Abstract
In-depth interviews were conducted with French breast cancer survivors 24 month after cancer diagnosis (N = 21 women). We documented their experience of chronic pain, compared their pain narratives with their answers to the WHOQOL-BREF questionnaire, and studied both the meaning they gave to their pain and how they dealt with it in their daily lives. Half of participants reported are suffering from iatrogenic chronic pain. Most of the time, this pain was not captured by the WHOQOL questionnaire and was not medically treated. Patients “normalized” their pain in various ways: they considered it either as a necessary step on the road to recovery, as the proof of treatment efficacy, or as a permanent condition one must learn to live with. They learned to deal with pain by taking precautions, giving up certain activities, and changing the way they performed others. Participants were also prone to compare themselves with other patients suffering worse pain. Breast cancer survivors should be better informed about chronic pain and how to alleviate it. Physicians should contribute to fighting pain-related beliefs which lead patients to conceal their pain. Techniques used by patients to cope with chronic pain in their daily lives should also be promoted.
Highlights
With about one million new cases in the world each year, breast cancer is the most common malignancy in women and comprises 18% of all female cancers [1]
We documented their experience of chronic pain, compared their pain narratives with their answers to the World Health Organization Quality of Life (WHOQOL)-BREF questionnaire, and studied both the meaning they gave to their pain and how they dealt with it in their daily lives
This pain was not captured by the WHOQOL questionnaire and was not medically treated
Summary
With about one million new cases in the world each year, breast cancer is the most common malignancy in women and comprises 18% of all female cancers [1]. In France, it accounts for 36% of all female cancers and its incidence is increasing sharply (+60% during the past 20 years), among women aged 50–64 and probably because of improved breast cancer screening in this age group [2]. Progress in terms of screening, treatment, and care has contributed to improving the relative survival rate for this cancer (the 5 year survival rate after diagnosis is 82% in France) [3, 4]. It is crucial to develop patient-based outcome measures for these women, such as quality of life (QoL). Most studies to date examining QoL in cancer survivors have relied on psychometric instruments, and especially tools measuring general health-related QoL, such as the WHOQOL or SF36 [6,7,8]
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