Lore Dams1,2,3, Elien Van der Gucht4,5, Vincent Haenen6,4,5, Magalie Lauwers6, Sofie De Pauw6, Tinne Steurs6, Nele Devoogdt4,7, Ann Smeets8, Koen Bernar9, Tessa De Vrieze6,4, An De Groef6,4,5, Mira Meeus6,5,10. 1. Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Campus Drie Eiken - Universiteitsplein 1, R.315, 2610 Wilrijk, Antwerp, Belgium. lore.dams@uantwerpen.be. 2. Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium. lore.dams@uantwerpen.be. 3. Pain In Motion International Research Group, http://www.paininmotion.be, Brussels, Belgium. lore.dams@uantwerpen.be. 4. Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium. 5. Pain In Motion International Research Group, http://www.paininmotion.be, Brussels, Belgium. 6. Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Campus Drie Eiken - Universiteitsplein 1, R.315, 2610 Wilrijk, Antwerp, Belgium. 7. Department of Vascular Surgery and Department of Physical Medicine and Rehabilitation, Center for Lymphedema, UZ Leuven - University Hospitals Leuven, Leuven, Belgium. 8. Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium. 9. The Leuven Centre for Algology and Pain Management, University Hospitals Leuven, Leuven, Belgium. 10. Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
Abstract
PURPOSE: Knowledge regarding risk factors for pain in the long term after surgery for breast cancer may be of great value in preventing this prevalent and debilitating side effect. Despite the biopsychosocial nature of pain, the predictive value of both pre- and postoperative biopsychosocial functioning for long-term pain intensity and pain-related disability has not yet been studied. METHODS: One hundred sixty-six women planned for unilateral breast cancer surgery were included in this prospective cohort study. Pre- and postoperative outcomes related to pain, psychosocial, and somatosensory functioning (questionnaires and quantitative sensory testing) were evaluated as risk factors for pain intensity (visual analog scale) and pain-related disability (pain disability index) 1 year after surgery for breast cancer. Both bivariable and stepwise linear regression analyses were performed. RESULTS: The most consistent biopsychosocial risk factors were symptoms related to altered central somatosensory functioning (central sensitization inventory), psychological symptoms, and social support (psychological symptoms and support subscale of McGill Quality of Life Questionnaire). Results also showed that a pre- and postoperative disturbed functioning of the somatosensory nervous system in the surgical area could provide additional information regarding pain intensity or pain-related disability in the long term after surgery for breast cancer. CONCLUSION: This study revealed several biopsychosocial characteristics that might be used to identify women more vulnerable to have pain and pain-related disability in the long term after surgery for breast cancer, allowing for more effective pain management and prevention.
PURPOSE: Knowledge regarding risk factors for pain in the long term after surgery for breast cancer may be of great value in preventing this prevalent and debilitating side effect. Despite the biopsychosocial nature of pain, the predictive value of both pre- and postoperative biopsychosocial functioning for long-term pain intensity and pain-related disability has not yet been studied. METHODS: One hundred sixty-six women planned for unilateral breast cancer surgery were included in this prospective cohort study. Pre- and postoperative outcomes related to pain, psychosocial, and somatosensory functioning (questionnaires and quantitative sensory testing) were evaluated as risk factors for pain intensity (visual analog scale) and pain-related disability (pain disability index) 1 year after surgery for breast cancer. Both bivariable and stepwise linear regression analyses were performed. RESULTS: The most consistent biopsychosocial risk factors were symptoms related to altered central somatosensory functioning (central sensitization inventory), psychological symptoms, and social support (psychological symptoms and support subscale of McGill Quality of Life Questionnaire). Results also showed that a pre- and postoperative disturbed functioning of the somatosensory nervous system in the surgical area could provide additional information regarding pain intensity or pain-related disability in the long term after surgery for breast cancer. CONCLUSION: This study revealed several biopsychosocial characteristics that might be used to identify women more vulnerable to have pain and pain-related disability in the long term after surgery for breast cancer, allowing for more effective pain management and prevention.
Authors: Lindsay C Burns; Sarah E Ritvo; Meaghan K Ferguson; Hance Clarke; Ze'ev Seltzer; Joel Katz Journal: J Pain Res Date: 2015-01-05 Impact factor: 3.133