Persistent Pain After Breast Cancer Treatment: A Critical Review of Risk Factors and Strategies for Prevention

Andersen, Kenneth Geving; Kehlet, Henrik

doi:10.1016/j.jpain.2010.12.005

Cited by 411 publications

(410 citation statements)

References 99 publications

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“…Fabro et al (2012) monitored 205 women over a six-month period and identified that six months post-surgery, the incidence of chronic pain was 108.4 (52.9%) in the 205 women evaluated. The chronic pain which appears after surgery is explained as the result of the injury to structures such as muscles and ligaments -and as neuropathic, when it affects nerves or is a dysfunction of the nervous system 6,8 . Therefore, when one evaluates the impact that these operations can have on the patients' quality of life, it is evidenced that the mastectomy can result in a lower score for quality of life, as the pain which can be caused by the surgery can lead to functional compromise 11 .…”

Section: Resultsmentioning

confidence: 99%

“…Because the women often believe that the presence of pain after the treatment is to be expected, they experience the symptom without often reporting it to the team. This being so, the team must inform the woman as to the occurrence of pain and when she mentions this complaint during consultations, she must be listened to and valued, this being an aspect which is generally neglected, since -according to Andersen and Kehlet (2011) 6 -there is a significant disagreement between the intensity of the pain understood by the health professional and that experienced by the patient. This disagreement is often one of the causes of the inadequate control of the pain 6 .…”

Section: Introductionmentioning

confidence: 99%

“…This being so, the team must inform the woman as to the occurrence of pain and when she mentions this complaint during consultations, she must be listened to and valued, this being an aspect which is generally neglected, since -according to Andersen and Kehlet (2011) 6 -there is a significant disagreement between the intensity of the pain understood by the health professional and that experienced by the patient. This disagreement is often one of the causes of the inadequate control of the pain 6 . Thus, this study's objective was to characterize, locate and identify the resources used for pain relief in the women who received treatment for breast cancer.…”

Section: Introductionmentioning

confidence: 99%

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Characterization of pain in women after breast cancer treatment

Ferreira¹,

Prado²,

Panobianco³

et al. 2014

Escola Anna Nery - Revista De Enfermagem

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The aim was to characterize and locate the pain in women who received breast cancer treatment. The study has an exploratory-descriptive character with a quantitative approach, undertaken through measures of central tendency and percentages.The research was undertaken in the Center for Teaching, Research and Assistance in the Rehabilitation of Mastectomized Women, with 30 women. Data was collected in February -August 2008, using an instrument containing variables able to characterize and locate the pain. The data was treated using means, medians, mode, standard deviation and percentages. It stood out that 56.7% of the women mentioned that the pain is daily, 46.7% of the women mention that the pain began after the breast surgery, and that for 40% the pain is constant. Knowledge, recognition and management of the symptom allow alternative therapeutic options for pain relief, minimizing physical and emotional effects which may be caused in the lives of women who receive breast cancer treatment. El 56,7% de las mujeres destacaron el dolor diario; el 46,7%, informaron que el dolor tuvo inicio después de la cirugía y para 40% de las enfermas, el dolor es constante. El conocimiento, el reconocimiento y la gestión de las ofertas de los síntomas permiten terapias alternativas para disminuir el dolor, reducir al mínimo los efectos físicos y emocionales que se pueden causar en las vidas de las mujeres que reciben tratamiento para el cáncer de mama. Keywords Palabras

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Characterization of pain in women after breast cancer treatment

Ferreira¹,

Prado²,

Panobianco³

et al. 2014

Escola Anna Nery - Revista De Enfermagem

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“…In breast cancer surgery, multiple factors may determine the risk of persistent pain, including intercostobrachial nerve damage, the extent of the surgical procedure, and radio-and chemotherapy. 22 More detailed studies are required in nerve-sparing techniques with axillary dissection. In other operations with significant persistent postsurgical pain, such as major gynecological procedures and joint arthroplasty, future detailed studies are required to document the effect of minimal invasive nervesparing techniques vs other risk factors (psychosocial, inflammation, etc.…”

Section: Modified Surgical Techniquesmentioning

confidence: 99%

“…Dans les cas de chirurgies de cancer du sein, de nombreux facteurs peuvent déterminer le risque de douleur persistante, notamment les lésions aux nerfs intercostobrachiaux, l'étendue de l'intervention chirurgicale, ainsi que la radio-et la chimiothérapie. 22 Des études plus détaillées sont nécessaires pour explorer les techniques épargnant les nerfs lors d'une dissection axillaire. Dans le cas d'autres opérations entraînant une importante douleur postchirurgicale persistante, telles que les interventions gynécologiques majeures et les arthroplasties totales, des études détaillées sont nécessaires à l'avenir afin de documenter l'effet des techniques épargnant les nerfs et minimalement effractives par rapport à d'autres facteurs de risque (psychosociaux, inflammation, etc.…”

Section: Les Interventions Médicamenteuses Systémiquesunclassified

Prevention of chronic pain after surgery: new insights for future research and patient care

Gilron

Kehlet

2013

Can J Anesth/J Can Anesth

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Hyperbaric Oxygen Therapy and Late Local Toxic Effects in Patients With Irradiated Breast Cancer

Mink van der Molen,

Batenburg,

Maarse

et al. 2024

JAMA Oncol

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ImportanceHyperbaric oxygen therapy (HBOT) is proposed as treatment for late local toxic effects after breast irradiation. Strong evidence of effectiveness is lacking.ObjectiveTo assess effectiveness of HBOT for late local toxic effects in women who received adjuvant radiotherapy for breast cancer.Design, Setting, and ParticipantsThis was a hospital-based, pragmatic, 2-arm, randomized clinical trial nested within the prospective UMBRELLA cohort following the trials within cohorts design in the Netherlands. Participants included 189 women with patient-reported moderate or severe breast, chest wall, and/or shoulder pain in combination with mild, moderate, or severe edema, fibrosis, or movement restriction 12 months or longer after breast irradiation. Data analysis was performed from May to September 2023.InterventionReceipt of 30 to 40 HBOT sessions over a period of 6 to 8 consecutive weeks.Main Outcomes and MeasuresBreast, chest wall, and/or shoulder pain 6 months postrandomization measured by the European Organization for Research and Treatment of Cancer QLQ-BR23 questionnaire. Secondary end points were patient-reported fibrosis, edema, movement restriction, and overall quality of life. Data were analyzed according to intention-to-treat (ITT) and complier average causal effect (CACE) principles.ResultsBetween November 2019 and August 2022, 125 women (median [range] age at randomization, 56 [37-85] years) with late local toxic effects were offered to undergo HBOT (intervention arm), and 61 women (median [range] age at randomization, 60 [36-80] years) were randomized to the control arm. Of those offered HBOT, 31 (25%) accepted and completed treatment. The most common reason for not accepting HBOT was high treatment intensity. In ITT, moderate or severe pain at follow-up was reported by 58 of 115 women (50%) in the intervention arm and 32 of 52 women (62%) in the control arm (odds ratio [OR], 0.63; 95% CI, 0.32-1.23; P = .18). In CACE, the proportion of women reporting moderate or severe pain at follow-up was 32% (10 of 31) among those completing HBOT and 75% (9.7 of 12.9) among control participants expected to complete HBOT if offered (adjusted OR, 0.34; 95% CI, 0.15-0.80; P = .01). In ITT, moderate or severe fibrosis was reported by 35 of 107 (33%) in the intervention arm and 25 of 49 (51%) in the control arm (OR, 0.36; 95% CI, 0.15-0.81; P = .02). There were no significant differences in breast edema, movement restriction, and quality of life between groups in ITT and CACE.Conclusions and RelevanceIn this randomized clinical trial, offering HBOT to women with late local toxic effects was not effective for reducing pain, but was effective for reducing fibrosis. In the subgroup of women who completed HBOT, a significant reduction in pain and fibrosis was observed. A smaller than anticipated proportion of women with late local toxic effects was prepared to undergo HBOT.Trial RegistrationClinicalTrials.gov Identifier: NCT04193722

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Persistent Pain After Breast Cancer Treatment: A Critical Review of Risk Factors and Strategies for Prevention

Cited by 411 publications

References 99 publications

Characterization of pain in women after breast cancer treatment

Characterization of pain in women after breast cancer treatment

Prevention of chronic pain after surgery: new insights for future research and patient care

Hyperbaric Oxygen Therapy and Late Local Toxic Effects in Patients With Irradiated Breast Cancer

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