Association between sensory dysfunction and pain 1 week after breast cancer surgery: a psychophysical study

Andersen, Kenneth Geving; Duriaud, Helle Molter; Aasvang, Eske Kvanner; Kehlet, Henrik

doi:10.1111/aas.12641

Cited by 17 publications

(51 citation statements)

References 28 publications

(38 reference statements)

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“…Our searches identified 189 potentially relevant studies, of which 41 full text reports were examined ( Figure 1). A total of 18 studies met the eligibility criteria ( Figure 1) (Andersen, Duriaud, Aasvang, & Kehlet, 2016;Andriamamonjy, Delmotte, Savinelli, Beaussier, & Coudore, 2017;Attal et al, 2009;Binder et al, 2007;Boyette-Davis et al, 2013, 2011aCaraceni et al, 2008;Cata et al, 2007;Dougherty, Cata, Burton, Vu, & Weng, 2007;Dougherty, Cata, Cordella, Burton, & Weng, 2004;Fallon et al, 2015;Forsyth et al, 1997;Hershman et al, 2011;Krøigård et al & Fallon, 2012;Velasco et al, 2015;Ventzel et al, 2017). Three studies included patients with tumour-related cancer pain (Andersen et al, 2016;Lipton et al, 1991;Scott et al, 2012).…”

Section: Included Studiesmentioning

confidence: 99%

“…A total of 18 studies met the eligibility criteria ( Figure 1) (Andersen, Duriaud, Aasvang, & Kehlet, 2016;Andriamamonjy, Delmotte, Savinelli, Beaussier, & Coudore, 2017;Attal et al, 2009;Binder et al, 2007;Boyette-Davis et al, 2013, 2011aCaraceni et al, 2008;Cata et al, 2007;Dougherty, Cata, Burton, Vu, & Weng, 2007;Dougherty, Cata, Cordella, Burton, & Weng, 2004;Fallon et al, 2015;Forsyth et al, 1997;Hershman et al, 2011;Krøigård et al & Fallon, 2012;Velasco et al, 2015;Ventzel et al, 2017). Three studies included patients with tumour-related cancer pain (Andersen et al, 2016;Lipton et al, 1991;Scott et al, 2012). Fifteen studies included patients with chemotherapy induced peripheral neuropathy (CIPN) (Andriamamonjy et al, 2017;Attal et al, 2009;Binder et al, 2007;Boyette-Davis et al, 2013, 2011aCaraceni et al, 2008;Cata et al, 2007;Dougherty et al, 2007Dougherty et al, , 2004Fallon et al, 2015;Forsyth et al, 1997;Hershman et al, 2011;Krøigård et al, 2014;Velasco et al, 2015;Ventzel et al, 2017).…”

Section: Included Studiesmentioning

confidence: 99%

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The use of quantitative sensory testing in cancer pain assessment: A systematic review

Martland

Rashidi

Bennett

et al. 2020

European Journal of Pain

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Objective To summarize the literature on the use of quantitative sensory testing (QST) in the assessment of pain in people with cancer and to describe which QST parameters consistently demonstrate abnormal sensory processing in patients with cancer pain. Databases and Data Treatment Medline, EMBASE, AMED, CINAHL, SCOPUS and CENTRAL were searched for observational or experimental studies using QST in patients with a cancer diagnosis and reporting pain. Search strategies were based on the terms “quantitative sensory testing”, “cancer”, “pain”, “cancer pain” and “assessment”. Databases were searched from inception to January 2019. Data were extracted and synthesized narratively, structured around the different QST modalities and sub‐grouped by cancer pain aetiology (tumour‐ or treatment‐related pain). Results Searches identified 286 records of which 18 met the eligibility criteria for inclusion. Three studies included patients with tumour‐related pain, and 15 studies included patients with pain from chemotherapy‐induced peripheral neuropathy (CIPN). Across all studies, 50% (9/18) reported sensory abnormities using thermal detection thresholds (cool and warm), 44% (8/18) reported abnormal mechanical detection thresholds using von‐Frey filaments and 39% (7/18) found abnormal pinprick thresholds. Abnormal vibration and thermal pain (heat/cold) thresholds were each reported in a third of included studies. Conclusion This systematic review highlights the lack of published data characterizing the sensory phenotype of tumour‐related cancer pain. This has implications for our understanding of the underlying pathophysiological mechanisms of cancer pain. Understanding the multiple mechanisms driving cancer pain will help to move towards rational individualized analgesic treatment choices. Significance This systematic review found that pain in cancer patients is associated with abnormal sensory responses to thermal, mechanical and pinprick stimuli. However, these findings are based primarily on studies of chemotherapy‐induced peripheral neuropathy and data on tumour‐related pain are lacking, warranting further research.

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Section: Included Studiesmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

The use of quantitative sensory testing in cancer pain assessment: A systematic review

Martland

Rashidi

Bennett

et al. 2020

European Journal of Pain

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“…Damage to the ICBN is associated with significant morbidity and is believed to be involved with postoperative pain and sensory loss [1, 9-10]. …”

Section: Discussionmentioning

confidence: 99%

“…It has been estimated that between 10-60% of breast cancer survivors who have undergone operative procedures, experience PPBCT, and it is believed that this predominantly neuropathic pain contributes significantly to a reduced quality of life following breast cancer treatment [1, 9-10]. Aside from dysesthesia, paresthesia of the ICBN, sensory distribution is also very common [11].…”

Section: Introductionmentioning

confidence: 99%

Origin, Branching, and Communications of the Intercostobrachial Nerve: a Meta-Analysis with Implications for Mastectomy and Axillary Lymph Node Dissection in Breast Cancer

Henry¹,

Graves²,

Pękala³

et al. 2017

Cureus

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The intercostobrachial nerve (ICBN), which usually originates from the lateral cutaneous branch of the second intercostal nerve, innervates areas of the axilla, lateral chest, and medial arm. It is at risk for injury during operative procedures that are often used in the management of breast cancer and such injury has been associated with postoperative sensory loss and neuropathic pain, decreasing the quality of life. PubMed, Excerpta Medica Database (EMBASE), ScienceDirect, Google Scholar, China National Knowledge Infrastructure (CNKI), Scientific Electronic Library Online (SciELO), Biosciences Information Service (BIOSIS), and Web of Science were searched comprehensively. Data concerning the prevalence, branching, origin and communications of the ICBN were extracted and pooled into a meta-analysis. A total of 16 studies (1,567 axillas) reported data indicating that the ICBN was present in 98.4% of person. It most often (90.6%) originated from fibers at the T2 spinal level and commonly coursed in two branching patterns: as a single trunk in 47.0% of cases and as a bifurcating pattern in 42.2%. In the latter cases, the bifurcation was usually unequal (63.4%). Additionally, the ICBN presented with anastomosing communication to the brachial plexus in 41.3% of cases. The ICBN is a prevalent and variable structure at significant risk for injury during operative procedures of the axilla. In view of the postoperative pain and paresthesia experienced by patients following injury, surgeons need to exercise caution and aim to preserve the ICBN when possible. Ultimately, careful dissection and knowledge of ICBN anatomy could allow postoperative complications to be reduced and patient's quality of life increased.

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“…Others have demonstrated enhanced sensitivity to electrical and thermal stimulation [53, 54], further supporting the presence of central sensitization in persistent pain after breast cancer treatment. Recently, Andersen et al found a relationship between sensory disturbances and pain one week after surgery for breast cancer [55]. Hyperalgesia has also been reported 5 days after back surgery [56] and early postoperative hyperalgesia has been linked to persistent pain development in smaller studies after abdominal surgery [57, 58].…”

Section: Discussionmentioning

confidence: 99%

Hyperalgesia and Persistent Pain after Breast Cancer Surgery: A Prospective Randomized Controlled Trial with Perioperative COX-2 Inhibition

et al. 2016

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BackgroundPersistent pain is a challenging clinical problem after breast cancer treatment. After surgery, inflammatory pain and nociceptive input from nerve injury induce central sensitization which may play a role in the genesis of persistent pain. Using quantitative sensory testing, we tested the hypothesis that adding COX-2 inhibition to standard treatment reduces hyperalgesia after breast cancer surgery. A secondary hypothesis was that patients developing persistent pain would exhibit more postoperative hyperalgesia.Methods138 women scheduled for lumpectomy/mastectomy under general anesthesia with paravertebral block were randomized to COX-2 inhibition (2x40mg parecoxib on day of surgery, thereafter 2x200mg celecoxib/day until day five) or placebo. Preoperatively and 1, 5, 15 days and 1, 3, 6, 12 months postoperatively, we determined electric and pressure pain tolerance thresholds in dermatomes C6/T4/L1 and a 100mm VAS score for pain. We calculated the sum of pain tolerance thresholds and analyzed change in these versus preoperatively using mixed models analysis with factor medication. To assess hyperalgesia in persistent pain patients we performed an additional analysis on patients reporting VAS>30 at 12 months.Results48 COX-2 inhibition and 46 placebo patients were analyzed in a modified intention to treat analysis. Contrary to our primary hypothesis, change in the sum of tolerance thresholds in the COX-2 inhibition group was not different versus placebo. COX-2 inhibition had an effect on pain on movement at postoperative day 5 (p<0.01). Consistent with our secondary hypothesis, change in sum of pressure pain tolerance thresholds in 11 patients that developed persistent pain was negative versus patients without pain (p<0.01) from day 5 to 1 year postoperatively.ConclusionsPerioperative COX-2 inhibition has limited value in preventing sensitization and persistent pain after breast cancer surgery. Central sensitization may play a role in the genesis of persistent postsurgical pain.

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Association between sensory dysfunction and pain 1 week after breast cancer surgery: a psychophysical study

Cited by 17 publications

References 28 publications

The use of quantitative sensory testing in cancer pain assessment: A systematic review

The use of quantitative sensory testing in cancer pain assessment: A systematic review

Origin, Branching, and Communications of the Intercostobrachial Nerve: a Meta-Analysis with Implications for Mastectomy and Axillary Lymph Node Dissection in Breast Cancer

Hyperalgesia and Persistent Pain after Breast Cancer Surgery: A Prospective Randomized Controlled Trial with Perioperative COX-2 Inhibition

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