Ironwood Cancer and Research Centers, Chandler, AZ; Arizona Cancer Center, University of Arizona, Tucson, AZ.
Arizona Cancer Center, University of Arizona, Tucson, AZ; Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson, AZ.
Clin Breast Cancer. 2023 Apr;23(3):330-337. doi: 10.1016/j.clbc.2022.12.004. Epub 2022 Dec 14.
Post-treatment mastalgia is a common complaint in up to 68% of patients after treatment. This symptom is worrisome to patients as many believe it is a sign of recurrence. The current study was performed to evaluate if post-treatment mastalgia is associated with a second breast cancer diagnosis.
Patients included were seen from January 1, 2000 to December 31, 2020. All patients who were treated for breast cancer and then presented with breast pain during follow up were considered to have post-treatment mastalgia. All patients who were diagnosed with a second breast cancer but did not experience post-treatment mastalagia were also evaluated.
1799 patients had a mean age 52.9 years. 36% of patients experienced post-treatment mastalgia. Of patients who complained of post-treatment mastalgia, 19 were diagnosed with a chest wall recurrence (CW), ipsilateral breast tumor recurrence (IBTR), or contralateral breast cancer (CBC). 17 of the 19 patients had breast pain after the second diagnosis and treatment were completed. The average duration between their second diagnosis and initial complaint of breast pain was 6.2 years. The two patients who complained of breast pain prior to their second diagnosis did not have mastalgia at the time of their second diagnosis. Local recurrence or contralateral breast cancer were more common in patients without post treatment mastalgia (10.1% vs 0.3%, p < 0.0001) during follow up.
Post treatment mastalgia is not associated with recurrence. Interval or repeat imaging does not appear necessary and instead patient education and reassurance are important in its management.
治疗后乳房痛是治疗后高达 68%的患者常见的主诉。许多患者认为这种症状是复发的迹象，因此对此感到担忧。本研究旨在评估治疗后乳房痛是否与第二乳腺癌诊断相关。
纳入的患者于 2000 年 1 月 1 日至 2020 年 12 月 31 日就诊。所有接受乳腺癌治疗后在随访期间出现乳房疼痛的患者均被认为患有治疗后乳房痛。所有诊断为第二乳腺癌但未经历治疗后乳房痛的患者也进行了评估。
1799 例患者的平均年龄为 52.9 岁。36%的患者经历了治疗后乳房痛。在主诉治疗后乳房痛的患者中，有 19 例被诊断为胸壁复发（CW）、同侧乳房肿瘤复发（IBTR）或对侧乳腺癌（CBC）。在这 19 例患者中，有 17 例在第二次诊断和治疗完成后出现乳房疼痛。他们第二次诊断和首次主诉乳房疼痛之间的平均时间间隔为 6.2 年。在第二次诊断前主诉乳房疼痛的两名患者在第二次诊断时没有乳房痛。在随访期间，无治疗后乳房痛的患者局部复发或对侧乳腺癌更为常见（10.1%比 0.3%，p<0.0001）。
治疗后乳房痛与复发无关。在治疗后乳房痛的管理中，似乎不需要进行间隔或重复影像学检查，而患者教育和安抚更为重要。
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