Joint pain and falls among women with breast cancer on aromatase inhibitors
Menée auprès de 667 patientes atteintes d'un cancer du sein ER+ de stade I à III (âge médian : 63 ans), cette étude de cohorte prospective évalue le risque de chutes liées à la sévérité des douleurs articulaires induites par un traitement adjuvant par inhibiteurs de l'aromatase (durée de suivi : 24 mois)
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.