Psychosocial predictors of posttreatment pain after nonmetastatic breast cancer treatment: a systematic review and meta-analysis of prospective studies
Open accessAbstract
Background: The search for risk factors of pain after breast cancer, which affects a considerable proportion of the women, has primarily focused on clinical factors. The aim of this meta-analysis was to explore the less well-studied psychosocial predictors of pain after breast cancer treatment. Methods: Two independent searches were conducted in PubMed, PsycINFO, Web of Science, and CINAHL. Eligible studies were prospective, observational studies of women aged ≥18 years, diagnosed and treated for nonmetastatic breast cancer ≥3 months previously. Additional inclusion criteria were that studies had assessed at least one pain outcome and at least one psychosocial predictor. The psychosocial predictors investigated included: 1) psychological–behavioral states, 2) psychological traits, and 3) social support. Effect size correlations (ESr) were chosen as the effect size and pooled using a random effects model. We also explored a number of study characteristics as possible moderators of the effect with meta-regression. Results: Of the total of 13 eligible studies identified, most studies measured psychosocial predictors at presurgery. Neither psychological–behavioral states (ESr: 0.05; p =0.13; K=11) nor psychological traits (ESr: 0.02; p =0.48; K=6) emerged as statistically significant predictors of pain. In contrast, higher levels of social support were statistically significantly associated with less pain (ESr: −0.24; p <0.001; K=4). In studies of psychological–behavioral states, longer follow-up was associated with smaller effect sizes ( p =0.023). Furthermore, older mean sample age was associated with larger effect sizes for both psychological–behavioral states ( p =0.0004) and psychological traits ( p =0.035). Conclusion: The results of this meta-analysis suggest that psychosocial factors measured at presurgery may only be of modest predictive value in identifying women at risk of developing pain after breast cancer treatment. While speculative, psychosocial factors may play a larger role in the postsurgery trajectory, which could be valuable to investigate in future studies. Keywords: breast cancer, pain, predictors, personality traits, social support, behavioral symptoms
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The Multiphase Optimization Strategy has the potential to lead to increased efficacy by excluding treatment components with either neutral or detrimental effects on the outcome, and improved cost-effectiveness by excluding treatment components with no or only negligible effects on the outcome.
“Thus, MOST has the potential to lead to (a) increased efficacy by excluding treatment components with either neutral or detrimental effects on the outcome, and (b) improved cost-effectiveness by excluding treatment components with no or only negligible effects on the outcome, thus reducing costs of the intervention.12–14”
From Optimising psychological treatment for pain after breast cancer: a factorial design study protocol in Denmark (2023) · cites this paper as [14]
Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredA second subset of studies found no sex differences in DNIC response.
“However, a second subset of studies have found no sex differences in DNIC response 179–181.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [181]
A meta-analysis of prospective studies found no significant downstream effect of trait or state psychological factors on subsequent persistent breast pain.
“a recent meta-analysis of prospective studies examining psychological factors as predictors of subsequent PBP did not find trait or state psychological factors to have a significant downstream impact on PBP [20].”
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- Authors
- Johannsen, M., Frederiksen, Y., Jensen, A., & Zachariae, R.
- Affiliations
- Aarhus University (DK)
- Aarhus University Hospital (DK)
- Corresponding author
- Johannsen, M
- Venue
- Journal of Pain Research
- Publisher
- Informa UK Limited
- Published
- 2017-12
- Volume
- Volume 11
- Pages
- 23-36
- ISSN
- 1178-7090 (ISSN-L)
- PMC
- PMC5743183
- OpenAlex
- W2779584096
- Cited by
- 22
- References
- 68
- Citations by year
- 2025: 1 · 2023: 2 · 2022: 3 · 2021: 5 · 2020: 2 · 2019: 6 · 2018: 2 · 2017: 1
- FWCI
- 0.32
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Pain Research (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- non-metastatic breast cancer, psychosocial predictors, social support, psychological characteristics, breast cancer survivors, risk factors for pain, personality traits
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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