta-analysis of observational studies. CMAJ. 2016 Oct 4;188(14):E352-E361. doi: 10.1503/cmaj.151276. Epub 2016 Jul 11. PMID: 27402075; PMCID: PMC5047835