J Breast Cancer.  2016 Dec;19(4):447-454. 10.4048/jbc.2016.19.4.447.

Persistent Pain after Breast Cancer Treatment: A Questionnaire-Based Study on the Prevalence, Associated Treatment Variables, and Pain Type

• Juhl AA
• Christiansen P
• Damsgaard

• KMID: 2362932
• DOI: http://doi.org/10.4048/jbc.2016.19.4.447

Abstract

PURPOSE
Persistent pain is a common side effect of breast cancer treatment. The present study aimed to assess the prevalence, associated treatment-related factors, and the type of pain (neuropathic or nociceptive) in patients who had undergone a unilateral mastectomy.
METHODS
All women who underwent a unilateral mastectomy at a University Hospital between 2009 and 2013 were eligible for inclusion. Women with breast reconstruction or active cancer were excluded. Participants were mailed a questionnaire evaluating the prevalence, location, intensity, and frequency of surgical site pain. Additionally, the painDETECT®, a validated instrument to evaluate neuropathic pain, was mailed to all participants.
RESULTS
A total of 305 women were included, and of them, 261 (85.6%) completed the study questionnaire. After a median follow-up period of 3.0 years, 100 women (38.3%) reported experiencing pain at the surgical site. Body mass index ≥30 kg/m², radiation therapy, and axillary lymph node dissection were significantly associated with persistent pain in univariate models. However, only body mass index ≥30 kg/m² was independently associated with persistent pain (odds ratio, 2.13; 95% confidence interval, 1.06-4.27; p=0.034) in a multivariate analysis. Of the patients reporting pain, 71.0% were unlikely to have a neuropathic pain component. A moderate, but highly significant, positive correlation was observed between the pain intensity and the painDETECT® score (rs=0.47, p<0.001).
CONCLUSION
Persistent pain after breast cancer treatment continues to have a high prevalence. Our results indicate that the largest proportion of patients experiencing persistent pain after breast cancer treatment do not have a clear neuropathic pain component.

Keyword

Breast neoplasms; Chronic pain; Mastectomy; Neuralgia

MeSH Terms

Body Mass Index
Breast Neoplasms*
Breast*
Chronic Pain
Female
Follow-Up Studies
Humans
Lymph Node Excision
Mammaplasty
Mastectomy
Multivariate Analysis
Neuralgia
Postal Service
Prevalence*

Figure

• 

  Figure 1 Flowchart of the patient inclusion process. DBCG=Danish Breast Cancer Cooperative Group.

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