Preoperative Breast Pain Predicts Persistent Breast Pain and Disability After Breast Cancer Surgery.

Abstract

CONTEXT Approximately 30% of the women report pain in the affected breast before breast cancer surgery. OBJECTIVES The purpose of this secondary analysis of our prospective study was to determine how women who experienced both preoperative and persistent postsurgical breast pain (n=107) differed from women who did not report preoperative breast pain and did (n=158) or did not (n=122) experience persistent postsurgical breast pain. METHODS Differences in demographic and clinical characteristics were evaluated. Linear mixed effects (LME) modeling was used to evaluate for group differences in symptom severity, function, sensation, and quality of life (QOL) over time. RESULTS Between-group differences in demographic and clinical characteristics as well as trajectories of shoulder function and QOL were identified. Women with both preoperative and persistent postsurgical breast pain were younger; were more likely to report swelling, strange sensations, hardness, and numbness in the affected breast before surgery; and were more likely to have reconstruction at the time of surgery. Women with both preoperative and persistent postsurgical breast pain had more biopsies in the prior year, more lymph nodes removed, and reported more severe acute postsurgical pain than women without preoperative breast pain. The LME modeling revealed significant group effects for most outcomes evaluated. Over the six months of the study, women with both preoperative and persistent postsurgical pain had persistently poorer shoulder flexion and physical well-being than women without preoperative breast pain. CONCLUSION Investigations of the etiology and molecular mechanisms of preoperative breast pain, as well as interventions for this high-risk group, are needed.

DOI: 10.1016/j.jpainsymman.2014.11.292

Cite this paper

@article{Langford2015PreoperativeBP, title={Preoperative Breast Pain Predicts Persistent Breast Pain and Disability After Breast Cancer Surgery.}, author={Dale J. Langford and Brian L. Schmidt and Jon D Levine and Gary M. Abrams and Charles Elboim and Laura Esserman and Deborah Hamolsky and Judy Mastick and Steven M Paul and Bruce A Cooper and Kord M. Kober and Marylin J. Dodd and Laura B. Dunn and Bradley E. Aouizerat and Christine Miaskowski}, journal={Journal of pain and symptom management}, year={2015}, volume={49 6}, pages={981-94} }