Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer. / Bruce, J.; Thornton, A. J.; Scott, N. W.; Marfizo, S.; Powell, R.; Johnston, M.; Wells, M.; Heys, S. D.; Thompson, A. M.
In: British Journal of Cancer, Vol. 107, 04.09.2012, p. 937-946.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer
A1 - Bruce,J.
A1 - Thornton,A. J.
A1 - Scott,N. W.
A1 - Marfizo,S.
A1 - Powell,R.
A1 - Johnston,M.
A1 - Wells,M.
A1 - Heys,S. D.
A1 - Thompson,A. M.
AU - Bruce,J.
AU - Thornton,A. J.
AU - Scott,N. W.
AU - Marfizo,S.
AU - Powell,R.
AU - Johnston,M.
AU - Wells,M.
AU - Heys,S. D.
AU - Thompson,A. M.
PY - 2012/9/4
Y1 - 2012/9/4
N2 - 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.British Journal of Cancer advance online publication, 31 July 2012; doi:10.1038/bjc.2012.341 www.bjcancer.com.
AB - 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.British Journal of Cancer advance online publication, 31 July 2012; doi:10.1038/bjc.2012.341 www.bjcancer.com.
UR - http://www.scopus.com/inward/record.url?partnerID=yv4JPVwI&eid=2-s2.0-84864375385&md5=b91b214644f54e853e4ba521fe7e997c
U2 - 10.1038/bjc.2012.341
DO - 10.1038/bjc.2012.341
M1 - Article
JO - British Journal of Cancer
JF - British Journal of Cancer
SN - 0007-0920
VL - 107
SP - 937
EP - 946
ER -