Bruce, J. (Julie), Thornton, A. J. (Alison J.), Scott, N. W. (Neil W.), Marfizo, S., Powell, R. (Rachael), Johnston, Marie, Wells, Mary, MSc, Heys, Steven (Steven D.) and Thompson, Alastair M.. (2012) Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer. British Journal of Cancer, Vol.107 (No.6). pp. 937-946. ISSN 0007-0920

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Abstract

Background: Few epidemiological studies have prospectively investigated preoperative and surgical risk factors for acute postoperative pain after surgery for breast cancer. We investigated demographic, psychological, pain-related and surgical risk factors in women undergoing resectional surgery for breast cancer. Methods: Primary outcomes were pain severity, at rest (PAR) and movement-evoked pain (MEP), in the first postoperative week. Results: In 338 women undergoing surgery, those with chronic preoperative pain were three times more likely to report moderate to severe MEP after breast cancer surgery (OR 3.18, 95% CI 1.45–6.99). Increased psychological ‘robustness’, a composite variable representing positive affect and dispositional optimism, was associated with lower intensity acute postoperative PAR (OR 0.63, 95% CI 0.48–0.82) and MEP (OR 0.71, 95% CI 0.54–0.93). Sentinel lymph node biopsy (SLNB) and intraoperative nerve division were associated with reduced postoperative pain. No relationship was found between preoperative neuropathic pain and acute pain outcomes; altered sensations and numbness postoperatively were more common after axillary sample or clearance compared with SLNB. Conclusion: Chronic preoperative pain, axillary surgery and psychological robustness significantly predicted acute pain outcomes after surgery for breast cancer. Preoperative identification and targeted intervention of subgroups at risk could enhance the recovery trajectory in cancer survivors.

Item Type:	Journal Article
Subjects:	R Medicine > RD Surgery
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences
Library of Congress Subject Headings (LCSH):	Breast -- Cancer -- Surgery, Postoperative pain -- Susceptibility
Journal or Publication Title:	British Journal of Cancer
Publisher:	Nature Publishing Group
ISSN:	0007-0920
Date:	2012
Volume:	Vol.107
Number:	No.6
Page Range:	pp. 937-946
Identification Number:	10.1038/bjc.2012.341
Status:	Peer Reviewed
Publication Status:	Published
Funder:	Cancer Research UK (CRUK)
Grant number:	C23143/A7531 (CRUK)
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URI:	http://wrap.warwick.ac.uk/id/eprint/50818

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