AAAPT Diagnostic Criteria for Acute Pain Following Breast Surgery

Area of Science:

• Pain Medicine
• Surgical Oncology
• Quality of Life Research

Background:

• Acute pain post-breast surgery significantly impacts cancer survivor quality of life.
• Existing prevalence rates for this pain vary widely (10-80%) due to inconsistent definitions and methods.
• A standardized framework is needed for consistent assessment of acute breast surgery pain and outcomes.

Purpose of the Study:

• To apply the 5-dimensional framework of the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (AAAPT) to acute pain after breast surgery.
• To establish core criteria, common features, modulating factors, impact domains, and neurobiological mechanisms for this specific pain type.
• To provide a comprehensive approach for guiding the assessment of acute pain and related outcomes in breast cancer survivors.

Main Methods:

• A multidisciplinary task force conducted a focused review and synthesis of existing literature.
• The 5-dimensional AAAPT framework was applied to acute pain following breast surgery.
• Key aspects including core criteria, common features, modulating factors, impact, and mechanisms were delineated.

Main Results:

• Defined core criteria: location, timing, severity, and impact of breast surgery pain.
• Established common features: character, expected trajectories, and identified assessment tools for relevant surgical subgroups.
• Delineated modulating factors (biological, psychological, social) and outlined impact/functional consequences.
• Specified putative neurobiological mechanisms, including nerve injury, inflammation, and sensitization.

Conclusions:

• The AAAPT framework offers a standardized approach to define and assess acute pain after breast surgery.
• This will enhance the generalizability of research findings, facilitate meta-analyses, and aid in studying interindividual variations and mechanisms.
• It enables better comparison of treatments across institutions and with other acute pain conditions.