Risk factors for chronic pain following breast cancer surgery: a prospective study.
Chronic pain following breast cancer surgery is associated with decreased health-related quality of life and is a source of additional psychosocial distress in women who are already confronting the multiple stresses of cancer. Few prospective studies have identified risk factors for chronic pain following breast cancer surgery. Putative demographic, clinical, and psychosocial risk factors for chronic pain were evaluated prospectively in 95 women scheduled for breast cancer surgery. In a multivariate analysis of the presence of chronic pain, only younger age was associated with a significantly increased risk of developing chronic pain 3 months after surgery. In an analysis of the intensity of chronic pain, however, more invasive surgery, radiation therapy after surgery, and clinically meaningful acute postoperative pain each independently predicted more intense chronic pain 3 months after surgery. Preoperative emotional functioning variables did not independently contribute to the prediction of either the presence or the intensity of chronic pain after breast cancer surgery. These findings not only increase understanding of risk factors for chronic pain following breast cancer surgery and the processes that may contribute to its development but also provide a basis for the development of preventive interventions.


CONCLUSIONS
Clinical variables and severe acute pain were risk factors for chronic pain following breast cancer surgery, but psychosocial distress was not, which provides a basis for hypothesizing that aggressive management of acute postoperative pain may reduce chronic pain.
Poleshuck
Ellen L
EL
Department of Psychiatry, University of Rochester School of Medicine and Dentistry, New York 14642, USA.
Katz
Jennifer
J
Andrus
Carl H
CH
Hogan
Laura A
LA
Jung
Beth F
BF
Kulick
Dale I
DI
Dworkin
Robert H
RH
D000208:Acute Disease; D000328:Adult; D000342:Affective Symptoms / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000601:surgery*; D002277:Carcinoma / Q000601:surgery*; D002908:Chronic Disease; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology / Q000523:psychology; D010149:Postoperative Pain / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D011446:Prospective Studies; D011584:Psychology; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects*