Abstract 3703: A prospective study of racial/ethnic disparities in pain experience among breast cancer patients undergoing radiotherapy

Abstract

Abstract Purpose: Pain is one of the multiple quality of life issues in breast cancer survivors. We sought to determine whether race/ethnic disparity exists in radiotherapy (RT)-induced pain and to assess associated risk factors. Methods and Materials: Consecutive 375 female patients undergoing adjuvant RT after breast-conserving surgery during 2009-2014 were evaluated. Pain score was assessed as mean of the four pain severity items (pain at its worst, least, average, and now) using 11-point numeric rating scale (0-10) at pre-RT and post-RT. Pain scores of 4 to 10 were regarded as clinically relevant pain. Pain presence and RT-induced change were examined. In multivariable logistic regression analysis, we evaluated risk factors for pre-RT, post-RT, and RT-induced pain. Results: A total of 15.5% participants self-identified as non-Hispanic white (NHW), 20.8% African American (AA), and 63.7% as Hispanic white (HW). AA patients were more likely to be obese, to report comorbidities, and to have advanced diseases. Pain prevalence was 15.9% at pre-RT and 31.3% at post-RT while 19.7% of patients experienced RT-induced pain. Post-RT pain severity and pain presence were associated with race/ethnicity, age, BMI, number of comorbidity, tumor stage, HER2 status, axillary surgery, fractionation, RT dose, breast volume, and hotspot volume (V105). Multivariable analyses identified HW and obese as independently associated with pre-RT pain while AA, HW, younger age (<50), number of comorbidity (≥2), V105, and pre-RT pain score with post-RT pain. Multivariable analysis also identified AA (OR = 3.23; 95% CI = 1.05-9.93, p = 0.041), younger age (OR = 2.45, 95% CI = 1.24-4.85, p = 0.010), and number of comorbidity (OR = 3.05, 95% CI = 1.29-7.21, p = 0.011 for 2; OR = 4.58, 95% CI = 1.46-14.37, p = 0.009 for at least 3) as risk factors for RT-induced pain. Conclusions: This prospective study demonstrates AA and younger women are more susceptible to RT-induced pain. In addition, the management of comorbidity conditions, such as diabetes, hypertension, and thyroid disease, deserves attention to prevent RT-induced pain in breast cancer patients. Citation Format: Eunkyung Lee, Cristiane Takita, Jean L. Wright, Isildinha M. Reis, Wei Zhao, Jennifer J. Hu. A prospective study of racial/ethnic disparities in pain experience among breast cancer patients undergoing radiotherapy. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3703. doi:10.1158/1538-7445.AM2015-3703