title: Identification of patient subgroups and risk factors for persistent breast pain following breast cancer surgery.
abstract: Study purposes were to determine the prevalence of persistent pain in the breast; characterize distinct persistent pain classes using growth mixture modeling; and evaluate for differences among these pain classes in demographic, preoperative, intraoperative, and postoperative characteristics. In addition, differences in the severity of common symptoms and quality of life outcomes measured prior to surgery, among the pain classes, were evaluated. Patients (n = 398) were recruited prior to surgery and followed for 6 months. Using growth mixture modeling, patients were classified into no (31.7%), mild (43.4%), moderate (13.3%), and severe (11.6%) pain groups based on ratings of worst breast pain. Differences in a number of demographic, preoperative, intraoperative, and postoperative characteristics differentiated among the pain classes. In addition, patients in the moderate and severe pain classes reported higher preoperative levels of depression, anxiety, and sleep disturbance than the no pain class. Findings suggest that approximately 25% of women experience significant and persistent levels of breast pain in the first 6 months following breast cancer surgery.
  
  
  CONCLUSIONS
  Persistent pain is a significant problem for 25% of women following surgery for breast cancer. Severe breast pain is associated with clinically meaningful decrements in functional status and quality of life.
authors.affiliation: School of Nursing, University of California, San Francisco, CA, USA. chris.miaskowski@nursing.ucsf.edu
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
authors.forename: Bruce
authors.initials: B
authors.lastname: Cooper
authors.forename: Steven M
authors.initials: SM
authors.lastname: Paul
authors.forename: Claudia
authors.initials: C
authors.lastname: West
authors.forename: Dale
authors.initials: D
authors.lastname: Langford
authors.forename: Jon D
authors.initials: JD
authors.lastname: Levine
authors.forename: Gary
authors.initials: G
authors.lastname: Abrams
authors.forename: Deborah
authors.initials: D
authors.lastname: Hamolsky
authors.forename: Laura
authors.initials: L
authors.lastname: Dunn
authors.forename: Marylin
authors.initials: M
authors.lastname: Dodd
authors.forename: John
authors.initials: J
authors.lastname: Neuhaus
authors.forename: Christina
authors.initials: C
authors.lastname: Baggott
authors.forename: Anand
authors.initials: A
authors.lastname: Dhruva
authors.forename: Brian
authors.initials: B
authors.lastname: Schmidt
authors.forename: Janine
authors.initials: J
authors.lastname: Cataldo
authors.forename: John
authors.initials: J
authors.lastname: Merriman
authors.forename: Bradley E
authors.initials: BE
authors.lastname: Aouizerat
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D059373:Mastodynia / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000175:diagnosis* / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires