Researchers from the University of California San Francisco studied a sample of women scheduled for breast cancer surgery and sought to determine the occurrence rate for preoperative breast pain, describe characteristics of the pain, evaluate the demographic and clinical variation in the women with preoperative pain, and assess the role of in pro-and anti inflammatory cytokine genes. They concluded that preoperative breast pain involves an inflammatory process and this information may help identify women who are at risk for preoperative breast pain. Their findings were published in The Journal of Pain, the peer-review publication of the American Pain Society, www.ampainsoc.org.
Though postoperative breast cancer pain has been examined extensively, few studies have been published about preoperative breast cancer pain. This is the first study to describe the characteristics of preoperative breast pain in a sample of women prior to breast cancer surgery, and to evaluate for genetic variations in pro-and anti-inflammatory genes in women who did and did not report pain. The analysis was part of a larger study on neuropathic pain and lymphedema in women who had breast cancer surgery. Three hundred ninety-eight women participated.
Patients answered questionnaires designed to evaluate overall functional status, co morbid medical conditions and pain characteristics, and all patients were given genotype tests.
Women who reported presurgical pain were younger and had poorer functional status than the non-pain group. Also, a higher percentage of non-white women reported pain, and a potential reason cited is that more of the non-white women in the sample were diagnosed with advanced disease. Possible contributors to presurgical breast pain are tissue injury or nerve damage, inflammation associated with tumor growth, and the number of biopsies performed. Women in the pain group had a significantly higher number of biopsies. Further, the pain qualities reported by women with presurgical breast pain were nociceptive not neuropathic, which suggest that differences in inflammatory responses could be influencing presurgical breast pain development.
From analyzing the genotyping data, the authors concluded that preoperative breast pain involves an inflammatory process. Further research is needed to determine if preoperative breast pain influences the severity of postoperative pain and /or development of chronic pain after breast cancer surgery.