title: Breast cancer survivors suffer from persistent postmastectomy pain syndrome and posttraumatic stress disorder (ORTHUS study): a study of the palliative care working committee of the Turkish Oncology Group (TOG).
abstract: Persistent postmastectomy pain syndrome (PMPS) is one of the most important disturbing symptoms. Posttraumatic stress disorder (PTSD) is an anxiety disorder which is characterized by reactions to reminders of the trauma that has been experienced. The purpose of this study is to evaluate the predictors of PMPS and PTSD in Turkish breast cancer survivors and the correlation between PMPS and PTSD.
  
  
  
  The study is designed as a multicenter survey study. Breast cancer patients in remission were evaluated. Patients were evaluated with structured questionnaires to assess the PMPS and clinical parameters associated with it. The Turkish version of the posttraumatic stress disorder checklist-civilian version (PCL-C) was used.
  
  
  
  Between February 2015 and October 2015, 614 breast cancer survivors in outpatient clinics were evaluated. The incidence of PMPS documented is 45.1 %. In the multivariate analysis low income, presence of PTSD and <46 months after surgery were associated with increased risk of PMPS. PTSD was documented in 75 %, and the mean PCL-C score was 32.4 ± 11.1. PMPS and being married at the time of the evaluation were linked with PTSD.
  
  
  
  It is the first data about the association between PMPS and PTSD. The clinicians should be aware of PMPS and PTSD in breast cancer survivors.
authors.affiliation: Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey. alkanali@yahoo.com.|Medical Oncology, Ankara University School of Medicine, Ankara Üniversitesi Tıp fakültesi hastanesi, Cebeci hastanesi, Tıbbi onkoloji bilim dalı, Mamak/Ankara, TR 06890, Turkey. alkanali@yahoo.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Alkan
authors.affiliation: Department of Medical Oncology, Dokuz Eylül University School of Medicine, İzmir, Turkey.
authors.forename: Zeynep Gulsum
authors.initials: ZG
authors.lastname: Guc
authors.affiliation: Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Filiz Cay
authors.initials: FC
authors.lastname: Senler
authors.affiliation: Department of Medical Oncology, Dokuz Eylül University School of Medicine, İzmir, Turkey.
authors.forename: Tugba
authors.initials: T
authors.lastname: Yavuzsen
authors.affiliation: Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Handan
authors.initials: H
authors.lastname: Onur
authors.affiliation: Department of Medical Oncology, Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Mutlu
authors.initials: M
authors.lastname: Dogan
authors.affiliation: Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Karci
authors.affiliation: Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Yasar
authors.affiliation: Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Elif Berna
authors.initials: EB
authors.lastname: Koksoy
authors.affiliation: Department of Medical Oncology, Mugla Sitki Kocman University, Muğla, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Tanriverdi
authors.affiliation: Department of Medical Oncology, Marmara University School of Medicine, İstanbul, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Turhal
authors.affiliation: Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Yuksel
authors.initials: Y
authors.lastname: Urun
authors.affiliation: Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Asiye
authors.initials: A
authors.lastname: Ozkan
authors.affiliation: Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Dilsa
authors.initials: D
authors.lastname: Mizrak
authors.affiliation: Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Akbulut
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008408:Mastectomy / Q000009:adverse effects* / Q000523:psychology; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology* / Q000523:psychology; D010166:Palliative Care / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology*; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D017741:Survivors; D013577:Syndrome
keywords: Breast cancer survivor; Persistent postmastectomy pain syndrome; Posttraumatic stress disorder