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Although studies demonstrate the sensitivities and specificities of the individual methods, there are
no studies on the influence of the selected methods on survival depending on treatment changes or
quality of life. By not examining pain free patients from the first follow-up, however, this study
probably underestimated the prevalence of patients with treatment related pain as the present study
shows dynamics in persistent pain after treatment. Tryggvadottir L, Gislum M, Bray F, Klint A,
Hakulinen T, Storm HH, et al. Linkage between the different registers is possible because of a unique
civil registration number assigned to all Danish citizens. Restoring body image after cancer (ReBIC):
results of a randomized controlled trial. This care includes surveillance for cancer recurrence with a
history and physical examination every three to six months for the first three years after treatment,
every six to 12 months for two more years, and annually thereafter. If you provide content to
customers through CloudFront, you can find steps to troubleshoot and help prevent this error by
reviewing the CloudFront documentation. The 2008 study did not find a relation between increasing
pain intensity and young age when it looked at women with moderate or severe pain compared with
those with light pain. 14 The difference in the two studies is probably caused by different methods of
interpreting pain severity. Gallen International Expert Consensus on the Primary Therapy of Early
Breast Cancer 2011. We excluded year of surgery from all multivariate models and endocrine
therapy from all pain models as these were not associated with the outcomes in the univariate
analyses. In the absence of a genetic syndrome, there is no indication for enhanced screening for
these other cancers. Prevention and monitoring of cardiac dysfunction in survivors of adult cancers:
American Society of Clinical Oncology clinical practice guideline. Five-year follow-up of a
randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia.
Design Repeated cross sectional study in a previously examined nationwide cohort. A difference of
at least 2 in pain reporting was considered clinically relevant according to the IMMPACT
recommendations. 22 We subsequently performed multivariate logistic regression analysis to examine
the influence of treatment modalities and age on pain progression of ?2. Vaginal dryness is treated
with vaginal lubricants and gels. Core outcome measures for chronic pain clinical trials: IMMPACT
recommendations. Another study, by Peuckmann and colleagues, looked at persistent pain in long
term breast cancer survivors. 7 They found that 29% experienced persistent pain after treatment and
47% had paraesthesia 5-10 years after treatment. In the present study, 389 (36%) of these women no
longer reported persistent pain after treatment. Effect of complex decongestive therapy on edema and
the quality of life in breast cancer patients with unilateral lymphedema. Lymphology.
2007;40(3):143-151. The median age for the cohort was 64 (range 33-77). Looking at pain
progression and regression, 277 (11%) women reported a pain increase of ?2 on the numerical rating
scale, and 488 (20%) reported a pain decrease of ?2. Radiotherapeutic approaches consist of
hypofractionated applications. This requires that patients be provided with differentiated information,
particularly if the expected benefit is only slight. However, this only applies if the indicated adjuvant
treatment measures (systemic treatment and radiotherapy with boost) are carried out ( 8 ). Pain and
functional impairment 6 years after inguinal herniorrhaphy. Dominik Meier, Ron Kikinis February
2010. Overview. takes how long to do. The most common subtype, postmastectomy pain syndrome
(PMPS), lasts at least three months. Discussion In this nationwide follow-up study, over a third of
women treated for primary breast cancer reported persistent pain after treatment five to seven years
after treatment and half reported sensory disturbances. Of the remaining population, 2411
questionnaires (89%) had been returned by 8 May 2012.
Breast Cancer Treatment detection and Cure Breast Cancer Treatment detection and Cure breast
cancer breast cancer BREAST CANCER.pptx BREAST CANCER.pptx Breast Cancer 2021 Breast
Cancer 2021 1. A prospective cohort study. Ann Surg. 2011;253(1):101-108. C 9 Nonhormonal
treatments should be used to manage hot flashes in breast cancer survivors. Although studies
demonstrate the sensitivities and specificities of the individual methods, there are no studies on the
influence of the selected methods on survival depending on treatment changes or quality of life. All
eligible women who underwent surgery for primary breast cancer in Denmark in 2005 and 2006 and
were examined in 2008 were surveyed again with the same questionnaire. Among those who had
pain, 705 (78% of women with pain) also had sensory disturbances in contrast with 492 (33%) of
women with no pain but with sensory disturbances. Patients who develop lymphedema should be
referred to a lymphedema therapist. For women who want pharmacologic treatment, selective
serotonin reuptake inhibitors, the serotonin-norepinephrine reuptake inhibitor venlafaxine, and
gabapentin (Neurontin) are preferred medications. 2, 11, 12 Physicians should consider each
medication's adverse effects when deciding which one is most appropriate for individual patients. Of
the remaining population, 2411 questionnaires (89%) had been returned by 8 May 2012. KGA and
MKM wrote the first draft of the article, and all authors approved the final version. Highlights in the
Management of Breast Cancer. “Taxanes vs Anthra-containing chemotherapy in the treatment of
early-BC and the issue of cardiac toxicity”. Tools for determining risk are available in the U.S.
Preventive Services Task Force guideline at. Among those reporting pain, 203 (22%) used analgesics:
181 women used weak analgesics, 40 used opioids, and 16 used other analgesics (such as gabapentin,
amitriptyline, pregabalin). Approximately 80% of recommendations were identified as needing
revision and thus adapted in accordance with the AWMF rules for guidelines. Gallen International
Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Younger women are
particularly affected by declines in body image. 49, 50. An update on cancer- and chemotherapy-
related cognitive dysfunction: current status. Reliability and responsiveness of three different pain
assessments. In the case of severe side effects that reduce therapy adherence, a swap from an
aromatase inhibitor to tamoxifen and vice versa or between aromatase inhibitors (steroidal vs.
Suggested recommendations were then proposed by interdisciplinary working groups and modified
and graded in a nominal consensus procedure. In contrast, 15% of the women who did not report
pain in 2008 reported it in 2012. The associations between severity of early postoperative pain,
chronic postsurgical pain and plasma concentration of stable nitric oxide products after breast
surgery. Breast Cancer Prevention The Genesis Prevention Centre Breast cancer rates in UK and
worldwide. We can't connect to the server for this app or website at this time. Interpreting the
clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT
recommendations. Bisphosphonates and other bone agents for breast cancer. Data on mortality were
retrieved from the Danish Civil Registration System. Adjusted odds ratios and 95% confidence
intervals were calculated and the Wald ? 2 test was used to test the overall significance of each
parameter. Chronic pain-related disability and use of analgesia and health services in a Sydney
community.
Surveillance and beliefs about follow-up care among long-term breast cancer survivors: a comparison
of primary care and oncology providers. Young age has consistently been shown to be a predictive
factor for persistent pain after treatment for breast cancer, 4 as well as a predictive factor for both
acute and persistent postsurgical pain in general. 29 30 Our study shows young age to be a risk factor
for long term persistent pain after treatment, moderate to severe pain on at least a weekly basis, and
sensory disturbances. The German S3 guideline of 2012 has now been updated to take account of
advances in the early detection, diagnostic evaluation, treatment, and follow-up care of this disease.
Determination of moderate-to-severe postoperative pain on the numeric rating scale: a cut-off point
analysis applying four different methods. NOTE: We only request your email address so that the
person you are recommending the page to knows that you wanted them to see it, and that it is not
junk mail. Tryggvadottir L, Gislum M, Bray F, Klint A, Hakulinen T, Storm HH, et al. For the
purposes of updating the guideline, recommendations were adopted and recommendation grades
defined during two consensus conferences using a formal consensus process. Discussion In this
nationwide follow-up study, over a third of women treated for primary breast cancer reported
persistent pain after treatment five to seven years after treatment and half reported sensory
disturbances. Of these, 378 (16%) reported pain of ?4 on a numerical rating scale (scale 0-10), a fall
from 19%. OpenUrl CrossRef PubMed Web of Science View Abstract. Among these, 331 (25%) no
longer reported sensory disturbances in 2012. Adjusted odds ratios and 95% confidence intervals
were calculated and the Wald ? 2 test was used to test the overall significance of each parameter.
Dominik Meier, Ron Kikinis February 2010. Overview. takes how long to do. Evidence-based
interventions for cancer- and treatment-related cognitive impairment. Among those who reported
persistent pain after treatment for breast cancer, 469 (53%) also reported pain in other parts of the
body compared with 358 (25%) in women without pain after treatment. Comorbidity and survival of
Danish breast cancer patients from 1995 to 2005. C 2, 9, 12 Primary care physicians should monitor
breast cancer survivors for signs and symptoms of cardiotoxicity. The most common subtype,
postmastectomy pain syndrome (PMPS), lasts at least three months. Core outcome measures for
chronic pain clinical trials: IMMPACT recommendations. Table 3 shows the frequency and severity
of pain in the four areas ?:195 (22%) women reported pain in all areas, 228 (25%) had pain in three
areas, 270 (30%) had pain in two areas, and 208 (23%) had pain in only one area. Management of
urogenital atrophy in breast cancer patients: a systematic review of available evidence from
randomized trials. The action you just performed triggered the security solution. This care includes
surveillance for cancer recurrence with a history and physical examination every three to six months
for the first three years after treatment, every six to 12 months for two more years, and annually
thereafter. Of women who undergo axillary node dissection, the cumulative incidence of
lymphedema is 41% at 10 years. 2, 29. There is also a greater incidence of lymphedema in patients
receiving axillary lymph node dissection vs. Of these, 119 (64%) had developed light pain, 56 (30%)
moderate pain, and nine (5%) severe pain (table 6 ? ). Add all the information that you consider
important in the design, it’s 100% editable and will give you all the creative freedom you need. The
need to update the guideline also arises from the emergence of new scientific knowledge. Long-term
follow-up of breast cancer survivors with post-mastectomy pain syndrome. Duke Clinical Research
Institute, Durham, NC: Guidelines Development Group 2014.
NCCN Task Force report: bone health in cancer care. Chronic pain-related disability and use of
analgesia and health services in a Sydney community. Unleashing the Power of AI Tools for
Enhancing Research, International FDP on. Goldhirsch A, Wood WC, Gelber RD, Coates AS,
Thurlimann B, Senn HJ. We excluded year of surgery from all multivariate models and endocrine
therapy from all pain models as these were not associated with the outcomes in the univariate
analyses. Pregnancy and breastfeeding are protective against breast cancer. Prevention and
management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American
Society of Clinical Oncology clinical practice guideline summary. Risk factors for having pain were
axillary lymph node dissection rather than sentinel lymph node biopsy (odds ratio 2.04, 95%
confidence interval 1.60 to 2.61; P Conclusions Persistent pain after treatment for breast cancer
remains an important problem five to seven years later. Estimating adjusted NNT measures in logistic
regression analysis. In 2008, with a mean follow-up of 26 months, a questionnaire was sent to 3754
eligible patients and returned by 3253 (87%). 14 The present questionnaire study was a follow-up of
the same cohort in 2012, at which time 2828 of the 3253 patients were eligible in the Danish Breast
Cancer Cooperative Group (DBCG) database, 15 according to the inclusion and exclusion criteria
below. The present study has some limitations as to what a woman with breast cancer might expect
in the future. Because neuropathic pain may be resistant to opioid analgesia, there is little or no role
for chronic opioid use in patients with PMPS. Gerbershagen HJ, Rothaug J, Kalkman CJ, Meissner
W. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials:
IMMPACT recommendations. Patients with treatment-induced menopause develop decreased bone
density and should receive dual energy x-ray absorptiometry and pharmacologic and
nonpharmacologic therapies. Among women who reported persistent pain after treatment in 2008,
36% no longer reported it in 2012, and 48% of the patients who reported moderate to severe pain on
at least a weekly basis in 2008 did not report it in 2012. They may be due to side effects of treatment
or completely unrelated to your condition. MEEQAT HOSPITAL Breast Cancer Treatment detection
and Cure Breast Cancer Treatment detection and Cure Wpratikhsahospital breast cancer breast
cancer Acharjee Mahasweta BREAST CANCER.pptx BREAST CANCER.pptx CherryAnnBaal
Breast Cancer 2021 Breast Cancer 2021 EMMANUEL AKOMANIN ASIAMAH 1. Looking at pain
progression and regression, 277 (11%) women reported a pain increase of ?2 on the numerical rating
scale, and 488 (20%) reported a pain decrease of ?2. The median age for the cohort was 64 (range
33-77). There is also a greater incidence of lymphedema in patients receiving axillary lymph node
dissection vs. Therefore it is likely that the prevalence of persistent pain after treatment for breast
cancer was slightly underestimated and the decline in prevalence of pain overestimated. Long-term
follow-up of breast cancer survivors with post-mastectomy pain syndrome. Data on mortality were
retrieved from the Danish Civil Registration System. Consistent implementation of the guideline
recommendations makes it possible to optimize quality along the treatment chain (Table) and can lead
to a reduction in the morbidity and mortality of breast cancer. Gartner R, Jensen MB, Kronborg L,
Ewertz M, Kehlet H, Kroman N. Incidence and risk factors of lymphedema after breast cancer
treatment: 10 years of follow-up. Breast. 2017;36:67-73. Excludes 1086 women who reported no
pain in 2008 and in 2012 Download figure. Impaired cognition after chemotherapy is also common;
treatment includes cognitive rehabilitation therapy. A local boost radiation dose to the tumor bed
reduces the rate of local recurrence in the breast, without conferring a significant survival benefit
(cumulative incidence, 10.2% with vs. 6.2% without boost) ( 29 ).
Women aged over 70 years should be given the option to undergo screening taking into consideration
their individual risk profile and health status, as well as a life expectancy of more than 10 years.
Therefore it is likely that the prevalence of persistent pain after treatment for breast cancer was
slightly underestimated and the decline in prevalence of pain overestimated. Hormonal receptors
discrepancy around 40% Also different profile for HER-2 marker Most of the studies are
retrospectives on design. Dworkin RH, Turk DC, Farrar JT, Haythornthwaite JA, Jensen MP, Katz
NP, et al. Rapid and profound bone loss may occur as a result of chemotherapy-induced ovarian
failure or ovarian suppression from adjuvant therapies such as aromatase inhibitors. 23. Several
studies have found radiation treatment to be a risk factor for persistent pain after treatment,
including the previous study from 2008. 4 14 Furthermore, some studies suggested that women with
breast cancer who undergo radiotherapy have a lifelong risk of developing brachial plexus
neuropathy. 35 36 Surprisingly radiotherapy was no longer a risk factor for having either persistent
pain after treatment or sensory disturbances in our follow-up study. Review data on management of
primary tumor in setting of metastatic disease. A subgroup analysis looking at pain reporting in 2008
among the 2411 respondents from the present study showed that radiotherapy was not significantly
associated with pain, unlike the whole cohort in 2008, 14 suggesting that our results might either
have been influenced by selection bias or that women with pain in relation to radiotherapy have been
excluded because of death or cancer recurrence. There is also a greater incidence of lymphedema in
patients receiving axillary lymph node dissection vs. Cognitive training for improving executive
function in chemotherapy-treated breast cancer survivors. Dworkin RH, Turk DC, Wyrwich KW,
Beaton D, Cleeland CS, Farrar JT, et al. Immunohistochemistry discrepancy between prymary tumor
and metastases. Risk of ischemic heart disease in women after radiotherapy for breast cancer. Putting
evidence into practice: evidence-based interventions for hot flashes resulting from cancer therapies.
A meta-analysis reported that local recurrence was diagnosed in 9.8% with tumor-free margins of 1
mm, in 4.9% with 2 mm, and 4.4 % with 5 mm and described no significant association ( 8 ). There
might be too much traffic or a configuration error. In the case of severe side effects that reduce
therapy adherence, a swap from an aromatase inhibitor to tamoxifen and vice versa or between
aromatase inhibitors (steroidal vs. The immunohistochemically determined markers ER, PgR, HER-2,
and Ki-67 are considered surrogate parameters for the molecular subtypes ( 33 ). Furthermore, 16%
reported moderate to severe pain on at least a weekly basis. MEEQAT HOSPITAL Breast Cancer
Treatment detection and Cure Breast Cancer Treatment detection and Cure Wpratikhsahospital
breast cancer breast cancer Acharjee Mahasweta BREAST CANCER.pptx BREAST CANCER.pptx
CherryAnnBaal Breast Cancer 2021 Breast Cancer 2021 EMMANUEL AKOMANIN ASIAMAH 1.
Radiotherapeutic approaches consist of hypofractionated applications. The median age for the cohort
was 64 (range 33-77). Predictors of postoperative pain and analgesic consumption: a qualitative
systematic review. In 2008, with a mean follow-up of 26 months, a questionnaire was sent to 3754
eligible patients and returned by 3253 (87%). 14 The present questionnaire study was a follow-up of
the same cohort in 2012, at which time 2828 of the 3253 patients were eligible in the Danish Breast
Cancer Cooperative Group (DBCG) database, 15 according to the inclusion and exclusion criteria
below. Factors influencing the effect of age on prognosis in breast cancer: population based study.
Tools for determining risk are available in the U.S. Preventive Services Task Force guideline at. By
contacting your healthcare team they will be able to advise and reassure you. Kroman N, Jensen MB,
Wohlfahrt J, Mouridsen HT, Andersen PK, Melbye M. Main outcome measures Prevalence, location,
and severity of persistent pain after treatment for breast cancer in well defined treatment groups and
changes in pain reporting and sensory disturbances from 2008 to 2012. Bajrovic A, Rades D,
Fehlauer F, Tribius S, Hoeller U, Rudat V, et al.
Another study, by Peuckmann and colleagues, looked at persistent pain in long term breast cancer
survivors. 7 They found that 29% experienced persistent pain after treatment and 47% had
paraesthesia 5-10 years after treatment. Furthermore, the study was a follow-up of a previously well
studied cohort, and we used the same methods of questioning. Immunohistochemistry discrepancy
between prymary tumor and metastases. Neuropsychologic impact of standard-dose systemic
chemotherapy in long-term survivors of breast cancer and lymphoma. In our study, we considered it
more clinically meaningful to include the temporal aspect of pain and to compare women with more
severe pain with the entire cohort. The optimal duration of denosumab therapy is unclear, but
durations of up to 24 months have been studied. 24, 25 Of note, the use of bisphosphonates may be
associated with a lower risk of metastatic disease in patients with early breast cancer. 26. The health
of older-adult, long-term cancer survivors. This care includes surveillance for cancer recurrence with
a history and physical examination every three to six months for the first three years after treatment,
every six to 12 months for two more years, and annually thereafter. Bisphosphonates and other bone
agents for breast cancer. A difference of at least 2 in pain reporting was considered clinically
relevant according to the IMMPACT recommendations. 22 We subsequently performed multivariate
logistic regression analysis to examine the influence of treatment modalities and age on pain
progression of ?2. However, echocardiography should be considered six to 12 months after breast
cancer treatment in asymptomatic patients at high risk of cardiotoxicity (e.g., those who received
high-dose anthracycline chemotherapy, trastuzumab or low-dose anthracyclines in combination with
cardiac risk factors or radiation therapy with the heart in the treatment field, or high-dose radiation
with the heart in the treatment field). 17. Patients should also be educated about the signs and
symptoms of local recurrence. 2. To this end, source guidelines developed specifically for breast
cancer patients were researched. Among women reporting pain in 2008, 36% no longer reported it in
2012. Persistent postmastectomy pain in breast cancer survivors: analysis of clinical, demographic,
and psychosocial factors. J Pain. 2013;14(10):1185-1195. Table 7 ?Multivariate logistic regression
analysis of effect of methods of treatment and age on sensory disturbances in women after treatment
for breast cancer. Estimating adjusted NNT measures in logistic regression analysis. Health-related
quality of life in survivors with breast cancer 1 year after diagnosis compared with the general
population. American Society for Radiation Oncology Do not perform surveillance testing
(biomarkers) or imaging (positron emission tomography, computed tomography, and radionuclide
bone scans) for asymptomatic individuals who have been treated for breast cancer with curative
intent. Effect of complex decongestive therapy on edema and the quality of life in breast cancer
patients with unilateral lymphedema. Lymphology. 2007;40(3):143-151. Prevention and management
of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of
Clinical Oncology clinical practice guideline summary. Of women who undergo axillary node
dissection, the cumulative incidence of lymphedema is 41% at 10 years. 2, 29. Unleashing the Power
of AI Tools for Enhancing Research, International FDP on. Hormonal receptors discrepancy around
40% Also different profile for HER-2 marker Most of the studies are retrospectives on design.
However, this only applies if the indicated adjuvant treatment measures (systemic treatment and
radiotherapy with boost) are carried out ( 8 ). Carol Marquez, M.D. Associate Professor Department
of Radiation Medicine OHSU. Reliability and responsiveness of three different pain assessments.
Timescale of evolution of late radiation injury after postoperative radiotherapy of breast cancer
patients. OpenUrl PubMed ? Lundeberg T, Lund I, Dahlin L, Borg E, Gustafsson C, Sandin L, et al.
Radiotherapeutic approaches consist of hypofractionated applications.
Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT
recommendations. Trial registration Clinicaltrials.gov NCT No 01543711. Introduction Breast cancer
is the most common cancer in women worldwide with more than a million new cases diagnosed
every year. 1 The prognosis has improved considerably over the past 30 years, and the five year
overall survival of patients with a diagnosis of primary breast cancer has increased to about 85%. 2 3
Consequently, the population of long term survivors is increasing, emphasising the need for
knowledge on long term sequelae. Body image in younger breast cancer survivors: a systematic
review. Although studies demonstrate the sensitivities and specificities of the individual methods,
there are no studies on the influence of the selected methods on survival depending on treatment
changes or quality of life. The action you just performed triggered the security solution. Gartner R,
Jensen MB, Kronborg L, Ewertz M, Kehlet H, Kroman N. Conclusion: Consistent implementation of
the recommendations in the newly updated guideline can help lessen morbidity and mortality from
breast cancer. Ethical approval: The study was approved by the Data Protection Agency No 2007-41-
1530, and the regional bioethics committee of the capital region in Denmark, H-D-2007-0099 Data
sharing statement: No additional data available. A systematic search in multiple literature databases
was carried out, and the full texts of the selected articles were evaluated. These symptoms do not
necessarily mean the cancer has returned. Exclusion criteria were death; new, recurrent, or other
cancer; reconstructive breast surgery; and emigration. JANE TUCKER, MD, is medical director and
an assistant professor in the Department of Family and Community Medicine at Saint Louis
University School of Medicine. The number needed to be exposed to axillary lymph node dissection
instead of sentinel lymph node biopsy to have one more woman with long term persistent pain after
treatment for breast cancer was 6.12 (95% confidence interval 4.53 to 9.43). The exposure impact
number was 6.25 (4.73 to 9.20). Surgical procedure in the breast, radiotherapy, and chemotherapy
were not significantly associated with pain. Post-breast cancer lymphedema: incidence increases
from 12 to 30 to 60 months. Lymphology. 2010;43(3):118-127. Review data on management of
primary tumor in setting of metastatic disease. Restoring body image after cancer (ReBIC): results of
a randomized controlled trial. Main outcome measures Prevalence, location, and severity of
persistent pain after treatment for breast cancer in well defined treatment groups and changes in pain
reporting and sensory disturbances from 2008 to 2012. Suggested recommendations were then
proposed by interdisciplinary working groups and modified and graded in a nominal consensus
procedure. The Surveillance and Management of Inherited Breast Cancer. Overview. Introduction
Increased risk groups Consideration of genetic testing Management of patients with mutation
Follow-up. A meta-analysis reported that local recurrence was diagnosed in 9.8% with tumor-free
margins of 1 mm, in 4.9% with 2 mm, and 4.4 % with 5 mm and described no significant association
( 8 ). All eligible women who underwent surgery for primary breast cancer in Denmark in 2005 and
2006 and were examined in 2008 were surveyed again with the same questionnaire. Amitriptyline
effectively relieves neuropathic pain following treatment of breast cancer. Pain. 1996;64(2):293-302.
Data on mortality were retrieved from the Danish Civil Registration System. However, only around
50% of women with breast cancer adhere to treatment over the recommended 5-year period. Current
doses and techniques of radiation therapy for breast cancer do not appear to increase cardiovascular
toxicity. 16 Breast cancer survivors should continue to receive regular age-appropriate cardiovascular
risk screening and risk factor reduction according to the U.S. Preventive Services Task Force and
other guidelines. Another study, by Peuckmann and colleagues, looked at persistent pain in long
term breast cancer survivors. 7 They found that 29% experienced persistent pain after treatment and
47% had paraesthesia 5-10 years after treatment. A difference of at least 2 in pain reporting was
considered clinically relevant according to the IMMPACT recommendations. 22 We subsequently
performed multivariate logistic regression analysis to examine the influence of treatment modalities
and age on pain progression of ?2. C 2, 9, 12 Primary care physicians should monitor breast cancer
survivors for signs and symptoms of cardiotoxicity. Results: The value of mammographic screening is
confirmed in the updated guideline. NCCN Task Force report: bone health in cancer care.