The Incidence, Impact and Risk Factors for Moderate to Severe Persistent Pain After Breast Cancer Surgery a Prospective Cohort Study

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aut.relation.endpage1034
aut.relation.issue9
aut.relation.journalPain Medicine
aut.relation.startpage1023
aut.relation.volume24
dc.contributor.authorChiang, Daniel LC
dc.contributor.authorRice, David A
dc.contributor.authorHelsby, Nuala A
dc.contributor.authorSomogyi, Andrew A
dc.contributor.authorKluger, Michal T
dc.date.accessioned2023-11-23T03:52:06Z
dc.date.available2023-11-23T03:52:06Z
dc.date.issued2023-05-15
dc.description.abstractBackground: Few Australasian studies have evaluated persistent pain after breast cancer surgery. Objective: To evaluate the incidence, impact, and risk factors of moderate to severe persistent pain after breast cancer surgery in a New Zealand cohort. Design: Prospective cohort study Methods: Consented patients were reviewed at 3 timepoints (preoperative, 2 weeks and 6 months postoperative). Pain incidence and interference, psychological distress and upper limb disability were assessed perioperatively. Clinical, demographic, psychological, cancer treatment-related variables, quantitative sensory testing, and patient genotype (COMT, OPRM1, GCH1, ESR1, and KCNJ6) were assessed as risk factors using multiple logistic regression. Results: Of the 173 patients recruited, 140 completed the 6-month follow-up. Overall, 15.0% (n = 21, 95% CI: 9.5% - 22.0%) of patients reported moderate to severe persistent pain after breast cancer surgery with 42.9% (n = 9, 95% CI: 21.9% - 66.0%) reporting likely neuropathic pain. Pain interference, upper limb dysfunction and psychological distress were significantly higher in patients with moderate to severe pain (P <. 004). Moderate to severe preoperative pain (OR= 3.60, 95% CI: 1.13-11.44, P =. 03), COMT rs6269 GA genotype (OR = 5.03, 95% CI: 1.49 - 17.04, P =. 009) and psychological distress at postoperative day 14 (OR= 1.08, 95% CI: 1.02 - 1.16, P =. 02) were identified as risk factors. Total intravenous anesthesia (OR= 0.31, 95% CI: 0.10 - 0.99, P =. 048) was identified as protective. Conclusion: The incidence of moderate to severe persistent pain after breast cancer surgery is high with associated pain interference, physical disability, and psychological distress. Important modifiable risk factors were identified to reduce this important condition.
dc.identifier.citationPain Medicine, ISSN: 1526-2375 (Print); 1526-4637 (Online), Oxford University Press (OUP), 24(9), 1023-1034. doi: 10.1093/pm/pnad065
dc.identifier.doi10.1093/pm/pnad065
dc.identifier.issn1526-2375
dc.identifier.issn1526-4637
dc.identifier.urihttp://hdl.handle.net/10292/16990
dc.languageen
dc.publisherOxford University Press (OUP)
dc.relation.urihttps://academic.oup.com/painmedicine/article/24/9/1023/7162695
dc.rights© The Author(s) 2023. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
dc.rights.accessrightsOpenAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectbreast cancer
dc.subjectimpact
dc.subjectpersistent pain
dc.subjectpostmastectomy pain
dc.subjectrisk factors
dc.subjectsurgery
dc.subject4203 Health Services and Systems
dc.subject32 Biomedical and Clinical Sciences
dc.subject3202 Clinical Sciences
dc.subject42 Health Sciences
dc.subjectBreast Cancer
dc.subjectClinical Research
dc.subjectCancer
dc.subjectPrevention
dc.subjectChronic Pain
dc.subjectPain Research
dc.subjectRehabilitation
dc.subjectCancer
dc.subject3 Good Health and Well Being
dc.subject1103 Clinical Sciences
dc.subject1115 Pharmacology and Pharmaceutical Sciences
dc.subject1117 Public Health and Health Services
dc.subjectAnesthesiology
dc.subject3202 Clinical sciences
dc.subject4203 Health services and systems
dc.subject5203 Clinical and health psychology
dc.subject.meshHumans
dc.subject.meshFemale
dc.subject.meshBreast Neoplasms
dc.subject.meshProspective Studies
dc.subject.meshIncidence
dc.subject.meshPain, Postoperative
dc.subject.meshRisk Factors
dc.subject.meshHumans
dc.subject.meshBreast Neoplasms
dc.subject.meshPain, Postoperative
dc.subject.meshIncidence
dc.subject.meshRisk Factors
dc.subject.meshProspective Studies
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshFemale
dc.subject.meshBreast Neoplasms
dc.subject.meshProspective Studies
dc.subject.meshIncidence
dc.subject.meshPain, Postoperative
dc.subject.meshRisk Factors
dc.titleThe Incidence, Impact and Risk Factors for Moderate to Severe Persistent Pain After Breast Cancer Surgery a Prospective Cohort Study
dc.typeJournal Article
pubs.elements-id506540
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