Pain in women with breast cancer.

Objective: To describe the prevalence of pain in women with breast cancer. Methodology: The search for scientific articles was carried out in the databases

Authors: Magno B. Cirqueira1, Carolina R. de Mendonça1, Leonardo R. Soares1, Marise A. R. Moreira2, Ruffo Freitas-Júnior3,4

1 Postgraduate Program in Health Sciences of the Federal University of Goiás (UFG), Goiânia, Goiás, Brazil.

2 Department of Pathology, Federal University of Goiás, Goiânia, Goiás, Brazil.

3 Federal University of Goiás (HC/UFG), Mastology Program, Clinics Hospital, Goiânia, GO, Brazil.

4 Goiás Association to Cancer Combat (ACCG), Araújo Jorge Hospital, Goiânia, GO, Brazil.

Objective: To describe the prevalence of pain in women with breast cancer. Methodology: The search for scientific articles was carried out in the databases: PubMed, LILACS and SciELO. Articles published between 2000 and 2018 were selected in English, Portuguese or Spanish. The searches in the databases were performed with the following combinations: (“Pain”[MeSH Terms] OR “Chronic Pain”[MeSH Terms] AND “Breast Neoplasms”[MeSH Terms] OR “Prevalence” [MeSH Terms]). Results: Painful perception in breast cancer patients is multifactorial and presents different prevalence rates. Persistent pain in the breast (duration ≥ 6 months) was reported by 46.5% of breast cancer survivors and 12.7% of women without a history of breast cancer. In Denmark, it was observed that the prevalence of chronic pain after breast cancer treatment ranged from 22% to 53%. In patients submitted to mastectomy, the prevalence of chronic pain may vary between 20 and 68%. Among the justifications for the variation in the prevalence rates of pain in women with breast cancer, the different criteria of pain measurement and the heterogeneity of this population stand out. The occurrence of preoperative breast pain was 27.1%. In the postoperative period, there is also a high prevalence of breast pain. In a prospective study involving 398 women with breast cancer, it was observed that approximately 25% of the sample had significant and persistent levels of breast pain in the first six months after surgery. In another similar study, breast pain after six months of surgery was described by 52.9% of the patients. In another study, three months after surgery, 60 patients (40%) reported persistent pain in the breast, for which 62% used analgesics. It should be noted that this painful perception is usually of musculoskeletal origin and may suffer variations due to the surgical technique used and the length of each procedure. In a study comparing quality of life after axillary lymphadenectomies and sentinel lymph node biopsies in breast cancer patients, ipsilateral shoulder and upper limb pain was observed in 68% and 36% of patients, respectively. Conclusion: Breast cancer represents a public health problem, with a high incidence of pain related to the disease or the treatment performed. Strategies to improve persistent breast pain should be explored for incorporation into the standard treatment of breast cancer survivors.

Key words: pain, chronic pain, breast neoplasms, prevalence.