Patients still report some level of pain 1 year after breast cancer surgery

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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. Factors associated with pain included chronic preoperative pain, chemotherapy, preoperative depression, and pain in the area to undergo surgery.

"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," wrote the authors of the study, which was published in JAMA (2014;11[1]:90-92).

Tuomo J. Meretoja, MD, PhD, 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 treatment. The study included 860 patients younger than 75 years with nonmetastasized breast cancer treated at the Helsinki University Central Hospital between 2006 and 2010. Among these patients, 57% received chemotherapy, 73% received radiotherapy, and 68% received endocrine therapy. A questionnaire was sent to patients 12 months after surgery, with assessments of the presence and intensity of pain.

At 12 months after surgery, 34.5% of the patients reported no pain, 49.7% mild pain, 12.1% moderate pain, and 3.7% 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 wrote. This research team had previously developed a six-factor model for pain at 6 months, but it did not include any treatment-related factors.

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