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Original article
Available online 1 February 2024
Chronic pain after breast surgery: incidence, risk factors and impact on quality of life
Dolor crónico tras la cirugía de mama: incidencia, factores de riesgo e impacto en la calidad de vida
S. Nogueiraa,
Corresponding author
sara_meira87@live.com.pt

Corresponding author.
, D. Rodriguesa, M. Barrosa, J. Menezesb, L. Guimarães-Pereiraa,c
a Department of Anaesthesiology, Centro Hospitalar Universitário São João, Alameda Prof. Hernâni Monteiro, Porto, Portugal
b Department of Medicine Faculty of Medicine of the University of Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal
c Cardiovascular R&D Centre – UnIC@RISE, Surgery and Physiology Department, Faculty of Medicine of the University of Porto, UnIC, CIM-FMUP, R. Dr. Plácido da Costa, Porto, Portugal
Received 06 October 2022. Accepted 06 April 2023
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Tables (4)
Table 1. Patients demographics, comorbidities, and surgical and anaesthesia factors (N = 120).
Table 2. Chronic postsurgical pain severity and interference using the Brief Painin Inventory --Short Form at 3 months (N = 39).
Table 3. Factors associated with CPBS at 3 months.
Table 4. QoL and CPBS at 3 months.
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Abstract
Introduction and Objectives

Breast cancer is the most frequently diagnosed malignancy, and chronic pain after breast surgery (CPBS) is an increasingly recognized therapy-related problem. We evaluated CPBS incidence, characteristics, associated factors, and impact on patient quality of life (QoL).

Materials and Methods

Six-month observational prospective study conducted in patients undergoing breast surgery in a tertiary university hospital. Data were collected using several questionnaires: Pain Catastrophizing Scale, Brief Pain Inventory-Short Form, Douleur Neuropathique 4 Questionnaire, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and its Breast Cancer Module.

Results

A total of 112 patients completed the study. Approximately, one third (34.8%) developed CPBS, and almost all with potentially neuropathic pain. CPBS interfered with patients’ daily life and reduced their QoL. Diabetes (p = 0.028), catastrophizing (p = 0.042), and acute postoperative pain severity (p < 0.001) were associated with CPBS.

Conclusions

This study broadens our understanding of CPBS and shows the impact of this syndrome. Healthcare workers need to be aware of CPBS and take steps to prevent and treat it, and provide patients with adequate information.

Keywords:
Breast cancer
Breast cancer surgery
Chronic postsurgical pain
Quality of life
Resumen
Introducción y Objetivos

El cáncer de mama es la neoplasia más frecuentemente diagnosticada, y el dolor crónico postoperatorio (DCPO) es un problema relacionado con la terapia crecientemente reconocido. Evaluamos la incidencia del DCPO, sus características, factores asociados e impacto en la calidad de vida (CdV) del paciente.

Materiales y Métodos

Se realizó un estudio prospectivo observacional de seis meses en pacientes sometidos a cirugía de mama en un hospital universitario terciario. Los datos se recopilaron utilizando diversos cuestionarios: Pain Catastrophizing Scale, Brief Pain Inventory-Short Form, Douleur Neuropathique 4, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire y Breast Cancer Module.

Resultados

Un total de 112 pacientes completaron el estudio, de los cuales aproximadamente un tercio (34,8%) desarrollaron DCPO, y casi todos ellos dolor neuropático potencial. El DCPO interfirió con la vida diaria de los pacientes y redujo su CdV. La diabetes (p = 0,028), la catastrofización (p = 0,042) y la gravedad del dolor posoperatorio agudo (p < 0,001) se asociaron a DCPO.

Conclusiones

Este estudio amplía nuestra comprensión sobre el DCPO y muestra el impacto de este síndrome. Los profesionales sanitarios deben ser conscientes del DCPO, y tomar medidas para prevenirlo y tratarlo, proporcionando a los pacientes la información suficiente.

Palabras clave:
Cáncer de mama
Cirugía de cáncer de mama
Dolor postoperatorio crónico
Calidad de vida

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