Identification of patient subgroups and risk factors for persistent breast pain following breast cancer surgery

Christine Miaskowski, Bruce Cooper, Steven M. Paul, Claudia West, Dale Langford, Jon D. Levine, Gary Abrams, Deborah Hamolsky, Laura Dunn, Marylin Dodd, John Neuhaus, Christina Baggott, Anand Dhruva, Brian Schmidt, Janine Cataldo, John Merriman, Bradley E. Aouizerat

Research output: Contribution to journalArticlepeer-review


Study purposes were to determine the prevalence of persistent pain in the breast; characterize distinct persistent pain classes using growth mixture modeling; and evaluate for differences among these pain classes in demographic, preoperative, intraoperative, and postoperative characteristics. In addition, differences in the severity of common symptoms and quality of life outcomes measured prior to surgery, among the pain classes, were evaluated. Patients (n = 398) were recruited prior to surgery and followed for 6 months. Using growth mixture modeling, patients were classified into no (31.7%), mild (43.4%), moderate (13.3%), and severe (11.6%) pain groups based on ratings of worst breast pain. Differences in a number of demographic, preoperative, intraoperative, and postoperative characteristics differentiated among the pain classes. In addition, patients in the moderate and severe pain classes reported higher preoperative levels of depression, anxiety, and sleep disturbance than the no pain class. Findings suggest that approximately 25% of women experience significant and persistent levels of breast pain in the first 6 months following breast cancer surgery. Perspective: Persistent pain is a significant problem for 25% of women following surgery for breast cancer. Severe breast pain is associated with clinically meaningful decrements in functional status and quality of life.

Original languageEnglish (US)
Pages (from-to)1172-1187
Number of pages16
JournalJournal of Pain
Issue number12
StatePublished - Dec 2012


  • Breast pain
  • breast cancer surgery
  • growth mixture modeling
  • latent class analysis
  • persistent postsurgical pain
  • risk factors

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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