Purpose: Endocrine therapy (Tamoxifen and Aromatase Inhibitors (AI): Letrozole, Anastrozole and Exemestane) in breast cancer have reduced the risk of recurrence and improve survival. But they can cause more broken bones and more joint pain (approximately one in two women). These chronic pains can become disabling and could have a negative impact on the patients’ quality of life and emotional state. However the specific impact of arthralgia with AI was little studied. The present cross-sectional and quantitative study explored links between arthralgia, quality of life, adherence to AI, emotional state and particularly fear of recurrence which is frequent after treatment for breast cancer.
Methods: Participants treated for breast cancer and currently under AI were recruited at the French Cancer Center Gustave Roussy Institute (N=71). They all signed written informed consent to participate to this prospective study. Patients responded to self-reported questionnaires about their pain (intensity with EVA and location) on psychological adjustment (STAI YA/YB, BDI-SF), quality of life (SF-36) and fear of recurrence of cancer (FCRI).

Results: Among the 71 women included, 70% reported having arthralgia. These women had a lower quality of life and poorer emotional state than women without pain. Only 48% of them reported taking analgesic medication. Half of the 71 patients have fear of recurrence which was associated with depression and anxiety symptoms and particularly with anxiety trait. This confirms its proximity with anxiety disorder. One third had thought to stop treatment because of side effects (particularly arthralgia).

Conclusion: Arthralgia is a frequent side effect of AI which needs a better management including mood and fear of recurrence evaluation. The fear of recurrence can be intense, pathological, and so can required a specific management like cognitive behavioural therapy.