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Risk factors linked to pain after breast cancer surgery

A woman's young age, extensive surgery, and whether she suffered severe, post-operative pain are risk factors for developing chronic pain after breast cancer surgery, a University of Rochester study found.

Up to half of all women who undergo a lumpectomy or mastectomy feel pain weeks or months later near the breast, adjacent armpit and upper arm on the same side. It is often described as burning, throbbing, and/or a sharp pain.

In a study published in the September 2006 Journal of Pain, lead author Robert H. Dworkin, Ph.D., a University of Rochester Medical Center professor of anesthesiology, neurology, oncology and psychiatry, and international pain management expert, recommends that women facing breast-cancer surgery should be counseled beforehand to alleviate any distress they may have and improve coping skills. Results of the study suggest that a combination of analgesic drugs and counseling immediately after surgery might also help to prevent long-term problems, he said.

"Women with breast cancer have unique concerns and fears that may be connected to pain," Dworkin said. "And despite considerable changes over time in surgical approaches, these results are consistent with other studies."

Few prospective studies have identified the characteristics of patients who are most likely to develop chronic pain, which can diminish a woman's quality of life by leading to job loss or marriage stress, even if the cancer is successfully treated.

Dworkin's group evaluated and interviewed 95 women scheduled for a simple lumpectomy, a lumpectomy with axillary lymph node dissection or a mastectomy. Researchers asked the women to rate their pain (on a scale from zero to 10) two days after surgery, 10 days after surgery and at the three-month point.

They also collected demographic and clinical information on each patient, and conducted tests to assess their mental health. Nearly half of the women (48 percent) said the
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Contact: Leslie Orr
leslie_orr@urmc.rochester.edu
585-275-5774
University of Rochester
22-Sep-2006


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