Development of a screening instrument for risk factors of persistent pain after breast cancer surgery

Sipilä, Raija; Am, Estlander; Tasmuth, Tiina; Kataja, Matti; Kalso, Eija

doi:10.1038/bjc.2012.445

Cited by 80 publications

(107 citation statements)

References 61 publications

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“…Moreover, it should be taken into consideration that obesity makes the practice of surgery more complicated. As a result of the study by Sipila et al (4) the authors mentioned an increase in chronic postoperative pain as body mass index increases, similar to our study.…”

Section: Discussionsupporting

confidence: 81%

“…We noticed an increase in chronic pain with aging of the patients. In a study supporting this finding, Sipila et al (4) noted that incidence of chronic pain increases in patients with breast cancer surgery with aging. As a reason for our assumption, it might be considered that we included not only the breast cancer patients but also those with other diagnoses such as breast mass and macromasty.…”

Section: Discussionsupporting

confidence: 63%

“…However the relation between chronic pain after breast surgery and presence of preoperative pain in breast is controversial. While Poleshuck et al (11) did not find any relation, Sipila et al (4) noted preoperative pain as a risk factor. They associated this discrepancy to the differences in study designs.…”

Section: Discussionmentioning

confidence: 92%

“…Sipila et al (4) reported that requirements for previous operations might increase susceptibility to chronic pain and sensitization of pain pathways since these needs emerge due to chronic diseases and systemic inflammations. In this study, chronic pain developed more frequently following breast surgery in those who had had different operations previously without any statistically significant intergroup difference.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic postoperative pain has a negative effect on the quality of life and creates important economic consequences for health system. Many pre-, intra-and postoperative risk factors for the development of chronic postoperative pain have been claimed to be young age, high BMI, preoperative and postoperative severe acute pain, radiotherapy, chemotherapy and axillary surgery (4) . Many studies have investigated the persistent pain, its incidence and risk factors following breast cancer surgery (3)(4)(5)(6)(7) .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Incidence and etiology of postoperative chronic pain after breast surgery

Turan¹,

Karaman²,

Tekgül³

et al. 2016

Terh

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Objective: The primary aim of this study was to determine the incidence of chronic postoperative pain after the types of breast surgery. The secondary aim was to examine the factors associated with chronic postoperative pain. Methods: The prospective study included 240 female patients. Data were collected on: visual analogue scale (VAS) pain scores in the Post Anesthesia Care Unit (PACU) at 1st month and at 3rd-6th months postoperatively; and age, BMI, preoperative pain, radiotherapy, chemotherapy, postoperative acute pain, length of hospital stay were the measures taken into account. Results: Chronic postoperative pain was experienced by 39.2% of patients at 3 rd month and 18.3% of patients at 6 th month. Chronic pain was detected in 41.8% of patients who had severe acute postoperative pain. BMI, age, preoperative and severe acute postoperative pain, the type of surgery, the length of hospital stay, development of complications, chemotherapy and radiotherapy treatment have been shown to be the risk factors in chronic postoperative pain after breast surgery. The incidence of postmastectomy pain syndrome (PMPS) was 29.5% in mastectomy cases, and 64% in those having mastectomy and axillary dissection. Conclusion: As they are considered as complication of surgery according to some authors, chronic postoperative pain and post-mastectomy pain syndrome are commonly discussed and studied clinical problems in recent years. More comprehensive studies about its etiology, risk factors and pathogenesis to prevent or treat the chronic postoperative pain and post-mastectomy pain syndrome are warranted as it both reduces life comfort and causes workforce loss following surgery.Key words: Postoperative pain, breast surgery, chronic pain ÖZ Amaç: Bu çalışmanın birincil amacı, farklı tiplerde meme cerrahisi sonrası kronik postoperatif ağrı insidansını, ikincil amacı, kronik postoperatif ağrı ile ilişkili faktörleri araştırmaktır. Yöntemler: Bu prospektif çalışma 240 kadın hasta ile yürütüldü. Hastaların postoperatif derlenme ünitesinde (PACU), postoperatif 1., 3. ve 6. aylarda VAS ağrı skorları, yaş, BMI, preoperatif ağrı, radyoterapi, kemoterapi, postoperatif akut ağrı ve hastanede kalış süresi verileri toplandı. Bulgular: Hastaların %39,2'si 3. ayda ve %18,3'ü ise postoperatif 6. ayda kronik postoperatif ağrı deneyimi yaşamıştır. Ciddi postoperatif ağrı çeken hastaların %41,8'inde kronik ağrı tespit edildi. BMI, yaş, preoperatif ve ciddi akut postoperatif ağrı, cerrahi tipi, hastanede kalış süresi, komplikasyon gelişmesi, kemoterapi ve radyoterapi tedavisi meme cerrahisi sonrasında kronik postoperatif ağrı gelişimi için risk faktörü olarak belirlendi. Mastektomi yapılan hastalarda postmastektomi ağrı sendromu (PMPS) %29,5 oranında görülürken, aksiller diseksiyonla birlikte mastektomi yapılanlarda bu oran %64 olarak saptandı. Tartışma ve Sonuç: Kimi otörler tarafından cerrahinin bir komplikasyonu olarak görülen kronik postoperatif ağrı ve postmastektomi sendromu son yıllarda sıkça tartışılmış ve çalışılmış klinik sorunla...

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Incidence and etiology of postoperative chronic pain after breast surgery

Turan¹,

Karaman²,

Tekgül³

et al. 2016

Terh

View full text Add to dashboard Cite

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Pain at 12 Months After Surgery for Breast Cancer

Meretoja

Leidenius

Tasmuth

et al. 2014

JAMA

105

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Persistent pain following breast cancer treatments remains a significant clinical problem despite improved treatment strategies. 1 Data on factors associated with persistent pain are needed to develop prevention and treatment strategies and to improve the quality of life for breast cancer patients. This prospective study examined the prevalence and severity of and the factors associated with chronic pain after breast cancer surgery and adjuvant treatments. Methods | Consecutive patients younger than 75 years with unilateral nonmetastasized breast cancer treated at the Helsinki University Central Hospital in 2006-2010 with either breastconserving surgery or mastectomy with axillary surgery were eligible. Patients receiving neoadjuvant treatment or immediate or delayed breast reconstruction or who had no breast cancer in the final histology were excluded. All women gave informed written consent. The ethics committee of the Helsinki University Central Hospital approved the study. Preoperatively, medical history, demographic data, Beck Depression Inventory, 2 and Spielberger State-Trait Anxiety Inventory 3 were obtained. Preoperative pain in the operative area (breast, axilla, arm) during the previous week was assessed with a numerical rating scale of 0 to 10 (0 = no pain; 1-3 = mild; 4-6 = moderate; ≥7 = severe). 4 Perioperative analgesia was standardized. All patients received acetaminophen and patient-controlled analgesia with intravenous oxycodone. Postoperatively, data were acquired on tumor and lymph node characteristics, complications of surgery, reoperations, and the prognostic risk category. 5 Adjuvant treatments were given according to international guidelines. 5 A questionnaire was sent to patients 12 months after surgery, with identical assessments of presence and intensity of pain. A bivariable analysis was conducted to determine factors related to pain at 12 months after surgery. The worst pain in any area was used for statistical analysis, in which pain was considered an ordinal variable. Variables with P < .10 in bivariable analyses were entered into an ordinal logistic regression analysis. All statistical tests were 2-sided with P < .05 considered statistically significant. SPSS Statistics version 20 (SPSS Inc) software was used.

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Transforming pain medicine: Adapting to science and society

Borsook

Kalso

2013

European Journal of Pain

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The field of chronic pain medicine is currently facing enormous challenges. The incidence of chronic pain is increasing worldwide, particularly in the developed world. As a result, chronic pain is imposing a growing burden on Western societies in terms of cost of medical care and lost productivity. This burden is exacerbated by the fact that despite research efforts and a huge expenditure on treatment for chronic pain, clinicians have no highly effective treatments or definitive diagnostic measures for patients. The lack of an objective measure for pain impedes basic research into the biological and psychological mechanisms of chronic pain and clinical research into treatment efficacy. The development of objective measurements of pain and ability to predict treatment responses in the individual patient is critical to improving pain management. Finally, pain medicine must embrace the development of a new evidence-based therapeutic model that recognizes the highly individual nature of responsiveness to pain treatments, integrates bio-psycho-behavioral approaches, and requires proof of clinical effectiveness for the various treatments we offer our patients. In the long-term these approaches will contribute to providing better diagnoses and more effective treatments to lessen the current challenges in pain medicine.

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Development of a screening instrument for risk factors of persistent pain after breast cancer surgery

Cited by 80 publications

References 61 publications

Incidence and etiology of postoperative chronic pain after breast surgery

Incidence and etiology of postoperative chronic pain after breast surgery

Pain at 12 Months After Surgery for Breast Cancer

Transforming pain medicine: Adapting to science and society

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