Joint pain and falls among women with breast cancer on aromatase inhibitors Journal Article


Authors: Basal, C.; Vertosick, E.; Gillis, T. A.; Li, Q.; Bao, T.; Vickers, A.; Mao, J. J.
Article Title: Joint pain and falls among women with breast cancer on aromatase inhibitors
Abstract: Purpose: Arthralgia is common among women with breast cancer on adjuvant aromatase inhibitor (AI) therapy. Pain is associated with falls in the general population; however, little is known about the relationship between arthralgia and falls among AI users. Our objective was to determine whether joint pain severity and interference predict future falls. Methods: We conducted a prospective cohort study of postmenopausal women with stage I-III estrogen receptor-positive breast cancer who were prescribed a third-generation AI. Arthralgia symptoms were measured at baseline using a modified version of the Brief Pain Inventory. Fall occurrence was obtained at 24-month follow-up. Results: Among 667 participants (median age 63 years, interquartile range 57–69 years), 232 (35%, 95% CI 31 to 39%) reported falls 12–24 months after baseline. Among women who fell, 65 (28%) reported seeking medical assistance. After controlling for multiple fall risk factors, we found significant non-linear associations between baseline joint pain severity and risk of falls (p = 0.001). Women with joint pain severity scores ≥ 4 had a more than twofold increase in fall risk compared to those without pain (41% vs. 20%). We observed a similar relationship for pain interference and fall risk (p < 0.001). Fewer than half of participants reported having been asked about falls in the past 12 months by their primary care physician (44%) or oncologist (36%). Conclusion: Joint pain increases the risk of falls among women with breast cancer on adjuvant AI therapy. Health care providers should evaluate and manage arthralgia symptoms and implement fall-prevention strategies for those who are at increased risk. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
Keywords: adult; cancer chemotherapy; controlled study; aged; cancer surgery; major clinical study; cancer radiotherapy; cancer staging; follow up; prospective study; breast cancer; mastectomy; cohort analysis; cancer survivor; exemestane; arthralgia; questionnaire; letrozole; anastrozole; postmenopause; general practitioner; aromatase inhibitors; lumpectomy; falling; brief pain inventory; oncologist; help seeking behavior; estrogen receptor positive breast cancer; falls; human; female; priority journal; article; numeric rating scale; fall risk; joint pain; pain severity
Journal Title: Supportive Care in Cancer
Volume: 27
Issue: 6
ISSN: 0941-4355
Publisher: Springer Verlag  
Date Published: 2019-06-01
Start Page: 2195
End Page: 2202
Language: English
DOI: 10.1007/s00520-018-4495-4
PUBMED: 30306326
PROVIDER: scopus
PMCID: PMC6758909
DOI/URL:
Notes: Article -- Export Date: 3 June 2019 -- Source: Scopus
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Citation Impact
MSK Authors
  1. Andrew J Vickers
    617 Vickers
  2. Ting   Bao
    33 Bao
  3. Jun J Mao
    100 Mao
  4. Coby R Basal
    2 Basal
  5. Qing Susan Li
    30 Li
  6. Theresa Ann Gillis
    1 Gillis