Predictors for pain after breast cancer surgery unveiled

Sep 5 2012

By Piriya Mahendra, medwireNews Reporter

Researchers have identified that chronic preoperative pain, axillary surgery, and psychologic robustness significantly predict acute pain outcomes after breast cancer surgery.

These findings could be used as a simple means of identifying which breast cancer patients may benefit from extra pain relief or support before they undergo surgery, say Julia Bruce (University of Warwick, UK) and colleagues in the British Journal of Cancer.

"Women generally receive the same advice and treatment for pain relief following breast cancer surgery, but this study shows how factors such as a patient's psychological state and whether they have a prior history of chronic pain can really affect their recovery," said Bruce in a press statement.

Bruce and team found that women who had chronic preoperative pain such as arthritis, low back pain, and migraine were three times more likely than those who did not to report moderate to severe movement-evoked pain after undergoing breast cancer surgery.

Women who had high psychologic robustness were 37% less likely to feel pain at rest and 29% less likely to experience movement-evoked pain in the first week after surgery.

Sentinel lymph node biopsy and intraoperative nerve division were significantly associated with reduced postoperative pain, while no association was found between preoperative neuropathic pain and acute pain outcomes.

"Doctors may be able to use this as a way of identifying women who need more intensive pain relief immediately after surgery," suggested Bruce. "These results are particularly important because research shows that severe pain in the first week after surgery can significantly delay recovery."

The study included 308 patients from across north Scotland in the UK. Each patient responded to questionnaires regarding their general health, how they were feeling, and whether they had any existing pain before they underwent surgery. One week after surgery, these patients were asked about the amount and type of pain they experienced and whether they had taken painkillers.

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