Prevalence of postmastectomy pain syndrome and associated risk factors

Abstract

Postmastectomy pain syndrome (PMPS) is a frequent complication of breast surgery, and is considered a chronic neuropathic pain in the side of surgery which persists more than 3 months. We conducted a retrospective analysis of the largest reported cohort to investigate the prevalence of PMPS and to analyze its associated risk factors as well as the influence on quality of life (QoL). Two thousand thirty-three surgically-treated female patients diagnosed between 2012 and 2017 with early-stage breast cancer were asked to complete a questionnaire survey about their current chronic neuropathic pain problems and quality of life. Multivariate logistic regression analyses were applied to determine the associated risk factors of PMPS. Results have shown that 1983 (97.5%) patients responded and completed a questionnaire survey. Among them, PMPS was found in 28.2% of patients. In univariate analysis, age≤35 years, tumor staging, history of chronic pain, total mastectomy, and axillary lymph node dissection (ALND) were significantly correlated with PMPS (P < .05). Multivariate analysis showed that age≤35 years, history of chronic pain, total mastectomy, and ALND were the independent risk factors of PMPS. QoL outcomes have shown that the global QoL score, physical function score, role function score, and social function score in the PMPS group were reduced in the PMPS group (P < .05), while the difference in emotional function score and cognitive function score showed no statistical significance (P > .05). Besides, patients with PMPS have worse body image, sexual enjoyment, and more breast symptoms. In conclusion, PMPS is linked with a high incidence among breast cancer patients, and has a considerable negative influence on the quality of life. In addition, age, total mastectomy, ALND, and history of chronic pain are the independent risk factors of PMPS.

Post-Mastectomy Pain: An Updated Overview on Risk Factors, Predictors, and Markers

“…The risk factors of 2033 women who underwent mastectomy were investigated in a retrospective study by asking them about the occurrence of chronic PMP. Based on the answers of 97.5% of responders, it emerged that 28.2% had developed chronic pain; using univariate analysis, age 35 years, tumor staging, previous chronic pain, total mastectomy, and axillary lymph node dissection were statistically associated with PMP [45] (Table 1). To explain the mechanisms through which younger age represents a risk factor for PMP, enhanced likelihood of a higher histopathological tumor grade and the need for adjuvant chemotherapy when the tumor occurs in younger women have been highlighted.…”

Efficacy of physical therapy interventions on quality of life and upper quadrant pain severity in women with post-mastectomy pain syndrome: a systematic review and meta-analysis

“…4 PMPS is a frequent complication of breast surgery and affects 28.2-64.1% of post-mastectomy patients worldwide. [4][5][6] PMPS occurs following all kinds of breast surgery, including mastectomy, lumpectomy, and quadrantectomy with axillary lymphadenectomy. 5 Post-mastectomy pain is associated with damage to nervous tissue, in particular the intercostobrachial, medial pectoral, lateral pectoral, thoracodorsal, or long thoracic nerves.…”

“…Post-mastectomy pain syndrome (PMPS) is defined as chronic neuropathic pain affecting the upper quadrant (including the breast, chest wall, axilla, and ipsilateral medial arm) after breast cancer surgery [ 1 ]. PMPS affects 20%–68% of post-mastectomy patients worldwide [ 2 ]. PMPS occurs following all kinds of breast surgery, including mastectomy, lumpectomy, and quadrantectomy with axillary lymphadenectomy [ 3 ], and persist for at least six months post-operatively [ 4 ].…”

Targeted Nipple Areola Complex Reinnervation in Gender-affirming Double Incision Mastectomy with Free Nipple Grafting

“…Chronic pain has been reported in 20%–68% of postcancer mastectomy patients. 18 Given the technical similarities between cancer and gender-affirming mastectomy, chronic pain is also relevant in the transgender mastectomy population. Although further research is required, one retrospective study discussed that 27.4% of patients report persistent pain after gender mastectomy.…”