Treatment-Related Factors Predisposing to Chronic Pain in Patients with Breast Cancer<i>A Multivariate Approach</i>

Tasmuth, Tiina; Kataja, Matti; Blomqvist, Carl; K, von Smitten; Kalso, Eija

doi:10.3109/02841869709001326

Cited by 152 publications

(93 citation statements)

References 29 publications

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“…Callesen et al [7] presented data from a large case series of hernia repairs and found that the prevalence of groin pain decreased from 3 months to 6 months to 12 months and then stabilized. Similar data for persistent pain following thoracotomy have been presented by Gottschalk's group [8] and the same is true for breast surgery [9]. For lower extremity amputation, Jensen et al documented a relatively constant prevalence of pain between 1 and 2 years [10].…”

Section: Definition and Timing Of Postsurgical Painsupporting

confidence: 62%

Postsurgical Pain Syndromes

Perkins

Ballantyne

2010

Evidence‐Based Chronic Pain Management

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Section: Definition and Timing Of Postsurgical Painsupporting

confidence: 62%

Postsurgical Pain Syndromes

Perkins

Ballantyne

2010

Evidence‐Based Chronic Pain Management

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“…Persistent postsurgical pain was reported at least 3 months after breast cancer surgery (range 3.28-72.50 mo) in all eligible studies. Seven studies reported that other causes of persistent pain had been excluded, 32,37,38,42,44,46,52 but only 1 study explicitly used the IASP criteria for defining persistent postsurgical pain. 44 The median sample size was 416 (IQR 250-772), and the median duration of follow-up was 24 months (IQR 12-42 mo) (Appendix 7, available at www.…”

Section: Resultsmentioning

confidence: 99%

“…26,35 Whether or not we incorporated missing data for nonsignificant predictors or converted categorical data for age and BMI to continuous data (Appendix 13, available at www.cmaj.ca/lookup/suppl/ doi:10.1503/cmaj.151276/-/DC1) did not appreciably influence the results. 42 Wilson et al, 2013 49 Mejdahl et al, 2013 26 Johansen et al, 2014 52 Lundstedt et al, 2012 41 De Oliveira et al, 2014 37 Steegers et al, 2008 44 Meretoja et al, 2014 58 Yang et al, 2010 51 Tasmuth et al, 1997 46 Shahbazi et al, 2015 60 Husen et al, 2006 40 Bell et al, 2014 59 Swenson et al …”

Section: Subgroup Analyses Meta-regression and Sensitivity Analysesmentioning

confidence: 99%

Predictors of persistent pain after breast cancer surgery: a systematic review and meta-analysis of observational studies

Wang

Guyatt

Kennedy

et al. 2016

CMAJ

247

239

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D espite a 10-year survival rate of 83%, 1,2 between 25% and 60% of surviving patients who have undergone surgery for breast cancer experience persistent postsurgical pain, [3][4][5][6][7][8][9] which is associated with reduced quality of life and functional impairment. [10][11][12][13] Systematic reviews summarizing proposed risk factors for persistent pain after breast cancer surgery -including demographic, intraoperative and postoperative factors -have had several limitations, including outdated searches, inadequate attention to risk-of-bias assessment, lack of statistical pooling of measures of association and failure to evaluate the quality of evidence.5,10-14 We conducted a systematic review and meta-analysis of observational studies to identify risk factors for persistent pain after breast cancer surgery, addressing the limitations of previous reviews. MethodsWe completed our systematic review in accordance with the MOOSE statement 15 and registered our protocol with PROSPERO (registration CRD42014013338). Background: Persistent pain after breast cancer surgery affects up to 60% of patients. Early identification of those at higher risk could help inform optimal management. We conducted a systematic review and meta-analysis of observational studies to explore factors associated with persistent pain among women who have undergone surgery for breast cancer. Predictors of persistent pain after breast cancer surgery: a systematic review and meta-analysis of observational studies

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“…Postoperative risk factors include radiation therapy [4,8,110,190,191] and increased severity of pain in the immediate postoperative period [4,191,192]. Evidence of post-surgical complication-for example, infection, seroma, hematoma, axillary web syndrome, etc.-contribution is mixed, with only one in four investigations finding an association with chronic pain [179,[191][192][193].…”

Section: Persistent Post-surgical (Chronic) Painmentioning

confidence: 99%

An Evidence-Based Review of the Efficacy of Perioperative Analgesic Techniques for Breast Cancer-Related Surgery

Cheng

2016

Pain Med

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Objective. To review the published evidence regarding perioperative analgesic techniques for breast cancer-related surgery.Design. Topical review.Methods. Randomized, controlled trials (RCTs) were selected for inclusion in the review. Also included were large prospective series providing estimates of potential risks and technical reports and small case series demonstrating a new technique or approaches of interest to clinicians.Results. A total of 514 abstracts were reviewed, with 284 studies meeting criteria for full review. The evidence regarding preemptive ketamine, scheduled opioids, perioperative non-steroidal anti-inflammatory drugs (NSAIDs), and intravenous lidocaine is mixed and deserves further investigation. There is strong evidence that both pregabalin and gabapentin provide analgesic benefits following breast surgery. There is minimal and conflicting data from highquality randomized, controlled studies suggesting that directly infiltrating and/or infusing local anesthetic (liposome encapsulated or unencapsulated) into the surgical wound is a reliably effective analgesic. In contrast, there is a plethora of data demonstrating the potent analgesia, opioid sparing, and decreased opioid-related side effects from thoracic epidural infusion and both single-injection and continuous paravertebral nerve blocks (the latter two demonstrating decreased persistent post-surgical pain between 2.5 and 12 months). Techniques with limited-yet promising-data deserving additional investigation include brachial plexus blocks, cervical epidural infusion, interfascial plane blocks, and interpleural blocks.Conclusions. While there are currently multiple promising analgesic techniques for surgical procedures of the breast that deserve further study, the only modalities demonstrated to provide potent, consistent perioperative pain control are thoracic epidural infusion and paravertebral nerve blocks.

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Treatment-Related Factors Predisposing to Chronic Pain in Patients with Breast CancerA Multivariate Approach

Cited by 152 publications

References 29 publications

Postsurgical Pain Syndromes

Postsurgical Pain Syndromes

Predictors of persistent pain after breast cancer surgery: a systematic review and meta-analysis of observational studies

An Evidence-Based Review of the Efficacy of Perioperative Analgesic Techniques for Breast Cancer-Related Surgery

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