Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer

J. Bruce, A. J. Thornton, N. W. Scott, S. Marfizo, R. Powell, M. Johnston, M. Wells, S. D. Heys, A. M. Thompson

    Research output: Contribution to journalArticle

    53 Citations (Scopus)

    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.British Journal of Cancer advance online publication, 31 July 2012; doi:10.1038/bjc.2012.341 www.bjcancer.com.
    Original languageEnglish
    Pages (from-to)937-946
    Number of pages10
    JournalBritish Journal of Cancer
    Volume107
    DOIs
    Publication statusPublished - 4 Sep 2012

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  • Press / Media

    Study uncovers simple way of predicting severe pain following Breast Cancer surgery

    Susan Marfizo, Mary Wells & Alastair Thompson

    4/09/12

    1 item of Media coverage

    Press/Media: Research

    Cite this

    Bruce, J., Thornton, A. J., Scott, N. W., Marfizo, S., Powell, R., Johnston, M., Wells, M., Heys, S. D., & Thompson, A. M. (2012). Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer. British Journal of Cancer, 107, 937-946. https://doi.org/10.1038/bjc.2012.341