Background:Few epidemiological studies have prospectively investigated preoperative and surgical risk factors for acute postoperative pain after surgery for breast cancer. We investigated demographic, psychological, pain-related and surgical risk factors in women undergoing resectional surgery for breast cancer.Methods:Primary outcomes were pain severity, at rest (PAR) and movement-evoked pain (MEP), in the first postoperative week.Results:In 338 women undergoing surgery, those with chronic preoperative pain were three times more likely to report moderate to severe MEP after breast cancer surgery (OR 3.18, 95% CI 1.45–6.99). Increased psychological ‘robustness', a composite variable representing positive affect and dispositional optimism, was associated with lower intensity acute postoperative PAR (OR 0.63, 95% CI 0.48–0.82) and MEP (OR 0.71, 95% CI 0.54–0.93). Sentinel lymph node biopsy (SLNB) and intraoperative nerve division were associated with reduced postoperative pain. No relationship was found between preoperative neuropathic pain and acute pain outcomes; altered sensations and numbness postoperatively were more common after axillary sample or clearance compared with SLNB.Conclusion:Chronic preoperative pain, axillary surgery and psychological robustness significantly predicted acute pain outcomes after surgery for breast cancer. Preoperative identification and targeted intervention of subgroups at risk could enhance the recovery trajectory in cancer survivors.

then irradiated with gamma-ray for preventing a replication of the cell and went to a cell death. Methods: MR images acquired at baseline (pre-treatment), as well as 6 and 12 months post-treatment, were evaluated by two experienced musculoskeletal radiologists in a blinded fashion using a modified WORMS (Whole Organ Magnetic Resonance Imaging Score) method. After this scoring, the images were presented to the two radiologists again, in time sequence, and radiological impressions were generated for cartilage, and any significant visible trends or changes were identified. During the un-blinded radiological evaluation a set of patients was noted to have improvements in the cartilage. Results: The following improvements were observed: full thickness cartilage defect filling, generalized cartilage thickening in the defect area, and improvement or resolution of cartilage blisters. One patient showed several of these findings, and additionally showed considerable bone regeneration (bone remodeling) and cartilage regeneration in the trochlea, restoring the trochlea shape. Although these patients demonstrated many areas of improvement, in some patients there was evidence of progression of OA as well. Conclusions: Based on these findings, there was an indication that in certain cases this treatment induced cartilage regeneration.

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