Long-Term Follow-Up of Pain and Emotional Characteristics of Women After Surgery for Breast Cancer

Context: Persistent pain after treatment for breast cancer (PPBCT) is a common side effect of breast cancer treatment, with prevalence as high as 50%. It is predominantly a neuropathic condition.

Objectives: The aim of this cross-sectional, questionnaire-based study was to examine the emotional characteristics of patients with PPBCT in long-term breast cancer patients. A secondary objective was to characterize the risk factors and severity of that pain.

Methods: From March 1, 2010 to April 9, 2010, long-term follow-up patients were invited to complete a questionnaire. This recorded their surgical and demographic data and ascertained whether they had PPBCT. If the patient had pain, she completed a range of validated self-report questionnaires and questions about the nature of the pain, including a visual analogue scale.

Results: One hundred eleven patients completed the questionnaire; 33 (29.7%) patients reported chronic pain at a median time of 64 months postoperatively (interquartile range 54.25). Patients with persistent pain were not significantly more anxious (t(105) = 0.369, P = 0.713) or depressed (t(105) = 0.713, P = 0.507) than patients without pain. Patients with constant pain compared with intermittent pain were significantly more anxious (t(25) = 3.460, P = 0.002). Preoperative pain conferred a fivefold increased risk of PPBCT (odds ratio [OR] = 5.17, 95% confidence interval [CI] = 1.79-14.97, P = 0.002); chemotherapy conferred a threefold increased risk (OR = 3.004, 95% CI = 1.22-7.40, P = 0.017).

Conclusion: We have shown significant numbers of patients suffer from PPBCT. At a median time of 64.5 months, women with pain are not significantly more anxious or depressed than women without pain. Preoperative pain and chemotherapy have been highlighted as risk factors.