Risk factors for chronic pain following breast cancer surgery: a prospective study

J Pain. 2006 Sep;7(9):626-34. doi: 10.1016/j.jpain.2006.02.007.

Abstract

Chronic pain following breast cancer surgery is associated with decreased health-related quality of life and is a source of additional psychosocial distress in women who are already confronting the multiple stresses of cancer. Few prospective studies have identified risk factors for chronic pain following breast cancer surgery. Putative demographic, clinical, and psychosocial risk factors for chronic pain were evaluated prospectively in 95 women scheduled for breast cancer surgery. In a multivariate analysis of the presence of chronic pain, only younger age was associated with a significantly increased risk of developing chronic pain 3 months after surgery. In an analysis of the intensity of chronic pain, however, more invasive surgery, radiation therapy after surgery, and clinically meaningful acute postoperative pain each independently predicted more intense chronic pain 3 months after surgery. Preoperative emotional functioning variables did not independently contribute to the prediction of either the presence or the intensity of chronic pain after breast cancer surgery. These findings not only increase understanding of risk factors for chronic pain following breast cancer surgery and the processes that may contribute to its development but also provide a basis for the development of preventive interventions.

Perspective: Clinical variables and severe acute pain were risk factors for chronic pain following breast cancer surgery, but psychosocial distress was not, which provides a basis for hypothesizing that aggressive management of acute postoperative pain may reduce chronic pain.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Acute Disease
  • Adult
  • Affective Symptoms / complications
  • Affective Symptoms / physiopathology
  • Affective Symptoms / psychology
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / surgery*
  • Carcinoma / surgery*
  • Chronic Disease
  • Disability Evaluation
  • Female
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Pain Measurement
  • Pain Threshold / physiology
  • Pain Threshold / psychology
  • Pain, Postoperative / etiology*
  • Pain, Postoperative / physiopathology
  • Pain, Postoperative / psychology
  • Prospective Studies
  • Psychology
  • Radiotherapy / adverse effects
  • Risk Factors
  • Surgical Procedures, Operative / adverse effects*