Journal Article

Postmastectomy Pain： A Cross-sectional Study of Prevalence, Pain Characteristics, and Effects on Quality of Life

Serbiuenl Gokhan Beyaz Jalan Serbetcigil Erganenc Tolga Ergonenc Ozlem Uysal Sonmez Unal Erkorkmaz Fatih Allintoprak

2016

Overview

Background： Postmastectomy pain syndrome （PM PS） is defined as a chronic （continuing for 3 or more months） neuropathic pain affecting the axilla, medial arm, breast, and chest wall after breast cancer surgery. The prevalence of PMPS has been reported to range from 20% to 68%. In this study, we aimed to determine the prevalence of PMPS among mastectomy patients, the severity of neuropathic pain in these patients, risk factors that contribute to pain becoming chronic, and the effect of PMPS on life quality. Methods： This cross-sectional study was approved by the Sakarya University, Medical Faculty Ethical Council and included 146 patients ranging in age from 18 to 85 years who visited the pain clinic, general surgery clinic, and oncology clinic and had breast surgery between 2012 and 2014. Patients were divided into two groups according to whether they met PMPS criteria： pain at axilla, arm, shoulder, chest wall, scar tissue, or breast at least 3 months after breast surgery. All patients gave informed consent prior to entry into the study. Patient medical records were collected, and pain and quality of life were evaluated by the visual analog scale （VAS） for pain, a short form of the McGill Pain Questiomlaire （SF-MPQ）, douleur neuropathique-4 （DN-4）, and SF-36. Results： Patient mean age was 55.2 ± 11.8 years （33.0-83.0 years）. PMPS prevalence was 36%. Mean scores on the VAS, SF-MPQ, and DN-4 in PMPS patients were 1.76 ±2.38 （0-10）, 1.73 ± 1.54 （0-5）, and 1.64 ± 2.31 （0-8）, respectively. Of these patients, 31 （23.7%） had neuropathic pain characteristics, and 12 （9.2%） had phantom pain according to the DN-4 survey. Patients who had modified radical mastectomy were significantly more likely to develop PMPS than patients who had breast-protective surgery （P = 0.028）. Only 2 （2.4%） of PMPS patients had received proper treatment （anticonvulsants or opioids）. Conclusions： PMPS seriously impacts patients＇ emotional situation, daily activities, and social relationships and is a majior economic burden for health systems. We conclude that the rate of PMPS among patients receiving breast cancer surgery in Turkey is 64.1% and that challenges to the proper treatment of these patients deserve further investigation.

• Publisher: Wolters Kluwer - Medknow Publications,Medknow Publications and Media Pvt. Ltd,Lippincott Williams & Wilkins Ovid Technologies,Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Sakarya University, Sakarya, Republic of Turkey%Department of Anesthesiology, Sakarya University Training and Research Hospital, Sakarya, Republic of Turkey%Department of Oncology, Yeditepe University Medical School, Istanbul, Republic of Turkey%Department of Biostatistics, Faculty of Medicine, Sakarya University, Sakarya, Republic of Turkey%Department of General Surgery, Faculty of Medicine, Sakarya University, Sakarya, Republic of Turkey,Medknow Publications & Media Pvt Ltd,Wolters Kluwer
• Subject: Adolescent / Adult / Aged / Aged, 80 and over / Anesthesiology / Biopsy / Breast cancer / Breast Cancer; Mastectomy; Neuropathic Pain; Postmastectomy Pain; Surgery / Breast surgery / Cancer surgery / Cancer therapies / Chemotherapy / Chronic illnesses / Cross-Sectional Studies / Female / Health aspects / Hospitals / Humans / Lymphatic system / Male / Mastectomy / Mastectomy - adverse effects / Medicine / Middle Aged / Original / Pain / Pain management / Pain, Postoperative - epidemiology / Pain, Postoperative - physiopathology / PMPs / Prevalence / Prevalence studies (Epidemiology) / Quality of Life / Questionnaires / Radiation therapy / Risk factors / Studies / Tumors / Variance analysis / Young Adult / 严重程度 / 乳腺癌 / 平均年龄 / 患病率 / 横断面 / 生活质量 / 疼痛