Study examines prevalence, severity and factors associated with chronic pain after breast cancer surgery

In a study that included more than 800 women who had undergone surgery for breast cancer, the majority reported some level of pain 12 months after surgery, and factors associated with pain included chronic preoperative pain, chemotherapy, preoperative depression and pain in the area to be operated, according to a study appearing in the January 1 issue of JAMA.

"Persistent pain following breast cancer treatments remains a significant clinical problem despite improved treatment strategies. Data on factors associated with persistent pain are needed to develop prevention and treatment strategies and to improve the quality of life for breast cancer patients," according to background information in the article.

Tuomo J. Meretoja, M.D., Ph.D., of Helsinki University Central Hospital, Helsinki, Finland, and colleagues examined the prevalence and severity and factors associated with chronic pain after breast cancer surgery and treatments. The study included 860 patients younger than 75 years with nonmetastasized breast cancer treated at the Helsinki University Central Hospital in 2006-2010. A questionnaire was sent to patients 12 months after surgery, with assessments of presence and intensity of pain.

At 12 months after surgery, 34.5 percent of the patients reported no pain, 49.7 percent mild pain, 12.1 percent moderate pain, and 3.7 percent severe pain. The factors associated with pain at 12 months were chronic preoperative pain, preoperative pain in the area to be operated, axillary lymph node dissection, preoperative depression, chemotherapy and radiotherapy.

"These findings may be useful in developing strategies for preventing persistent pain following breast cancer treatment. To identify patients who would benefit from preventive interventions, a risk assessment tool is needed," the authors write.