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Breast Cancer Survivorship: Chronic Post-operative Pain and Sensory Changes

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Breast Cancer Management for Surgeons

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Abstract

Chronic pain and sensory changes are extremely common after breast cancer surgery and adjuvant treatments. Approximately 15–20% of breast cancer patients have clinically relevant moderate-to-severe intensity persistent pain at 1 year from surgery. Axillary clearance is the most important risk factor for persistent pain, although many other risk factors have been recognized. Neuropathic pain should be distinguished from the common-type post-operative pain and treated early on. There should be a low threshold for referring breast cancer patients with persistent pain to a dedicated pain clinic with multidisciplinary evaluation and treatment.

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References

  1. Meretoja TJ, Leidenius MH, Tasmuth T, Sipilä R, Kalso E. Pain at 12 months after surgery for breast cancer. JAMA. 2014;311(1):90–2.

    Article  CAS  PubMed  Google Scholar 

  2. Mejdahl MK, Andersen KG, Gärtner R, Kroman N, Kehlet H. Persistent pain and sensory disturbances after treatment for breast cancer: six year nationwide follow-up study. BMJ. 2013;346:f1865.

    Article  PubMed  Google Scholar 

  3. Langford DJ, Paul SM, West C, Levine JD, Hamolsky D, Elboim C, et al. Persistent breast pain following breast cancer surgery is associated with persistent sensory changes, pain interference, and functional impairments. J Pain. 2014;15(12):1227–37.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367(9522):1618–25.

    Article  PubMed  Google Scholar 

  5. Bruce J, Thornton AJ, Powell R, Johnston M, Wells M, Heys SD, et al. Psychological, surgical, and sociodemographic predictors of pain outcomes after breast cancer surgery: a population-based cohort study. Pain. 2014;155(2):232–43.

    Article  PubMed  Google Scholar 

  6. Gärtner R, Jensen MB, Nielsen J, Ewertz M, Kroman N, Kehlet H. Prevalence of and factors associated with persistent pain following breast cancer surgery. JAMA. 2009;302(18):1985–92.

    Article  PubMed  Google Scholar 

  7. Andersen KG, Duriaud HM, Jensen HE, Kroman N, Kehlet H. Predictive factors for the development of persistent pain after breast cancer surgery. Pain. 2015;156(12):2413–22.

    Article  PubMed  Google Scholar 

  8. Warrier S, Hwang S, Koh CE, Shepherd H, Mak C, Carmalt H, et al. Preservation or division of the intercostobrachial nerve in axillary dissection for breast cancer: meta-analysis of randomised controlled trials. Breast. 2014;23(4):310–6.

    Article  PubMed  Google Scholar 

  9. Tasmuth T, von Smitten K, Kalso E. Pain and other symptoms during the first year after radical and conservative surgery for breast cancer. Br J Cancer. 1996;74(12):2024–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Andreae MH, Andreae DA. Regional anaesthesia to prevent chronic pain after surgery: a Cochrane systematic review and meta-analysis. Br J Anaesth. 2013;111(5):711–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Ilfeld BM, Madison SJ, Suresh PJ, Sandhu NS, Kormylo NJ, Malhotra N, et al. Persistent postmastectomy pain and pain-related physical and emotional functioning with and without a continuous paravertebral nerve block: a prospective 1-year follow-up assessment of a randomized, triple-masked, placebo-controlled study. Ann Surg Oncol. 2015;22(6):2017–25.

    Article  PubMed  Google Scholar 

  12. Kalso E, Tasmuth T, Neuvonen PJ. Amitriptyline effectively relieves neuropathic pain following treatment of breast cancer. Pain. 1996;64(2):293–302.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Comprehensive Cancer Center, Breast Surgery Unit, Helsinki University Hospital, P.O. Box 263, 00029 HUS, Helsinki, Finland

    Tuomo J. Meretoja MD, PhD

Authors
  1. Tuomo J. Meretoja MD, PhD
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Correspondence to Tuomo J. Meretoja MD, PhD .

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Editors and Affiliations

  1. The Medical School Department of Oncology, University of Sheffield, Sheffield, United Kingdom

    Lynda Wyld

  2. Athens University Medical School, Athens, Greece

    Christos Markopoulos

  3. Helsinki University Hospital, Helsinki, Finland

    Marjut Leidenius

  4. Department of Oncology & Radiotherapy, Gdańsk Medical University Department of Oncology & Radiotherapy, Gdańsk, Poland

    Elżbieta Senkus-Konefka

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Meretoja, T.J. (2018). Breast Cancer Survivorship: Chronic Post-operative Pain and Sensory Changes. In: Wyld, L., Markopoulos, C., Leidenius, M., Senkus-Konefka, E. (eds) Breast Cancer Management for Surgeons. Springer, Cham. https://doi.org/10.1007/978-3-319-56673-3_58

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  • DOI: https://doi.org/10.1007/978-3-319-56673-3_58

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56671-9

  • Online ISBN: 978-3-319-56673-3

  • eBook Packages: MedicineMedicine (R0)

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