Post-mastectomy pain syndrome: Incidence and risks

Fabro, Erica Alves Nogueira; Bergmann, Anke; Silva, Blenda do Amaral e; Ribeiro, Ana Carolina Padula; Abrahão, Karen de Souza; Ferreira, Maria Giseli da Costa Leite; Dias, Ricardo de Almeida; Thuler, Luiz Cláudio Santos

doi:10.1016/j.breast.2012.01.019

Cited by 130 publications

(104 citation statements)

References 16 publications

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“…The presence of pain in this study had higher frequency than in the studies found in the literature, for which rates ranged from 22% to 55% [20][21][22][23] . The findings of this research reveal the high prevalence of chronic pain, but there was no statistically significant difference between the groups.…”

Section: Discussioncontrasting

confidence: 68%

Reconstrução mamária imediata versus não reconstrução pós-mastectomia: estudo sobre qualidade de vida, dor e funcionalidade

et al. 2017

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This study derives from the project Funcionalidade do membro superior de mulheres pós-mastectomia radical modificada com e sem reconstrução mamária (Functionality of the upper limb of women after modified radical mastectomy without breast reconstruction), developed at Universidade Federal de Santa Maria -Santa Maria (RS), Brazil. RESUMEN | Con la evolución de las técnicas oncoplásticas que permiten la reconstrucción de la mama en el mismo instante de la mastectomía, sin comprometer la seguridad oncológica, resulta pertinente investigar las implicaciones de la reconstrucción inmediata con expansor o prótesis de silicona sobre el dolor, la funcionalidad del miembro superior homolateral a la cirugía y la calidad de vida (CV) de las mujeres. El objetivo de este estudio ha sido comparar el dolor, la funcionalidad y la CV de mujeres sometidas a la mastectomía radical modificada con reconstrucción mamaria inmediata y sin reconstrucción. Se trata de un estudio transversal, comparativo y descriptivo con abordaje cuantitativo, que evaluó 22 voluntarias postmastectomía radical modificada, divididas igualmente en dos grupos, de acuerdo a la realización de la reconstrucción mamaria inmediata (RI) o sin reconstrucción (SR). Las voluntarias han contestado al cuestionario sociodemográfico, clínico y de tratamiento oncológico, la EVA, para medir el dolor, DASH para evaluar la funcionalidad del miembro superior y, para evaluar la CV, se utilizó el cuestionario EORTC QLQ-C30 con su módulo específico para el CA de mama.Hubo alta prevalencia de dolor, moderada limitación funcional y satisfactoria CV. Sin embargo, no se encontraron diferencias significativas intergrupos para el dolor (p=0.586), funcionalidad (p=0.399) y CV (p>0.05). Para la muestra evaluada, hacer o no la reconstrucción de la mama con expansor o implante de silicona en el acto de la mastectomía no implicó sobre el dolor, la funcionalidad y la CV.Palabras clave | Neoplasias de la Mama; Dolor; Extremo Superior; Calidad de Vida; Mastectomía Radical Modificada.

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Section: Discussioncontrasting

confidence: 68%

Reconstrução mamária imediata versus não reconstrução pós-mastectomia: estudo sobre qualidade de vida, dor e funcionalidade

et al. 2017

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“…Persistent postsurgical pain was reported at least 3 months after breast cancer surgery (range 3.28-72.50 mo) in all eligible studies. Seven studies reported that other causes of persistent pain had been excluded, 32,37,38,42,44,46,52 but only 1 study explicitly used the IASP criteria for defining persistent postsurgical pain. 44 The median sample size was 416 (IQR 250-772), and the median duration of follow-up was 24 months (IQR 12-42 mo) (Appendix 7, available at www.…”

Section: Resultsmentioning

confidence: 99%

Predictors of persistent pain after breast cancer surgery: a systematic review and meta-analysis of observational studies

Wang

Guyatt

Kennedy

et al. 2016

CMAJ

240

239

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D espite a 10-year survival rate of 83%, 1,2 between 25% and 60% of surviving patients who have undergone surgery for breast cancer experience persistent postsurgical pain, [3][4][5][6][7][8][9] which is associated with reduced quality of life and functional impairment. [10][11][12][13] Systematic reviews summarizing proposed risk factors for persistent pain after breast cancer surgery -including demographic, intraoperative and postoperative factors -have had several limitations, including outdated searches, inadequate attention to risk-of-bias assessment, lack of statistical pooling of measures of association and failure to evaluate the quality of evidence.5,10-14 We conducted a systematic review and meta-analysis of observational studies to identify risk factors for persistent pain after breast cancer surgery, addressing the limitations of previous reviews. MethodsWe completed our systematic review in accordance with the MOOSE statement 15 and registered our protocol with PROSPERO (registration CRD42014013338). Background: Persistent pain after breast cancer surgery affects up to 60% of patients. Early identification of those at higher risk could help inform optimal management. We conducted a systematic review and meta-analysis of observational studies to explore factors associated with persistent pain among women who have undergone surgery for breast cancer. Predictors of persistent pain after breast cancer surgery: a systematic review and meta-analysis of observational studies

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“…Persistent post-surgical pain lasting over 3 months is a common complication following breast surgery [162], with a reported incidence between 20% and 68% [163][164][165][166]. The variance may be attributed to multiple factors, including differences in definition and the type of breast cancer surgery treatment involved.…”

Section: Persistent Post-surgical (Chronic) Painmentioning

confidence: 99%

“…[5] The pain itself, mostly neuropathic in nature, is often described as burning, shooting, pressure, numbness, or phantom [162,[165][166][167]; and is described as "severe" in 10% of patients [8,168]. Reported to occur in the axilla, chest wall and proximal medial arm or shoulder [53, 162,169,170], the pain may extend beyond the area of the mastectomy, and is strongly correlated with depression and anxiety [171].…”

Section: Persistent Post-surgical (Chronic) Painmentioning

confidence: 99%

An Evidence-Based Review of the Efficacy of Perioperative Analgesic Techniques for Breast Cancer-Related Surgery

Cheng

2016

Pain Med

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Objective. To review the published evidence regarding perioperative analgesic techniques for breast cancer-related surgery.Design. Topical review.Methods. Randomized, controlled trials (RCTs) were selected for inclusion in the review. Also included were large prospective series providing estimates of potential risks and technical reports and small case series demonstrating a new technique or approaches of interest to clinicians.Results. A total of 514 abstracts were reviewed, with 284 studies meeting criteria for full review. The evidence regarding preemptive ketamine, scheduled opioids, perioperative non-steroidal anti-inflammatory drugs (NSAIDs), and intravenous lidocaine is mixed and deserves further investigation. There is strong evidence that both pregabalin and gabapentin provide analgesic benefits following breast surgery. There is minimal and conflicting data from highquality randomized, controlled studies suggesting that directly infiltrating and/or infusing local anesthetic (liposome encapsulated or unencapsulated) into the surgical wound is a reliably effective analgesic. In contrast, there is a plethora of data demonstrating the potent analgesia, opioid sparing, and decreased opioid-related side effects from thoracic epidural infusion and both single-injection and continuous paravertebral nerve blocks (the latter two demonstrating decreased persistent post-surgical pain between 2.5 and 12 months). Techniques with limited-yet promising-data deserving additional investigation include brachial plexus blocks, cervical epidural infusion, interfascial plane blocks, and interpleural blocks.Conclusions. While there are currently multiple promising analgesic techniques for surgical procedures of the breast that deserve further study, the only modalities demonstrated to provide potent, consistent perioperative pain control are thoracic epidural infusion and paravertebral nerve blocks.

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Post-mastectomy pain syndrome: Incidence and risks

Cited by 130 publications

References 16 publications

Reconstrução mamária imediata versus não reconstrução pós-mastectomia: estudo sobre qualidade de vida, dor e funcionalidade

Reconstrução mamária imediata versus não reconstrução pós-mastectomia: estudo sobre qualidade de vida, dor e funcionalidade

Predictors of persistent pain after breast cancer surgery: a systematic review and meta-analysis of observational studies

An Evidence-Based Review of the Efficacy of Perioperative Analgesic Techniques for Breast Cancer-Related Surgery

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