title: Pain and quality of life after surgery for breast cancer.
abstract: BACKGROUND
  In breast cancer (BC) patients, conservative surgery (CS) followed by irradiation or immediate breast reconstruction (IBR) after modified radical mastectomy (MRM) has been proposed in the attempt to avoid the negative impact of MRM on feminine body image. Regardless of the type of operation, BC patients may feel pain even without recurrent disease with poor adjustment in terms of quality of life (QL).
  
  
  METHODS
  We adopted a questionnaire comprising the short form of the McGill Pain questionnaire, and a previously validated questionnaire able to identify four subscales exploring physical well-being, physical autonomy, relational life and psychological well-being. The questionnaire was mailed in 1999 to a consecutive series of 757 (CS: 481 cases; MRM + IBR with skin expander: 93 cases; MRM: 183 cases) disease-free patients treated for BC between March 1995 and March 1998.
  
  
  RESULTS
  The final analysis assessed the data relating to 529 patients who underwent axillary dissection. Pain was reported by 39.7% of women with higher incidence in patients who underwent CS than in those who underwent MRM +/- IBR, but this difference did not reach statistical significance (p = 0.07). The only statistically significant difference (p < 0.05) between the surgical groups was the pain appearance that occurred earlier in the CS patients and later in the MRM + IBR patients. No other differences were observed. The women with pain had significantly worse QL scores on all of the subscales than those without.
  
  
  CONCLUSIONS
  Pain after surgery for BC distress almost one-third of patients, regardless of the type of treatment, and had a negative effect on patients' QL. The different surgical procedures may marginally influence the quantitative characteristics of pain.
authors.affiliation: Department of Medical Oncology, Largo Medaglie d'Oro, Santa Chiara Hospital, Trento, Italy. caffo@tn.apss.tn.it
authors.forename: Orazio
authors.initials: O
authors.lastname: Caffo
authors.forename: Maurizio
authors.initials: M
authors.lastname: Amichetti
authors.forename: Antonella
authors.initials: A
authors.lastname: Ferro
authors.forename: Antonio
authors.initials: A
authors.lastname: Lucenti
authors.forename: Francesco
authors.initials: F
authors.lastname: Valduga
authors.forename: Enzo
authors.initials: E
authors.lastname: Galligioni
mesh_terms: D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy / Q000379:methods; D015411:Mastectomy, Modified Radical / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology*; D011788:Quality of Life; D012189:Retrospective Studies; D012647:Self-Assessment