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Updated: Aug 14, 2025
07:14
A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery
Published on: January 18, 2018
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Risk factors for persistent pain after breast cancer surgery: a multicentre prospective cohort study
H S Tan1, J K Plichta2, A Kong1
1Department of Women's Anaesthesia, KK Women's and Children's Hospital, Duke-NUS Medical School, Singapore.
Anaesthesia
|January 14, 2023
Summary
Persistent pain after breast cancer surgery affects over 64% of patients. Key risk factors include age, diabetes, pre-operative pain, previous mastitis, and stress, enabling better risk prediction.
Area of Science:
- Oncology
- Pain Medicine
- Epidemiology
Background:
- Persistent pain after breast cancer surgery is a significant issue impacting patient quality of life.
- Identifying predictive factors is crucial for personalized risk stratification and management strategies.
- Previous studies have been limited by single-population generalizability, necessitating multicenter approaches.
Purpose of the Study:
- To develop and validate a predictive model for persistent pain following breast cancer surgery.
- To identify independent risk factors associated with persistent pain in a diverse, multicenter cohort.
- To improve risk stratification for individualized patient management and intervention.
Main Methods:
- Prospective, multicenter cohort study involving Asian and American women undergoing elective breast cancer surgery.
- Collection of pre-operative patient and clinical characteristics, health status (EQ-5D-3L), and pain-related assessments (e.g., Pain Catastrophizing Scale, Central Sensitization Inventory).
- Multivariable logistic regression analysis to identify independent predictors of persistent pain, defined as pain score ≥3 or affecting daily living at 4 months post-surgery.
Main Results:
- 135 out of 210 (64.3%) patients developed persistent pain.
- The predictive model achieved an Area Under the Curve (AUC) of 0.807.
- Independent predictors included: older age, diabetes, pre-operative pain at non-breast sites, history of mastitis, and higher perceived stress scale scores.
Conclusions:
- A predictive model incorporating age, diabetes, pre-operative pain at non-breast sites, previous mastitis, and perceived stress effectively identifies patients at risk for persistent pain after breast cancer surgery.
- This model offers a valuable tool for risk stratification and guiding preemptive interventions.
- Further validation and evaluation of targeted interventions are recommended to mitigate persistent pain development.
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