Preoperative coping mechanisms have no predictive value for postoperative pain in breast cancer

This study evaluated the relationship between psychological coping mechanisms and symptoms of anxiety and depression in the preoperative and postoperative periods in relation to the intensity of postoperative pain among patients undergoing breast cancer surgery.

Female patients who were scheduled to receive immediate surgical treatment for breast cancer were invited to participate, and answered the following questionnaires: The Hospital Anxiety and Depression Scale (HADS), the Self Report Questionnaire (SRQ-20), the Coping Strategies Questionnaire (CSQ), and the visual analogue scale (VAS).

Of the 139 patients, 122 (87.8%) had an aggressive procedure. Eighty-five patients (61.2%) had a history of preoperative pain while 54 (38.7%) had not. There was no difference in VAS scores between patients subjected to aggressive or non-aggressive surgery. Only the CSQ subscale catastrophizing showed correlation with VAS at 24 hours and with HADS/D postoperatively. The HADS scores indicated both anxiety and depression, but did not distinguish patients subjected to aggressive or non-aggressive surgery.

The majority of patients did not exhibit depression and anxiety. Coping mechanisms and pain in the preoperative period did not have a strong predictive value for additional postoperative pain, but those with a higher anxiety score had greater pain.