Characteristics and Perioperative Risk Factors for Persistent Pain after Breast Cancer Surgery: A Prospective Cohort Study
Objective: Persistent pain is a common complication after breast cancer surgery. We sought to determine the characteristics of persistent pain after breast cancer surgery and identify perioperative risk factors associated with its development. Methods: This prospective cohort study uses data from a...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Surgeries |
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| Online Access: | https://www.mdpi.com/2673-4095/4/3/31 |
| _version_ | 1797576766248714240 |
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| author | Sachin Sahni Ronak Patel Li Wang Sarah Miles Elad Dana James S. Khan |
| author_facet | Sachin Sahni Ronak Patel Li Wang Sarah Miles Elad Dana James S. Khan |
| author_sort | Sachin Sahni |
| collection | DOAJ |
| description | Objective: Persistent pain is a common complication after breast cancer surgery. We sought to determine the characteristics of persistent pain after breast cancer surgery and identify perioperative risk factors associated with its development. Methods: This prospective cohort study uses data from a prior randomized controlled trial of 100 patients undergoing breast cancer surgery. Patients were assessed on the presence and characteristics of pain at 3 months after surgery. Baseline and perioperative data were explored for potential associations with persistent pain in univariate and multivariate logistic regression models. Results: Fifty-three percent of patients reported persistent pain 3-months after surgery. Pain was primarily located in the axilla, chest, and shoulder, with the vast majority of patients with pain (96.2%) reporting a neuropathic pain feature. The mean intensity of pain was 2.5 (standard deviation [SD] 2.4, on a 0 to 10 pain scale) and persistent pain was associated with worse quality of life scores (<i>p</i> = 0.004) and increased use of analgesics (<i>p</i> = 0.015). Variables found to be associated with persistent pain in our univariable and multivariable-adjusted analyses were preoperative employment (OR 2.70, 95% CI 1.04–9.66, <i>p</i> = 0.042), acute postoperative pain during movement (OR 1.63, 95% CI 1.06–2.51, <i>p</i> = 0.027), and adjuvant chemotherapy (OR 3.30, 95% CI 1.19 to 9.15, <i>p</i> = 0.022). Conclusions: Persistent pain after breast cancer surgery is neuropathic and is associated with reduced quality of life and increased analgesic need. Future research should focus on perioperative interventions to reduce acute postoperative pain and consideration of modified adjuvant chemotherapy regimens to address modifiable risk factors and potentially reduce the incidence of persistent pain after breast cancer surgery. |
| first_indexed | 2024-03-10T21:59:18Z |
| format | Article |
| id | doaj.art-5c49965254934ca89c33d50da9cbd96e |
| institution | Directory Open Access Journal |
| issn | 2673-4095 |
| language | English |
| last_indexed | 2024-03-10T21:59:18Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Surgeries |
| spelling | doaj.art-5c49965254934ca89c33d50da9cbd96e2023-11-19T13:01:07ZengMDPI AGSurgeries2673-40952023-06-014330131610.3390/surgeries4030031Characteristics and Perioperative Risk Factors for Persistent Pain after Breast Cancer Surgery: A Prospective Cohort StudySachin Sahni0Ronak Patel1Li Wang2Sarah Miles3Elad Dana4James S. Khan5Department of Anesthesia and Pain Medicine, University of Toronto, Toronto, ON M5G 1E2, CanadaDepartment of Anesthesia and Pain Medicine, University of Toronto, Toronto, ON M5G 1E2, CanadaDepartment of Anesthesia, McMaster University, Hamilton, ON L8S 4L8, CanadaDepartment of Anesthesia and Pain Management, University Health Network, Toronto, ON M5G 2C4, CanadaMount Sinai Hospital, Toronto, ON M5G 1X5, CanadaDepartment of Anesthesia and Pain Medicine, University of Toronto, Toronto, ON M5G 1E2, CanadaObjective: Persistent pain is a common complication after breast cancer surgery. We sought to determine the characteristics of persistent pain after breast cancer surgery and identify perioperative risk factors associated with its development. Methods: This prospective cohort study uses data from a prior randomized controlled trial of 100 patients undergoing breast cancer surgery. Patients were assessed on the presence and characteristics of pain at 3 months after surgery. Baseline and perioperative data were explored for potential associations with persistent pain in univariate and multivariate logistic regression models. Results: Fifty-three percent of patients reported persistent pain 3-months after surgery. Pain was primarily located in the axilla, chest, and shoulder, with the vast majority of patients with pain (96.2%) reporting a neuropathic pain feature. The mean intensity of pain was 2.5 (standard deviation [SD] 2.4, on a 0 to 10 pain scale) and persistent pain was associated with worse quality of life scores (<i>p</i> = 0.004) and increased use of analgesics (<i>p</i> = 0.015). Variables found to be associated with persistent pain in our univariable and multivariable-adjusted analyses were preoperative employment (OR 2.70, 95% CI 1.04–9.66, <i>p</i> = 0.042), acute postoperative pain during movement (OR 1.63, 95% CI 1.06–2.51, <i>p</i> = 0.027), and adjuvant chemotherapy (OR 3.30, 95% CI 1.19 to 9.15, <i>p</i> = 0.022). Conclusions: Persistent pain after breast cancer surgery is neuropathic and is associated with reduced quality of life and increased analgesic need. Future research should focus on perioperative interventions to reduce acute postoperative pain and consideration of modified adjuvant chemotherapy regimens to address modifiable risk factors and potentially reduce the incidence of persistent pain after breast cancer surgery.https://www.mdpi.com/2673-4095/4/3/31persistent painchronic painneuropathypost-mastectomy pain syndromepsychological factorspostoperative pain |
| spellingShingle | Sachin Sahni Ronak Patel Li Wang Sarah Miles Elad Dana James S. Khan Characteristics and Perioperative Risk Factors for Persistent Pain after Breast Cancer Surgery: A Prospective Cohort Study Surgeries persistent pain chronic pain neuropathy post-mastectomy pain syndrome psychological factors postoperative pain |
| title | Characteristics and Perioperative Risk Factors for Persistent Pain after Breast Cancer Surgery: A Prospective Cohort Study |
| title_full | Characteristics and Perioperative Risk Factors for Persistent Pain after Breast Cancer Surgery: A Prospective Cohort Study |
| title_fullStr | Characteristics and Perioperative Risk Factors for Persistent Pain after Breast Cancer Surgery: A Prospective Cohort Study |
| title_full_unstemmed | Characteristics and Perioperative Risk Factors for Persistent Pain after Breast Cancer Surgery: A Prospective Cohort Study |
| title_short | Characteristics and Perioperative Risk Factors for Persistent Pain after Breast Cancer Surgery: A Prospective Cohort Study |
| title_sort | characteristics and perioperative risk factors for persistent pain after breast cancer surgery a prospective cohort study |
| topic | persistent pain chronic pain neuropathy post-mastectomy pain syndrome psychological factors postoperative pain |
| url | https://www.mdpi.com/2673-4095/4/3/31 |
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