The prevalence of neuropathic pain is high after treatment for breast cancer: a systematic review

İlhan, Emre; Chee, Edwin; Hush, Julia M.; Moloney, Niamh

doi:10.1097/j.pain.0000000000001004

Cited by 45 publications

(47 citation statements)

References 51 publications

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“…A prior systematic review of neuropathic pain after breast cancer surgery reported the prevalence ranged from 14% to 27%, based on the questionnaire used. 15 Our systematic review found a pooled prevalence of 29% for persistent neuropathic pain after surgery, and no evidence for a subgroup effect based on instrument-defined neuropathic pain (e.g. DN4, LANSS, or S-LANSS) vs clinically assessed neuropathic pain.…”

Section: Relation To Other Studies and Implicationsmentioning

confidence: 61%

“…We screened the reference lists of all eligible studies and three previous systematic reviews for additional studies. 11,14,15 We included prospective and retrospective cohort or crosssectional studies that (i) enrolled 100 breast cancer patients and (ii) reported the prevalence or intensity of PPSP (3 months after surgery); Supplementary Appendix, section 1.2. We excluded conference abstracts, letters, and non-Englishlanguage articles.…”

Section: Data Sources and Searchesmentioning

confidence: 99%

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Prevalence and intensity of persistent post-surgical pain following breast cancer surgery: a systematic review and meta-analysis of observational studies

Wang

Cohen

Devasenapathy

et al. 2020

British Journal of Anaesthesia

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Background: The prevalence and intensity of persistent post-surgical pain (PPSP) after breast cancer surgery are uncertain. We conducted a systematic review and meta-analysis to further elucidate this issue. Methods: We searched MEDLINE, Embase, CINAHL, and PsycINFO, from inception to November 2018, for observational studies reporting persistent pain (3 months) after breast cancer surgery. We used random-effects meta-analysis and the Grading of Recommendations, Assessment, Development and Evaluations approach to rate quality of evidence. Results: We included 187 observational studies with 297 612 breast cancer patients. The prevalence of PPSP ranged from 2% to 78%, median 37% (inter-quartile range: 22e48%); the pooled prevalence was 35% (95% confidence interval [CI]: 32e39%). The pooled pain intensity was 3.9 cm on a 10 cm visual analogue scale (95% CI: 3.6e4.2 cm). Moderate-quality evidence supported the subgroup effects of PPSP prevalence for localized pain vs any pain (29% vs 44%), moderate or greater vs any pain (26% vs 44%), clinician-assessed vs patient-reported pain (23% vs 36%), and whether patients underwent sentinel lymph node biopsy vs axillary lymph node dissection (26% vs 43%). The adjusted analysis found that the prevalence of patient-reported PPSP (any severity/location) was 46% (95% CI: 36e56%), and the prevalence of patientreported moderate-to-severe PPSP at any location was 27% (95% CI: 10e43%).

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Section: Relation To Other Studies and Implicationsmentioning

confidence: 61%

Section: Data Sources and Searchesmentioning

confidence: 99%

Prevalence and intensity of persistent post-surgical pain following breast cancer surgery: a systematic review and meta-analysis of observational studies

Wang

Cohen

Devasenapathy

et al. 2020

British Journal of Anaesthesia

View full text Add to dashboard Cite

show abstract

“…From the regression model, the DASH score showed statistically significant differences between the groups in that the neuropathic group demonstrated impaired upper limb function (P = 0.002). More important, the DASH score mean of 35 (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46) in the nonneuropathic group versus 51 (41-67) in the neuropathic group met the minimum clinical important difference in change scores, indicating that these groups are not only statistically but also clinically different. 18 Due to the heavily skewed distribution of pain scores, the 11-point NPRS was analyzed based on percentages of those experiencing pain (NPRS 1 or higher) versus no pain.…”

Section: Resultsmentioning

confidence: 99%

Quantitative sensory profiles of upper extremity chemotherapy induced peripheral neuropathy: Are there differences in sensory profiles for neuropathic versus nociceptive pain?

Hammond

Pitz

Lambert

et al. 2019

Canadian Journal of Pain

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“…Chronic post-surgical neuropathic pain (NP, ICD 11 codes MG30.51 Chronic neuropathic pain after peripheral nerve injury and MG30.11 Chronic post cancer treatment pain) is common after breast cancer surgery with an estimated prevalence of 14-31% [1,2]. This condition may persist for years [3,4].…”

Section: Introductionmentioning

confidence: 99%

Sensory profiles in women with neuropathic pain after breast cancer surgery

Mustonen

Vollert

Rice

et al. 2020

Breast Cancer Res Treat

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Purpose We performed a detailed analysis of sensory function in patients with chronic post-surgical neuropathic pain (NP) after breast cancer treatments by quantitative sensory testing (QST) with DFNS (German Research Network on Neuropathic Pain) protocol and bed side examination (BE). The nature of sensory changes in peripheral NP may reflect distinct pathophysiological backgrounds that can guide the treatment choices. NP with sensory gain (i.e., hyperesthesia, hyperalgesia, allodynia) has been shown to respond to Na +-channel blockers (e.g., oxcarbazepine). Methods 104 patients with at least "probable" NP in the surgical area were included. All patients had been treated for breast cancer 4-9 years ago and the handling of the intercostobrachial nerve (ICBN) was verified by the surgeon. QST was conducted at the site of NP in the surgical or nearby area and the corresponding contralateral area. BE covered the upper body and sensory abnormalities were marked on body maps and digitalized for area calculation. The outcomes of BE and QST were compared to assess the value of QST in the sensory examination of this patient group. Results Loss of function in both small and large fibers was a prominent feature in QST in the area of post-surgical NP. QST profiles did not differ between spared and resected ICBN. In BE, hypoesthesia on multiple modalities was highly prevalent. The presence of sensory gain in BE was associated with more intense pain. Conclusions Extensive sensory loss is characteristic for chronic post-surgical NP several years after treatment for breast cancer. These patients are unlikely to respond to Na +-channel blockers.

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The prevalence of neuropathic pain is high after treatment for breast cancer: a systematic review

Abstract: PROSPERO registration CRD42015029987.

Cited by 45 publications

References 51 publications

Prevalence and intensity of persistent post-surgical pain following breast cancer surgery: a systematic review and meta-analysis of observational studies

Prevalence and intensity of persistent post-surgical pain following breast cancer surgery: a systematic review and meta-analysis of observational studies

Quantitative sensory profiles of upper extremity chemotherapy induced peripheral neuropathy: Are there differences in sensory profiles for neuropathic versus nociceptive pain?

Sensory profiles in women with neuropathic pain after breast cancer surgery

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