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Pain varies among women with late-stage breast cancer

Women of races other than white who have advanced breast cancer suffer more pain than white women with the same condition, a recent study finds. Researchers studied 1,124 women with Stage IV, or metastatic, breast cancer over the course of a year. They asked the women to rate their pain on a scale of 0 to 10, with 10 being the worst pain imaginable. Next, they compared the scores of 991 white women with 133 women from other races to determine which group of women more often scored 7 or higher on the Basic Pain Inventory. This scale was designed to measure the intensity of pain patients experience and how that pain interferes in their lives.

In addition to race, several other factors served as predictors of pain. Women who were inactive and embarking on radiation treatment were likely to score high on the pain scale. The authors suggest that women about to start radiation treatments were likely to have bone cancer, a very painful condition, and probably needed the treatments for more severe pain and tumor control. Further, many young women reported that their pain interfered with their daily lives. Demands such as motherhood or work, coupled with their illness, could explain this group's higher pain levels.

This study's findings support other studies that found that women of races other than white are at a high risk for being undertreated for pain. Although physicians rely on patients' candor, they should understand that minority patients may not report pain for fear of being labeled an addict or because of cultural values, the authors state. This study was funded in part by the Agency for Healthcare Research and Quality (T32 HS00032).

See "Racial differences in pain during 1 year among women with metastatic breast cancer: A hazards analysis of interval-censored data," by Liana D. Castel, Ph.D., Benjamin R. Saville, M.S., Venita DePuy, M.Stat., and others in the January 1, 2008, Cancer 112(1), pp. 162-170.

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