Cited by 188Pain Management and TreatmentAnesthesia and Pain ManagementPediatric Pain Management Techniques

Persistent pain in postmastectomy patients: comparison of psychophysical, medical, surgical, and psychosocial characteristics between patients with and without pain

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Schreiber, Kristin L., Martel, Marc O., Shnol, Helen, Shaffer, John R., Greco, Carol, Viray, Nicole, Taylor, Lauren N., McLaughlin, Meghan +5 more·2013·Pain

Abstract

Persistent postmastectomy pain (PPMP) is a major individual and public health problem. Increasingly, psychosocial factors such as anxiety and catastrophizing are being revealed as crucial contributors to individual differences in pain processing and outcomes. Furthermore, differences in patients' responses to standardized quantitative sensory testing (QST) may aid in the discernment of who is at risk for acute and chronic pain after surgery. However, characterization of the variables that differentiate those with PPMP from those whose acute postoperative pain resolves is currently incomplete. The purpose of this study was to investigate important surgical, treatment-related, demographic, psychophysical, and psychosocial factors associated with PPMP by comparing PPMP cases with PPMP-free controls. Pain was assessed using the breast cancer pain questionnaire to determine the presence and extent of PPMP. Psychosocial and demographic information were gathered via phone interview, and women underwent a QST session. Consistent with most prior research, surgical and disease-related variables did not differ significantly between cases and controls. Furthermore, treatment with radiation, chemotherapy, or hormone therapy was also not more common among those with PPMP. In contrast, women with PPMP did show elevated levels of distress-related psychosocial factors such as anxiety, depression, catastrophizing, and somatization. Finally, QST in nonsurgical body areas revealed increased sensitivity to mechanical stimulation among PPMP cases, while thermal pain responses were not different between the groups. These findings suggest that an individual's psychophysical and psychosocial profile may be more strongly related to PPMP than their surgical treatment.

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  • ACT, which does not directly target catastrophizing, is also effective in reducing catastrophizing.

    “Likewise, Acceptance and Commitment Therapy (ACT), which does not directly target catastrophizing, has shown to also be effective in reducing catastrophizing 324–327.”

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Authors
Schreiber, K. L., Martel, M. O., Shnol, H., Shaffer, J. R., Greco, C., Viray, N., Taylor, L. N., McLaughlin, M., Brufsky, A., Ahrendt, G., Bovbjerg, D., Edwards, R. R., & Belfer, I.
Affiliations
  • Brigham and Women's Hospital (US)
  • University of Pittsburgh (US)
Corresponding author
Schreiber, Kristin L.
Venue
Pain
Published
2013-05
Volume
154
Issue
5
Pages
660-668
ISSN
0304-3959 (ISSN-L)
OpenAlex
W1994684666
Cited by
188
References
86
Citations by year
2026: 8 · 2025: 9 · 2024: 14 · 2023: 11 · 2022: 16 · 2021: 25 · 2020: 15 · 2019: 10 · 2018: 17 · 2017: 17 · 2016: 12 · 2015: 15 · 2014: 15 · 2013: 4
FWCI
14.52
Type
journal article
Language
en
Open access
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health through the CTSI Virginia Kaufmann Pilot Project Program in Pain Research (PUH0010477)
Topics
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Keywords
breast cancer pain, psychosocial factors, anxiety, pain catastrophizing, somatization, depression, quantitative sensory testing, mechanical pain sensitivity, thermal pain sensitivity, risk factors for chronic pain, radiotherapy, chemotherapy, hormone therapy
MeSH terms
Adult, Aged, Blood Pressure, Cold Temperature, Female, Heart Rate, Hot Temperature, Humans, Mastectomy, Middle Aged, Pain Measurement, Postoperative Pain, Surveys and Questionnaires, Socioeconomic Factors, Cost of Illness, Pain Threshold, Catastrophization

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