Prevalence and Intensity of Persistent Post-Surgical Pain following Breast Cancer Surgery: A Systematic Review and Meta-Analysis of Observational Studies

Wang, Li; Devasenapathy, Niveditha; Hong, Brian Y.; Cohen, Jared C.; Kheyson, Sasha; Oparin, Yvgeniy; Kennedy, Sean A.; Romerosa, Beatriz; Arora, Nikita; Kwon, Henry Y.; Lu, Daniel; Jackson, Kate; Couban, Rachel; Busse, Jason W.

doi:10.1080/24740527.2019.1592389

Cited by 11 publications

(14 citation statements)

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“…In agreement to previous studies, we found that 38.3% of the patients who developed chronic pain after BCS described a neuropathic component [31,32]. Moreover, our study also confirmed that a substantial proportion of patients reported CPSP as moderate to severe in nature, which is in accordance with previous study [2]. Due to the cancer-related multimodal treatment, chronic pain after BCS is often described as a mixed pain, which consists predominantly of a neuropathic nature and partially related to intraoperative nerve injury [33,34].…”

Section: Discussionsupporting

confidence: 93%

“…The incidence of CPSP after BCS varied from 25 to 78% in previous studies [2]. This may partially be attributed to different definitions of chronic pain.…”

Section: Discussionmentioning

confidence: 84%

“…Being the most frequently diagnosed type of female malignancy, breast cancer accounts for a large number of cancer-related deaths worldwide [1]. Besides, patients that have undergone breast cancer surgery (BCS) are often left with chronic postsurgical pain (CPSP) with a prevalence up to 78% of the survivors [2]. CPSP may gravely impair quality of life and become a heavy burden to BCS patients [3,4].…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Preoperative Ultrasound-Guided Erector Spinae Plane Block on Chronic Postsurgical Pain After Breast Cancer Surgery: A Propensity Score-Matched Cohort Study

et al. 2021

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Section: Discussionsupporting

confidence: 93%

“…The incidence of CPSP after BCS varied from 25 to 78% in previous studies [2]. This may partially be attributed to different definitions of chronic pain.…”

Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Preoperative Ultrasound-Guided Erector Spinae Plane Block on Chronic Postsurgical Pain After Breast Cancer Surgery: A Propensity Score-Matched Cohort Study

et al. 2021

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“…In opposition with the results of a study by Wang L and collaborators, we did not record differences between the two groups with respect to chronic pain even though opioid consumption was lower in the RD2 group. The reason may be because we recruited patients only undergoing dissection of axillary lymph nodes, which is an independent risk factor for chronic pain (50).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Ultrasound Guided-Deep Serratus Anterior Plane Blockade With Different Doses of Dexmedetomidine for Women Undergoing Modified Radical Mastectomy: A Randomized Controlled Trial

Chen

Zhu

et al. 2022

Front. Med.

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BackgroundUltrasound guided-deep serratus anterior plane block (USG-DSAPB) has been used for pain management of patients undergoing modified radical mastectomy (MRM), but evidence supporting their adjuvant analgesic benefits is limited. We explored the efficacy and safety of preemptive use of ropivacaine combined with different doses of dexmedetomidine (DEX) in USG-DSAPB for patients undergoing MRM.MethodsNinety-five female patients undergoing unilateral MRM were allocated randomly to two groups. Group RD1 had 20 mL of 0.5% ropivacaine with 5 mg of dexamethasone and 0.5 μg·kg−1 DEX in USG-DSAPB. Group RD2 had 20 mL of 0.5% ropivacaine with 5 mg of dexamethasone and 1 μg·kg−1 DEX in USG-DSAPB. The primary outcome was sufentanil consumption 72 h after USG-DSAPB. Secondary outcomes were: postoperative pain scores and level of sedation; intraoperative hemodynamics; duration of post-anesthesia care unit (PACU) stay; prevalence of moderate-to-severe pain; one-time puncture success; procedure time of blockade; time to first rescue analgesia; requirement of rescue analgesia; satisfaction scores of patients and surgeons; duration of hospital stay; adverse events; prevalence of chronic pain; quality of postoperative functional recovery.ResultsCompared with the RD1 group, the visual analog scale score for coughing was significantly lower at 4, 8, 12 h and sufentanil consumption was significantly lower at 4, 8, 12, 24, and 48 h after surgery in the RD2 group (P < 0.05). The time to first rescue analgesia was significantly longer in the RD2 group (P < 0.05). The requirement for rescue analgesia was significantly higher in the RD1 group (P < 0.05). The prevalence of moderate-to-severe pain, number of patients using vasoactive agents, duration of PACU stay, as well as consumption of propofol, remifentanil, and DEX were significantly lower in the RD2 group (P < 0.05). There were no significant differences between the two groups with respect to one-time puncture success, procedure time of blockade, total dermatomal spread, satisfaction scores of patients and surgeons, postoperative complications, duration of hospital stay, 40-item Quality of Recovery questionnaire (QoR-40) score, or prevalence of chronic pain (P > 0.05).ConclusionsWe discovered that 1 μg·kg−1 (not 0.5 μg·kg−1) DEX combined with 20 mL of 0.5% ropivacaine and 5 mg of dexamethasone in USG-DSAPB could provide superior postoperative analgesia for patients undergoing MRM. However, the quality of postoperative functional recovery and prevalence of chronic pain were similar.Clinical Trial Registration:http://www.chictr.org.cn/showproj.aspx?proj=54929, identifier: ChiCTR2000033685.

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“…Breast cancer is the most common cancer amongst women. Seventy-three percent of people diagnosed with breast cancer have their cancer successfully treated, defined here as being alive 5 years after diagnosis [1], but 19.5-21.8% of them experience persisting moderate-to-severe pain [2,3]. Breast cancer survivors with persistent pain report worse scores on assessments of mental health, social functioning and vitality than pain-free survivors do [4,5].…”

Section: Introductionmentioning

confidence: 99%

Treating persistent pain after breast cancer: practice gaps and future directions

et al. 2022

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This paper discusses the growing problem of persisting pain after successful treatment of breast cancer and presents recommendations for improving pain-related outcomes for this group. We discuss the dominant treatment approach for persisting pain post-breast cancer treatment and draw contrasts with contemporary treatment approaches to persistent pain in noncancer-related populations. We discuss modern application of the biopsychosocial model of pain and the notion of variable sensitivity within the pain system, moment by moment and over time. We present the implications of increasing sensitivity over time for treatment selection and implementation. By drawing on transformative changes in treatment approaches to persistent non-cancer-related pain, we describe the potentially powerful role that an intervention called pain science education, which is now recommended in clinical guidelines for musculoskeletal pain, may play in improving pain and disability outcomes after successful breast cancer treatment. Finally, we present several research recommendations that centre around adaptation of the content and delivery models of contemporary pain science education, to the post-breast cancer context.

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Prevalence and Intensity of Persistent Post-Surgical Pain following Breast Cancer Surgery: A Systematic Review and Meta-Analysis of Observational Studies

Cited by 11 publications

References 0 publications

The Effect of Preoperative Ultrasound-Guided Erector Spinae Plane Block on Chronic Postsurgical Pain After Breast Cancer Surgery: A Propensity Score-Matched Cohort Study

The Effect of Preoperative Ultrasound-Guided Erector Spinae Plane Block on Chronic Postsurgical Pain After Breast Cancer Surgery: A Propensity Score-Matched Cohort Study

Efficacy and Safety of Ultrasound Guided-Deep Serratus Anterior Plane Blockade With Different Doses of Dexmedetomidine for Women Undergoing Modified Radical Mastectomy: A Randomized Controlled Trial

Treating persistent pain after breast cancer: practice gaps and future directions

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