Persistent Pain after Breast Cancer Treatment: A Questionnaire-Based Study on the Prevalence, Associated Treatment Variables, and Pain Type

Abstract

PurposePersistent pain is a common side effect of breast cancer treatment. The present study aimed to assess the prevalence, associated treatment-related factors, and the type of pain (neuropathic or nociceptive) in patients who had undergone a unilateral mastectomy.MethodsAll women who underwent a unilateral mastectomy at a University Hospital between 2009 and 2013 were eligible for inclusion. Women with breast reconstruction or active cancer were excluded. Participants were mailed a questionnaire evaluating the prevalence, location, intensity, and frequency of surgical site pain. Additionally, the painDETECT®, a validated instrument to evaluate neuropathic pain, was mailed to all participants.ResultsA total of 305 women were included, and of them, 261 (85.6%) completed the study questionnaire. After a median follow-up period of 3.0 years, 100 women (38.3%) reported experiencing pain at the surgical site. Body mass index ≥30 kg/m2, radiation therapy, and axillary lymph node dissection were significantly associated with persistent pain in univariate models. However, only body mass index ≥30 kg/m2 was independently associated with persistent pain (odds ratio, 2.13; 95% confidence interval, 1.06–4.27; p=0.034) in a multivariate analysis. Of the patients reporting pain, 71.0% were unlikely to have a neuropathic pain component. A moderate, but highly significant, positive correlation was observed between the pain intensity and the painDETECT® score (rs=0.47, p<0.001).ConclusionPersistent pain after breast cancer treatment continues to have a high prevalence. Our results indicate that the largest proportion of patients experiencing persistent pain after breast cancer treatment do not have a clear neuropathic pain component.

Prevalence of persistent pain after breast cancer surgery and associated risk factors in Saudi women

“…This study showed that a significant difference was found between patients with and without pain regarding axillary procedure (P value = 0.03) and ALND was more common than SN in patients with pain. A study by Juhl et al [5] was in agreement with this study, and found no association between ALND and persistent pain. Several previous studies have demonstrated that ALND was a risk factor for developing persistent pain after breast cancer surgery [6,14,24,25].…”

“…It was reported in one study that 38.3% of females in the study suffered surgical site pain [5]. The prevalence of pain presented in this study is higher than that reported by previous studies, whereas the prevalence rate reported in this study ranged from 24% to 47% [4,6,7,14].…”

“…Previous studies [6,14,18] stated that younger age was a risk factor for developing pain. The correlation between younger age and the persistent pain was not found in other two studies [5,19].…”

“…The pain persists for longer than 3 months [2], or it can persist for several years [3,4]. PPBCT is a side effect of breast cancer treatment [5].…”

“…Persistent pain often causes considerable morbidity as a result of decline in emotional and physical wellbeing and debilitates the affected patients [5]. It was demonstrated that the patients who suffer persistent pain also suffer from high level of perceived stress, more anxiety, and depressive symptoms when compared with patients having no pain [7].…”