Predictive factors for patients who need treatment for chronic post-surgical pain (CPSP) after breast cancer surgery

Abstract

Purpose: Although chronic postsurgical pain (CPSP) after breast cancer surgery is a common and prevalent postsurgical adverse event, the need for CPSP treatment has not been investigated. This study examined the proportion of patients who needed treatment for CPSP and associated predictors.Methods: We conducted a cross-sectional study with female patients who underwent breast cancer surgery at our institution. Participants were aged ≤65 years at the time of this study and were at least 1 year post surgery. The questionnaire examined the presence of and need for treatment for CPSP and included the Japanese version of the Concerns about Recurrence Scale (CARS-J). Multivariate analyses were used to identify independent predictors of needing treatment for CPSP.Results: In total, 305 patients completed the questionnaire. The mean time since surgery was 67.1 months; 151 (51%) patients developed CPSP after breast cancer surgery and 61 (39%) needed treatment for CPSP. Among patients that developed CPSP, the fear of breast cancer recurrence as assessed by the CARS-J (odds ratio [OR] 2.22, 95% con dence interval [CI]: 1.30-3.81, P=0.004) and >2 postsurgical pain regions (OR 2.52, 95% CI: 1.16-5.57, P=0.020) were independent predictors of needing treatment for CPSP.Conclusions: This study is the rst to identify the proportion and predictors of patients who need treatment for CPSP. Fear of breast cancer recurrence and >2 postsurgical pain regions may predict the need for CPSP treatment among patients following breast cancer surgery.

Chronic Pain Following Breast Reconstruction

“…This trend is also observed for other types of surgery, including major joint arthroplasties and abdominal hysterectomy 70 . The fear of recurrence of breast cancer might also lead to chronic pain that requires pain management 71 . Thus, psychological factors may potentially induce chronic pain following breast operations.…”

“…In general, there are 3 major types of treatment modalities to relieve chronic pain after mastectomy: surgical, systemic pharmacological, and regional anesthetic. Uemoto et al 71 reported that 39% of patients with chronic pain needed treatment for pain after surgery. These multimodal approaches may also prevent transition of pain from acute to chronic 14 .…”

“…70 The fear of recurrence of breast cancer might also lead to chronic pain that requires pain management. 71 Thus, psychological factors may potentially induce chronic pain following breast operations.…”