Chronic Pain After Breast Surgery: A Prospective, Observational Study

Spivey, Tara; Gutowski, Emily D.; Zinboonyahgoon, Nantthasorn; King, Tari A.; Dominici, Laura; Edwards, Richard E.; Golshan, Mehra; Schreiber, Kristin L.

doi:10.1245/s10434-018-6644-x

Cited by 60 publications

(63 citation statements)

References 21 publications

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“…Other factors associated with the development of chronic pain include psychosocial characteristics. Spivey et al found a significant positive association between baseline degree of preoperative anxiety, depression, and pain catastrophizing with patients' Pain Burden Index after 6 months [3]. This positive relationship between baseline depression and anxiety has also been correlated with pain after 1 week following breast surgery [23].…”

Section: Patient Risk Factorsmentioning

confidence: 98%

“…The development of chronic pain is suspected to be multifactorial, with patient demographics, psychosocial characteristics, and various surgical techniques playing a role in its development. Many studies have cited the inverse relationship between patients' age and development of chronic pain after breast surgery, with differing explanations to why this may be [3][4][5]23]. One explanation posited by Couceiro et al is that younger patients have higher nerve sensitivity and a lower threshold for pain due to increased anxiety levels [20,21].…”

Section: Patient Risk Factorsmentioning

confidence: 99%

“…Historically, incidence of chronic pain has been reported to be correlated with increasing invasiveness of surgical procedure: 49% for mastectomy with reconstruction, 31% for mastectomy, and 22% for breast reduction [2]. Even with advanced pain management strategies and surgical techniques, recent studies have continued to report an elevated incidence ranging from 20 to 43%; however, further analysis has found no evidence supporting a difference in chronic pain incidence based upon the type of surgical procedure [2][3][4][5][6][7][8]. While the financial impact of postoperative chronic breast-related pain has not been directly elucidated, chronic pain burdens the system via direct costs of healthcare resources and indirect costs related to reduced workplace productivity [9].…”

Section: Introductionmentioning

confidence: 99%

“…Patient characteristics associated with the development of postoperative chronic pain following cosmetic breast surgery include a younger age, larger BMI, smaller height, postoperative hyperesthesia, and elevated baseline depression, anxiety, and catastrophizing scores [3][4][5][10][11][12]. Each of these characteristics must be individually considered when evaluating for risk of chronic pain.…”

Section: Introductionmentioning

confidence: 99%

“…In particular, elevated rates of baseline anxiety and depression in breast cancer patients may predispose this patient population to have chronic pain following mastectomy and breast reconstruction [13,14]. Interestingly, baseline chronic pain was found not to be correlated with increased rates of postoperative chronic breast-related pain [3]. Additionally, compared to their pain-free counterparts, patients living with chronic pain have reported lower QoL in terms of daily activities, physical and social functionality, and their mental health [4,9].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Chronic Pain Following Cosmetic Breast Surgery: A Comprehensive Review

et al. 2020

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Section: Patient Risk Factorsmentioning

confidence: 98%

Section: Patient Risk Factorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Chronic Pain Following Cosmetic Breast Surgery: A Comprehensive Review

et al. 2020

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Interventions for reducing the use of opioids in breast reconstruction

Siotos

Cheah

Karahalios

et al. 2020

Cochrane Database of Systematic Reviews

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Data extraction and managementTwo review authors (CS, MAC) will develop a standard data extraction form and independently extract data from the included studies. A third review author (GDR) will resolve any disagreements regarding data collection and extraction. We will collect information on study design, participants, setting, interventions, outcomes, follow-up, methods employed to control for confounders and biases, sources of funding, and notable conflicts of interest of trial authors, amongst other items. For observational studies where we extract adjusted estimates, we will select the most fully adjusted model. Should we identify multiple papers that report results from the same study during the data extraction process, we will select a single paper as the primary Interventions for reducing the use of opioids in breast reconstruction (Protocol)

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Acute pain after breast surgery and reconstruction: A two‐institution study of surgical factors influencing short‐term pain outcomes

Azad

Bozkurt

Wheeler

et al. 2020

Journal of Surgical Oncology

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Background and ObjectivesAcute postoperative pain following surgery is known to be associated with chronic pain development and lower quality of life. We sought to analyze the relationship between differing breast cancer excisional procedures, reconstruction, and short‐term pain outcomes.MethodsWomen undergoing breast cancer excisional procedures with or without reconstruction at two systems: an academic hospital (AH) and Veterans Health Administration (VHA) were included. Average pain scores at the time of discharge and at 30‐day follow‐up were analyzed across demographic and clinical characteristics. Linear mixed effects modeling was used to assess the relationship between patient/clinical characteristics and interval pain scores with a random slope to account for differences in baseline pain.ResultsOur study included 1402 patients at AH and 1435 at VHA, of which 426 AH and 165 patients with VHA underwent reconstruction. Pain scores improved over time and were found to be highest at discharge. Time at discharge, 30‐day follow‐up, and preoperative opioid use were the strongest predictors of high pain scores. Younger age and longer length of stay were independently associated with worse pain scores.ConclusionsYounger age, preoperative opioid use, and longer length of stay were associated with higher levels of postoperative pain across both sites.

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Chronic Pain After Breast Surgery: A Prospective, Observational Study

Abstract: Amongst surgical variables, only axillary dissection was associated with greater pain at 6 months after surgery. Patient characteristics that were associated with higher PBI included lower age and higher BMI, as well as higher baseline anxiety, depression, and catastrophizing.

Cited by 60 publications

References 21 publications

Chronic Pain Following Cosmetic Breast Surgery: A Comprehensive Review

Chronic Pain Following Cosmetic Breast Surgery: A Comprehensive Review

Interventions for reducing the use of opioids in breast reconstruction

Acute pain after breast surgery and reconstruction: A two‐institution study of surgical factors influencing short‐term pain outcomes

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