Persistent breast pain following breast cancer surgery is associated with persistent sensory changes, pain interference, and functional impairments

Dale J. Langford, Steven M. Paul, Claudia West, Jon D. Levine, Deborah Hamolsky, Charles Elboim, Brian L. Schmidt, Bruce A. Cooper, Gary Abrams, Bradley E. Aouizerat, Christine Miaskowski

Research output: Contribution to journalArticle

Abstract

Interindividual variability exists in persistent breast pain following breast cancer surgery. Recently, we used growth mixture modeling to identify 3 subgroups of women (N = 398) with distinct persistent breast pain trajectories (ie, mild, moderate, severe) over 6 months following surgery. The purposes of this study were to identify demographic and clinical characteristics that differed among the breast pain classes and, using linear mixed effects modeling, to examine how changes over time and in sensitivity in the breast scar area, pain qualities, pain interference, and hand and arm function differed among these classes. Several demographic and clinical characteristics differentiated the breast pain classes. Of note, 60 to 80% of breast scar sites tested were much less sensitive than the unaffected breast. Significant group effects were observed for pain qualities and interference scores, such that, on average, women in the severe pain class reported higher scores than women in the moderate pain class. In addition, women in the moderate pain class reported higher scores than women in the mild pain class. Compared to women in the mild pain class, women in the severe pain class had significantly impaired grip strength, and women in the moderate and severe pain classes had impaired flexion and abduction.

Perspective Subgroups of women with persistent postsurgical breast pain differed primarily with respect to the severity rather than the nature or underlying mechanisms of breast pain. Pervasive sensory loss and the association between persistent breast pain and sustained interference with function suggest the need for long-term clinical follow-up.

Original languageEnglish (US)
Pages (from-to)1227-1237
Number of pages11
JournalJournal of Pain
Volume15
Issue number12
DOIs
StatePublished - Dec 1 2014

Keywords

  • Breast pain
  • breast cancer surgery
  • chronic pain
  • grip strength
  • pain interference
  • pain qualities
  • persistent pain
  • range of motion
  • sensory changes

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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