Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients
Background: Pain after breast cancer surgery remains largely unexplained and inconsistently quantified. This study aims to describe the perioperative pain patterns in patients with breast cancer, up to two years after surgery. Methods: This is a pre-planned sub-study of the Ketorolac in Breast Cance...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/12/3831 |
| _version_ | 1797546687393169408 |
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| author | Patrice Forget Taalke M. Sitter Rosemary J. Hollick Diane Dixon Aline van Maanen Alain Dekleermaker Francois P. Duhoux Marc De Kock Martine Berliere on behalf of the KBCt Group |
| author_facet | Patrice Forget Taalke M. Sitter Rosemary J. Hollick Diane Dixon Aline van Maanen Alain Dekleermaker Francois P. Duhoux Marc De Kock Martine Berliere on behalf of the KBCt Group |
| author_sort | Patrice Forget |
| collection | DOAJ |
| description | Background: Pain after breast cancer surgery remains largely unexplained and inconsistently quantified. This study aims to describe the perioperative pain patterns in patients with breast cancer, up to two years after surgery. Methods: This is a pre-planned sub-study of the Ketorolac in Breast Cancer (KBC) trial. The KBC trial was a multicentre, prospective, double-blind, placebo-controlled, randomised trial of a single dose of 30 mg of ketorolac just before breast cancer surgery, aiming to test its effect on recurrences. This sub-study focuses only on pain outcomes. From 2013 to 2015, 203 patients were randomised to ketorolac (<i>n</i> = 96) or placebo (<i>n</i> = 107). Structured questionnaires were delivered by telephone after one and two years, exploring the presence, location, permanence, and frequency of pain. Patients’ perceptions of pain were captured by an open-ended question, the responses to which were coded and classified using hierarchical clustering. Results: There was no difference in pain between the ketorolac and the placebo group. The reported incidence of permanent pain was 67% and 45% at one and two years, respectively. The largest category was musculoskeletal pain. Permanent pain was mainly described in patients with musculoskeletal pain. The description of pain changed in most patients during the second postoperative year, i.e., moved from one category to another (no pain, permanent, or non-permanent pain, but also, the localisation). This phenomenon includes patients without pain at one year. Conclusions: Pain is a complex phenomenon, but also a fragile and unstable endpoint. Pain after breast cancer surgery does not necessarily mean breast pain but also musculoskeletal and other pains. The permanence of pain and the pain phenotype can change over time. |
| first_indexed | 2024-03-10T14:32:46Z |
| format | Article |
| id | doaj.art-26734734d950407cb2b593a31563f2e5 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T14:32:46Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-26734734d950407cb2b593a31563f2e52023-11-20T22:25:38ZengMDPI AGJournal of Clinical Medicine2077-03832020-11-01912383110.3390/jcm9123831Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer PatientsPatrice Forget0Taalke M. Sitter1Rosemary J. Hollick2Diane Dixon3Aline van Maanen4Alain Dekleermaker5Francois P. Duhoux6Marc De Kock7Martine Berliere8on behalf of the KBCt GroupInstitute of Applied Health Sciences, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UKInstitute of Applied Health Sciences, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UKInstitute of Applied Health Sciences, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UKInstitute of Applied Health Sciences, Health Psychology, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UKBiostatistics Unit, King Albert II Institute, Cliniques universitaires Saint-Luc, 1200 Brussels, BelgiumClinical Pharmacology Unit, Cliniques universitaires Saint-Luc, 1200 Brussels, BelgiumInstitut Roi Albert II, Service d’Oncologie Médicale, Cliniques universitaires Saint-Luc and Institut de Recherche Expérimentale et Clinique (POLE MIRO), UCLouvain, 1200 Brussels, BelgiumDepartment of Anesthesiology, Centre Hospitalier Wallonie Picarde (CHWAPI), 7500 Tournai, BelgiumDepartment of Gynecology, Breast Clinic, King Albert II Institute, Cliniques universitaires Saint-Luc, UCLouvain, 1200 Brussels, BelgiumBackground: Pain after breast cancer surgery remains largely unexplained and inconsistently quantified. This study aims to describe the perioperative pain patterns in patients with breast cancer, up to two years after surgery. Methods: This is a pre-planned sub-study of the Ketorolac in Breast Cancer (KBC) trial. The KBC trial was a multicentre, prospective, double-blind, placebo-controlled, randomised trial of a single dose of 30 mg of ketorolac just before breast cancer surgery, aiming to test its effect on recurrences. This sub-study focuses only on pain outcomes. From 2013 to 2015, 203 patients were randomised to ketorolac (<i>n</i> = 96) or placebo (<i>n</i> = 107). Structured questionnaires were delivered by telephone after one and two years, exploring the presence, location, permanence, and frequency of pain. Patients’ perceptions of pain were captured by an open-ended question, the responses to which were coded and classified using hierarchical clustering. Results: There was no difference in pain between the ketorolac and the placebo group. The reported incidence of permanent pain was 67% and 45% at one and two years, respectively. The largest category was musculoskeletal pain. Permanent pain was mainly described in patients with musculoskeletal pain. The description of pain changed in most patients during the second postoperative year, i.e., moved from one category to another (no pain, permanent, or non-permanent pain, but also, the localisation). This phenomenon includes patients without pain at one year. Conclusions: Pain is a complex phenomenon, but also a fragile and unstable endpoint. Pain after breast cancer surgery does not necessarily mean breast pain but also musculoskeletal and other pains. The permanence of pain and the pain phenotype can change over time.https://www.mdpi.com/2077-0383/9/12/3831ketorolacbreast canceracute painchronic painmusculoskeletal pain |
| spellingShingle | Patrice Forget Taalke M. Sitter Rosemary J. Hollick Diane Dixon Aline van Maanen Alain Dekleermaker Francois P. Duhoux Marc De Kock Martine Berliere on behalf of the KBCt Group Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients Journal of Clinical Medicine ketorolac breast cancer acute pain chronic pain musculoskeletal pain |
| title | Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients |
| title_full | Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients |
| title_fullStr | Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients |
| title_full_unstemmed | Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients |
| title_short | Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients |
| title_sort | characterization of preoperative postsurgical acute and chronic pain in high risk breast cancer patients |
| topic | ketorolac breast cancer acute pain chronic pain musculoskeletal pain |
| url | https://www.mdpi.com/2077-0383/9/12/3831 |
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