Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer
Open accessAbstract
BACKGROUND: Few epidemiological studies have prospectively investigated preoperative and surgical risk factors for acute postoperative pain after surgery for breast cancer. We investigated demographic, psychological, pain-related and surgical risk factors in women undergoing resectional surgery for breast cancer. METHODS: Primary outcomes were pain severity, at rest (PAR) and movement-evoked pain (MEP), in the first postoperative week. RESULTS: In 338 women undergoing surgery, those with chronic preoperative pain were three times more likely to report moderate to severe MEP after breast cancer surgery (OR 3.18, 95% CI 1.45-6.99). Increased psychological 'robustness', a composite variable representing positive affect and dispositional optimism, was associated with lower intensity acute postoperative PAR (OR 0.63, 95% CI 0.48-0.82) and MEP (OR 0.71, 95% CI 0.54-0.93). Sentinel lymph node biopsy (SLNB) and intraoperative nerve division were associated with reduced postoperative pain. No relationship was found between preoperative neuropathic pain and acute pain outcomes; altered sensations and numbness postoperatively were more common after axillary sample or clearance compared with SLNB. CONCLUSION: Chronic preoperative pain, axillary surgery and psychological robustness significantly predicted acute pain outcomes after surgery for breast cancer. Preoperative identification and targeted intervention of subgroups at risk could enhance the recovery trajectory in cancer survivors.
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- Authors
- on behalf of the Recovery Study Group, Bruce, J., Thornton, A. J., Scott, N. W., Marfizo, S., Powell, R., Johnston, M., Wells, M., Heys, S. D., & Thompson, A. M.
- Affiliations
- University of Warwick (GB)
- University of Aberdeen (GB)
- University of Dundee (GB)
- Aston University (GB)
- Ninewells Hospital (GB)
- Corresponding author
- Bruce, J
- Venue
- British Journal of Cancer
- Published
- 2012-07-31
- Volume
- 107
- Issue
- 6
- Pages
- 937-946
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC3464763
- OpenAlex
- W1971289412
- Cited by
- 121
- References
- 62
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 6 · 2023: 12 · 2022: 8 · 2021: 11 · 2020: 12 · 2019: 8 · 2018: 13 · 2017: 9 · 2016: 5 · 2015: 5 · 2014: 10 · 2013: 6 · 2012: 1
- FWCI
- 7.18
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- www.springer.com/tdm (unspecified)
- Locations
- British Journal of Cancer (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Aston Publications Explorer (Aston University) (acceptedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- Aberdeen University Research Archive (Aberdeen University) (submittedVersion)
- Funders
- Cancer Research UK (C23143/A7531)
- Topics
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- breast cancer surgery, acute postoperative pain, dispositional optimism, positive affect, movement-evoked pain, sentinel lymph node biopsy, axillary surgery, nerve division, postoperative numbness, cancer survivorship
- MeSH terms
- Adaptation, Psychological, Adult, Aged, Breast Neoplasms, Factor Analysis, Statistical, Female, Humans, Mastectomy, Middle Aged, Pain Measurement, Pain, Postoperative, Postoperative Pain, Predictive Value of Tests, Prospective Studies, Severity of Illness Index, Temperament, Incidence, Multivariate Analysis, Logistic Models, Carcinoma, Ductal, Breast, Sentinel Lymph Node Biopsy, Preoperative Period, Chronic Pain
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