Management Of Breast Cancer Patients Research Articles

Spectrum and management of breast cancer patients with variant of uncertain significance mutations at a tertiary care centre in North India.

BackgroundThe spectrum and significance of Variants of Uncertain Significance (VUS) mutations in breast cancer predisposition genes is poorly defined in the Indian population.MethodsAll new female breast cancer patients from 1 March 2019 to 28 February 2020 were screened. Those providing informed consent and without previous genetic testing were recruited. Multigene panel testing (107 genes) by next-generation sequencing was performed for all patients. Descriptive statistics was used to describe the spectrum of VUS mutations.ResultsOut of 236 patients recruited in the study, a VUS was detected in 89 patients (37.71%). VUS pathogenic ratio was 2.02. A total of 121 different VUS mutations in 40 different genes were detected. Fourteen patients (15.7%) had a VUS in high penetrance genes and 36 VUS mutations (29.8%) were detected in one of the genes involved in homologous recombination repair pathway. No therapeutic interventions were done based on VUS.ConclusionsIn this large prospective study of genetic determinants of breast cancer from India, a high prevalence of VUS (37.71%) was detected with 15.7% patients having a VUS in high penetrance genes. More evidence needs to be generated from larger multicentric studies to better understand the implications of these genetic variants and enable their reclassification.

Multidisciplinary considerations in the management of breast cancer patients receiving neoadjuvant chemotherapy

Multidisciplinary considerations in the management of breast cancer patients receiving neoadjuvant chemotherapy

Application of PDCA cycle in management of breast cancer patients undergoing peripherally inserted central catheter placement

Application of PDCA cycle in management of breast cancer patients undergoing peripherally inserted central catheter placement

Anxiety and Depression Among Breast Cancer Patients in A Tertiary Hospital in Ghana

Background: Breast cancer is the second most common cancer globally and the most frequent cancer among women. It is associated with significant psychological morbidity including anxiety and depression. The extent of this burden has however not been documented in the Ghanaian setting. This study aimed at determining the prevalence of anxiety and depression amongst patients with breast cancer at the Korle Bu Teaching Hospital (KBTH).Design and Subjects: A cross-sectional study was carried out among 120 breast cancer patients using a structured questionnaire to obtain socio-demographic characteristics of patients. The hospital anxiety and depression scale (HADS) was used to assess fordepression and anxiety in these patients. Results: The overall prevalence of depression was 84.2%, while that for anxiety was 92.5%. Forty-four percent of the study participants had both anxiety and depression. There was no significant difference in depression (p=0.796) and anxiety (p=0.999) prevalencebetween post-menopausal (82.9% and 92.1% respectively) and pre-menopausal (86.4% and 93.2% respectively) patients. A significant difference in prevalence of depression alone (p=0.033) and depression in combination with anxiety (0.025) was found between those living with their partners and those living without their partners. Average monthly income was found to be significantly associated withanxiety alone (p=0.014) as well as anxiety and depression combination (p=0.032) but not with depression alone (p=0.101).Conclusion: The prevalence of anxiety and depression are quite high among breast cancer patients at the Korle Bu Teaching Hospital. Anxiety was significantly associated with the average monthly income while depression was associated with the marital status ofpatients. The high prevalence of both anxiety and depression among breast cancer patients makes it imperative for psychotherapy to be incorporated as an integral part of the management of breast cancer patients for the entire duration of the illness but moreespecially during the period immediately following diagnosis

Pattern of Breast Cancer Referral to Palliative Care and the Complimentary Role of a Palliative Care Unit in A Resource-Limited Country

Background: Poor quality of end of life care is an information problem. Information about palliative and end of life care is sparse from developing countries. Only 10 percent of the information in this field of care emanates from developing countries where about 85%of annual deaths due to cancerous diseases occur. We present review of breast cancer patients referred to Palliative unit of our hospital between May 2009 and June 2013. This article demonstrates challenges to palliative care and the complementary role of thepalliative unit to palliative care in developing countries
 Method: The records of the Palliative unit University of Ilorin Teaching Hospital were reviewed for information about the stage of the disease at referral, performance status of the patients, the support given by the palliative unit and outcome of care.Result: One hundred and one patients were reviewed for breast cancer by the Palliative unit during the study period. Most of the referrals were from one of a general surgery units in the hospital. The number of referrals per year showed no sustained commitment to referral for palliation. The palliative unit provided counselling, home visitation and source of psychosocial and financial support. The median survival duration was 3 months. 59 percent of the recorded deaths were at homeConclusion: This report demonstrated that even though the palliative unit filled a void in the management of breast cancer patients, palliative care is still not widely accepted.

Post-operative pain management with non-pharmacological interventions in patients undergoing breast cancer surgery: A systematic scoping review

Background: Breast cancer become the most incident of cancer among women, especially in Indonesia. Non-pharmacological therapy becomes the additional intervention to address the pain after breast cancer surgery.
 Objective: The purpose of this study was to determine various non-pharmacological therapeutic interventions that can be performed in pain management in post-operative breast cancer patients.
 Design: The design used in this literature review is a systematic scoping review. 
 Data Sources: This study used a scoping review system where after obtaining articles from three databases there are CINAHL, Pubmed, and Proquest. 
 Review Methods: The articles will be synthesized and assessed using the clinical appraisal tools of Joanna Briggs Institute (JBI). JBI version of Randomized controlled trial. 
 Results: From the total of 577 articles searched in the database, we obtained seven articles included in the study. The interventions to reduce pain include music therapy and progressive muscle relaxation therapy, acupuncture, foot reflexology, massage and meditation, autology, mindfulness-based cognitive therapy (MBCT), and neuromuscular taping on musculoskeletal (NMT). Apart from relieving pain various interventions that can be done can improve well-being, reduce stress, and reduce the length of treatment or treatment.
 Conclusions: The result of this study can be an additional intervention that can be applied by nurses and other health care workers.

Change in effectiveness of mammography screening with decreasing breast cancer mortality: a population-based study.

BackgroundReductions in breast cancer mortality observed over the last three decades are partly due to improved patient management, which may erode the benefit-harm balance of mammography screening.MethodsWe estimated the numbers of women needed to invite (NNI) to prevent one breast cancer death within 10 years. Four scenarios of screening effectiveness (5–20% mortality reduction) were applied on 10,580 breast cancer deaths among Norwegian women aged 50–75 years from 1986 to 2016. We used three scenarios of overdiagnosis (10–40% excess breast cancers during screening period) for estimating ratios of numbers of overdiagnosed breast cancers for each breast cancer death prevented.ResultsUnder the base case scenario of 20% breast cancer mortality reduction and 20% overdiagnosis, the NNI rose from 731 (95% CI: 644–830) women in 1996 to 1364 (95% CI: 1181–1577) women in 2016, while the number of women with overdiagnosed cancer for each breast cancer death prevented rose from 3.2 in 1996 to 5.4 in 2016. For a mortality reduction of 8.7%, the ratio of overdiagnosed breast cancers per breast cancer death prevented rose from 7.4 in 1996 to 14.0 in 2016. For a mortality reduction of 5%, the ratio rose from 12.8 in 1996 to 25.2 in 2016.ConclusionsDue to increasingly potent therapeutic modalities, the benefit in terms of reduced breast cancer mortality declines while the harms, including overdiagnosis, are unaffected. Future improvements in breast cancer patient management will further deteriorate the benefit–harm ratio of screening.

Abstract 2190: Brain-seeking extracellular vesicles derived from metastatic breast cancer cells modulate brain endothelial cell metabolism

Abstract Breast cancer, particularly the triple-negative subtype, is the primary cause of brain metastasis in women and affects ~10-16% of breast cancer patients. Breast cancer patients diagnosed with brain metastasis have limited therapeutic options and, therefore, a dismal prognosis with a median survival time of ~10 months. Recent studies have suggested that metastatic cells extravasate and grow along the blood-brain barrier (BBB) in a favorable microenvironment called the pre-metastatic niche. However, the early steps leading to the onset of breast-to-brain metastasis are poorly understood, limiting the development of strategies to prevent, detect and treat premetastatic or early-stage lesions. It is now well accepted that extracellular vesicles (EVs), nanoparticles secreted from cancer cells, can travel to distant organs, activate resident cells and promote the remodeling of the extracellular matrix and significantly impact organ-specific metastatic spread. Using our mouse model of breast to brain metastasis, we have demonstrated, for the first time, that EVs derived from brain-seeking breast cancer cells (Br-EVs) breach the intact BBB via transcytosis, are taken up by astrocytes and cause a significantly increased incidence of brain metastasis. Within this context, we are studying the interactions between Br-EVs and brain endothelial cells (ECs), the latter being a key functional component of the BBB. Utilizing primary human ECs and using a transwell assay established in our laboratory as an in vitro model of the BBB, we have identified the mechanism(s) through which Br-EVs modulate EC endocytic metabolism in favor of increased vesicle recycling and transcytosis. Our mechanistic studies demonstrate that ECs treated with Br-EVs show a significant decrease of multiple target proteins, all of which are involved in the long-recycling loop of the endocytic vesicles. Br-EVs mediate, at least in part, their effect through the delivery to the target cells of a specific subset of micro RNAs. As a result, Br-EVs upregulate EC basal transcytosis rate promoting their transfer to the brain parenchyma. These findings indicate that Br-EVs can alter BBB basal metabolism and help to prepare a microenvironment, better known as the pre-metastatic niche, that promotes and sustains the survival and growth of breast cancer metastases in the otherwise hostile brain microenvironment. These results increase our understanding of the early events that facilitate breast-to-brain metastasis and have the potential to identify key regulators in the early steps of brain metastasis formation. Our mechanistic studies will also inform and contribute to the development of EV-based diagnostic and therapeutic strategies for the early management of breast cancer patients with brain metastasis. (This work was supported by NIH R21 CA253051-01 and the Breast Cancer Research Foundation). Citation Format: Sara Busatto, Golnaz Morad, Marsha Moses. Brain-seeking extracellular vesicles derived from metastatic breast cancer cells modulate brain endothelial cell metabolism [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2190.

Acute dermatitis in adult female patients receiving hypofractionated radiotherapy for breast cancer: experience from a low- and middle-income country.

Radiotherapy (RT) is an important component of treatment in the management of breast cancer patients. The radiation treatment paradigm has been shifted towards hypofractionated RT. This study aims to determine the severity of acute dermatitis in patients receiving hypofractionated RT for breast cancer at a tertiary care university hospital in Pakistan. Patients with biopsy-proven invasive breast carcinoma or DCIS who were referred for radical radiotherapy after discussion in the breast tumour board were retrospectively reviewed. Physical assessment of the patients for evaluation of the severity of radiation dermatitis will be carried out in the first week, last week and on the first follow-up after 1 month of completion of RT, according to the Radiation Therapy Oncology Group/European Organisation For Research And Treatment Of Cancer (RTOG/EORTC) criteria. We identified 92 female patients in 6 months at Aga Khan University Hospital, with a mean age of 53.1 years. Most of the treated patients had clinical stage 3 (64%) cancer, while others were stage 2 (42%), stage 1 (2%) and stage 0 (2%). The surgeries performed were mastectomy in 59 patients and breast-conserving surgery in 33 patients. Histology was Intra Ductal Carcinoma (IDC) (95%), DCIS (3%) and Invasive Lobular Carcinoma (ILC) (2%). Most of the patients received chemotherapy (96%). Radiotherapy dose was 4256 cGy in 16 fractions, followed by a boost of 10 Gy. The radiation techniques used were intensity-modulated radiotherapy (47.8%) and three-dimensional conformal radiotherapy (52.2%). Most of the patients experienced no toxicity (59%), while grade I toxicity was observed in 29% of the patients and grade II toxicity was observed in 11%. Only 1% of the patients experienced grade III skin toxicity. Hypofractionated radiation therapy is beneficial because of the shorter overall treatment time which reduces the socio-economic burden, not only for patients but also for radiotherapeutic institutions. However, extended follow-up is to be reported for long-term toxicity and other consequences.

Encuesta del Grupo de Trabajo de Cirugía Radioguiada (GTCRG) de la Sociedad Española de Medicina Nuclear e Imagen Molecular (SEMNIM): localización radioguiada de lesiones no palpables de mama con o sin indicación de biopsia selectiva de ganglio centinela: ROLL, SNOLL y semillas de 125I

ObjectiveTo know the current status of the technique of radioguided localisation of non-palpable breast lesions with or without indication for selective sentinel node biopsy -ROLL, SNOLL and 125I seeds- by conducting a national survey developed by the Working Group on Radioguided Surgery (GTCRG) of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM). Material and methodsIn October 2020, the form was sent in digital format to the different nuclear medicine services in Spain. A response time of 2months with an overtime of 15 days was given. The number of ROLL/SNOLL procedures in each centre and the methodology used were obtained, including important technical details. In addition, a specific section on 125I seeds was included. The results were automatically downloaded into an Excel 2007 spreadsheet for subsequent analysis with the same program. ResultsThe survey was answered by 55 centres; 21 use wire-guided localisation while the remaining 34 use different radioguided surgery techniques (RGS) for the localisation of non-palpable breast lesions, with the results itemized into thirteen sections. The commonly used tracer dose is 111 MBq for the ROLL technique and 222 MBq for the SNOLL technique, with a volume of 0.2ml. The most common protocol is the two-day protocol. 26% of centres performing CRG use 125I seeds for both breast lesion and suspicious/pathological node detection, with the time between implantation and removal being about 3 days, with subsequent radiological control in most cases. ConclusionThe survey shows the relevance of radioguided surgery in the management of breast cancer patients at different stages of the disease, with disparity in the implementation of new techniques and tools, which responds to the multiple healthcare realities of Nuclear Medicine services.

Using Machine Learning on Imbalanced Guideline Compliance Data to Optimize Multidisciplinary Tumour Board Decision Making for the Management of Breast Cancer Patients.

Complex breast cancer cases that need further multidisciplinary tumor board (MTB) discussions should have priority in the organization of MTBs. In order to optimize MTB workflow, we attempted to predict complex cases defined as non-compliant cases despite the use of the decision support system OncoDoc, through the implementation of machine learning procedures and algorithms (Decision Trees, Random Forests, and XGBoost). F1-score after cross-validation, sampling implementation, with or without feature selection, did not exceed 40%.

Survey of the Radioguided Surgery Working Group (GTCRG-RGSWG) of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM): Radioguided localization of non-palpable breast lesions with or without indication for selective sentinel node biopsy: ROLL, SNOLL and 125I seeds

ObjectiveTo know the current status of the technique of radioguided localisation of non-palpable breast lesions with or without indication for selective sentinel node biopsy -ROLL, SNOLL and 125I seeds- by conducting a national survey developed by the Working Group on Radioguided Surgery (GTCRG) of the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM). Material and methodsIn October 2020, the form was sent in digital format to the different nuclear medicine services in Spain. A response time of 2 months with an overtime of 15 days was given. The number of ROLL/SNOLL procedures in each centre and the methodology used were obtained, including important technical details. In addition, a specific section on 125I seeds was included. The results were automatically downloaded into an Excel 2007 spreadsheet for subsequent analysis with the same program. ResultsThe survey was answered by 55 centres; 21 use wire-guided localisation while the remaining 34 use different radioguided surgery techniques (RGS) for the localisation of non-palpable breast lesions, with the results itemized into thirteen sections. The commonly used tracer dose is 111 MBq for the ROLL technique and 222 MBq for the SNOLL technique, with a volume of 0.2 ml. The most common protocol is the two-day protocol. 26% of centres performing CRG use 125I seeds for both breast lesion and suspicious/pathological node detection, with the time between implantation and removal being about 3 days, with subsequent radiological control in most cases. ConclusionThe survey shows the relevance of radioguided surgery in the management of breast cancer patients at different stages of the disease, with disparity in the implementation of new techniques and tools, which responds to the multiple healthcare realities of Nuclear Medicine services.

Sentinel node biopsy and regional recurrence following neoadjuvant chemotherapy in patients with isolated tumor cells: A rare event.

e12581 Background: Lack of consensus exists regarding the optimal surgical axillary management of breast cancer patients treated with neoadjuvant therapy followed by sentinel node biopsy (SNB) with only isolated tumor cells (ITCs) identified in the sentinel node (SN). Few studies with limited patients have addressed this. A prospectively maintained database was reviewed to identify residual nodal metastatic burden and outcomes for patients with SN ITCs. Methods: Operable breast cancer patients treated with neoadjuvant therapy followed by breast surgery with SNB were identified who had only ITCs in the SN. Patients were excluded who had recurrent breast cancer, metastatic disease at time of operation, or who had an operation performed at another institution. Residual burden of axillary metastatic disease in patients who underwent completion axillary dissection and locoregional recurrence were examined. All SNs were examined with both hematoxylin and eosin stains as well as well as immunohistochemical stains. Results: 875 patients underwent neoadjuvant therapy followed by breast surgery and SNB from July 2007 to November 2021. Seventeen patients (1.9%) had only ITCs in the SN. The mean patient age of these 17 patients was 55.6 years (range 31-83 years). The majority had invasive ductal carcinoma (n = 15, 88.2%). Fourteen patients (82.4%) had ER+ tumors, 11 (64.7%) PR+ tumors, 2 patients (11.7%) had HER2+, and 3 patients (17.6%) had triple negative cancers. All patients had clinical T1 to T3 tumors and clinical N0 (n = 11, 64.7%), N1 (n = 5, 29.4%), or N2 (n = 1, 5.9%) disease. Two patients had isolated tumor cells identified on frozen section. Both of these patients underwent axillary dissection during the index operation and had further nodal disease identified (1 patient with ITCs only and 1 patient with macrometastasis). Fourteen patients had SN tumor free frozen sections but ultimately had ITCs identified with H&E. Five of these patients underwent a completion axillary dissection. Three of the 5 patients (60%) had additional ITCs identified after completion ALND. Fourteen patients had nodal irradiation. The three patients who did not receive irradiation did not undergo ALND. All patients with ER+ tumors received adjuvant endocrine therapy, the 2 patients with HER2+ cancers received adjuvant targeted HER2 therapy, and 4 patients received adjuvant chemotherapy. At a mean follow-up of 21.8 months (range 2-63 months), no locoregional recurrences occurred in any patient. Conclusions: ITCs in the SN after neoadjuvant therapy is a rare finding and are unlikely to be associated with regional recurrence.

Pain management practices for outpatients with breast cancer

ObjectivesPain is a significant problem in patients with breast cancer. Limited data exist regarding the nature and extent of pain management in women with breast cancer visiting outpatient settings. This study examined the pain management practices and the factors associated with prescribing pain medications among breast cancer patients. MethodsThis cross-sectional study used the National Ambulatory Medical Care Survey (NAMCS) 2011–2016, nationally representative outpatient survey data. Women (age ≥18 years) with breast cancer as the primary diagnosis were included. Weighted descriptive analyses examined national-level pain management practices, while multivariable logistic regression evaluated the factors associated with the prescribing of pain medications and opioids. ResultsThere were 23.95 million (95% confidence interval [CI], 19.29–28.60) outpatient visits for breast cancer during the study period. Pain medications were prescribed in 27.12% of these visits, with non-opioids prescribed in 17.13% and opioids in 15.16% of visits. Logistic regression analyses revealed that patients on Medicaid/other state-based insurance (odds ratio [OR] =2.38, 95% CI:1.15–4.93), those visiting general/family practice physicians (OR = 3.18, 95% CI:1.22–8.29) and patients receiving adjuvant pain medications (OR = 4.74, 95% CI: 3.10–7.24) were associated with a greater odds of receiving pain medications; while patients who were white (OR = 0.50, 95% CI:0.3–0.85), those residing in the northeast region (OR = 0.31, 95% CI: 0.10–0.99), and non-primary care provider visits (OR = 0.37, 95% CI:0.15–0.94) were associated with lower odds of receiving pain medications. Regional variations were observed among those receiving pain medications: women in the Northeast (OR = 0.06, 95% CI:0.01–0.29), Midwest (OR = 0.15, 95% CI:0.04–0.62), and South (OR = 0.24, 95% CI:0.06–0.92) regions were less likely to receive opioids. However, patients visiting general and family practice specialties (OR = 6.76, 95% CI:1.71–26.70) were more likely to prescribe opioids than non-opioids. ConclusionsThe national survey data revealed one in four women visits and one in seven office visits for breast cancer received pain medication prescriptions and opioid medications, respectively. Both patient and provider characteristics contribute to variations in pain management in breast cancer patients. Further research is needed to evaluate the long-term consequences of these variations in breast cancer.

Management of breast cancer patients during the first coronavirus pandemic: Lessons learned and future directions

Introduction: The coronavirus (COVID-19) pandemic presented significant challenges to the management of breast cancer patients. Immunosuppression from chemotherapy increases risk of COVID-19 related complications and mortality. Balancing patient safety and service provision required careful assessment. ABS released guidelines on how services should adapt. This audit aimed to assess how well guidelines were adhered to and evaluate patient outcomes.

113P Axillary lymph node management in early breast cancer patients with positive sentinel lymph node: A systematic review and meta-analysis of randomized trials

Omitting axillary lymph node dissection (ALND) in patients with early breast cancer and 1 or 2 positive sentinel lymph nodes (SLNs) is still debated especially in those undergoing mastectomy. We aim to provide updated evidence on this topic.

AB079. SOH22ABS128. Receptor change on residual disease following neoadjuvant therapies for locally advanced breast cancer fails to impact oncological and survival outcomes

Background: Conventional breast cancer patient management involves prescription of neoadjuvant therapies (NAT). The aim of this study was to evaluate the rate of receptor status change following NAT and to determine the impact of these changes on oncological and survival outcomes.

The Patient Health Engagement Model in Cancer Management: Effect of Physical Activity, Distress Management, and Social Support Intervention to Improve the Quality of Life in Breast Cancer Patients.

Background Providing better care and encouraging behaviors promoting health are effective measures to manage breast cancer patients. The present research was conducted to carry out an intervention based on the PHE model to promote physical activity, distress management, social support, and quality of life in breast cancer patients. Methods This randomized control trial study was conducted on 123 women with breast cancer and their caregivers (group 1 = 61 and group 2 = 62). Subjects entered the study from the oncology ward of a specialized clinic in Shiraz, Iran. The education was done through clips, pamphlets, and lectures in 8 sessions with a duration of 15 to 25 minutes. A posttest was carried out in the both groups in 2 times (the end and 3 months) after intervention. The SPSS25 software was used to analyze the data. Results The mean and SD of age of group 1 were (45.77 ± 8.84) and control group 2 (45.58 ± 77.64). The fiding showed a significant difference between the mean scores of distress management, social support, physical activity, and cancer self-efficacy in group 1 vs. group 2 after intervention (P < 0.001). Also, the educational intervention improved quality of life (P = 0.003). Conclusion Intervention program based on the PHE model may facilitate the cognitive, emotional, and behavioral processes in breast cancer patient. Thus, it appears that the PHE model might promote patients' quality of life.

Surgery after Neoadjuvant Chemotherapy: A Clip-Based Technique to Improve Surgical Outcomes, a Single-Center Experience

Simple SummaryNeoadjuvant chemotherapy (NACT) has an important role in the treatment of locally advanced breast cancer. After NACT, some lesions may be no longer visible at preoperative imaging, making breast and axillary conservative surgery more difficult. Among others, radiopaque clips are the most commonly used method to mark lymph nodes and tumor sites to tailor surgery in the post neoadjuvant setting.Background: This study aims to describe the surgical management of breast cancer patients after neoadjuvant chemotherapy, with attention to the impact on surgical outcomes of a clip-based marking technique. Methods: Patients who underwent NACT at the Breast Unit of the A. O Ordine Mauriziano of Turin from January 2018 and had a surgical intervention by January 2022 were included. Data on the feasibility of clip insertion, after-treatment visibility, and successful removal during surgery were collected prospectively. Surgical outcomes in terms of breast-conserving surgery and axillary dissection reduction were described. Results: In 51 patients who had surgery after NACT, 55 clips were placed (34 breast and 21 axillary clips). Ultrasound visibility of the clips was optimal (91%) as well as preoperative localization and retrieval within the surgical specimen. Moreover, the use of the clip positively affected surgical outcomes. In our study, clip insertion allowed to avoid mastectomy and axillary dissection in patients with a complete radiological response. Conclusions: In our findings, the use of breast and/or lymph node clips has proved to be a simple and effective method to improve surgical conservative management of breast cancer patients after NACT.

Osteopathy as a complementary/alternative medicine for breast cancer: a Canadian case study and comprehensive review

Aim: In Canada, osteopathic medicine, a well-known branch of complementary/alternative medicine, has received minimal attention for pain management within oncology. Purpose: This review reports both the existing literature and patient experience surrounding the application of osteopathy as an effective treatment for pain in breast cancer patients. Results: Both the literature and this case study support, to some degree, the benefits of osteopathy as pain management for breast cancer patients. Conclusion: Due to contradictory reported findings, more studies would be required to make firm conclusions, especially within a Canadian context. However, a lack of standardization of osteopathic procedures and collaboration between osteopaths and traditional healthcare professionals are challenges in including osteopathy as a standard service offered to breast cancer patients.