Breast cancer patients are significantly more likely to have severe pain in the week after surgery if they suffer from other conditions such as arthritis, back pain and migraine, researchers have found.
The findings could be used as a simple way of identifying before surgery which patients might benefit from extra pain relief or support, according to the study authors, from the universities of Warwick, Aberdeen and Dundee.
They surveyed 338 patients before surgery, asking about general health and any existing pain. A week after surgery, patients were asked about the amount and type of any pain they were experiencing and whether they had taken painkillers.
One week after surgery, 41% of women reported moderate to severe pain at rest and 50% on movement.
Those with chronic preoperative pain were three times more likely to report moderate to severe movement-evoked pain after breast cancer surgery, the authors found. Those who had more extensive surgery to remove lymph nodes were prone to more severe pain.
Psychological state was also important, with women who felt more optimistic before surgery found to suffer lower intensity pain.
“Chronic preoperative pain, axillary surgery and psychological robustness significantly predicted acute pain outcomes after surgery for breast cancer,” the researchers said.
Lead author Julie Bruce, from Warwick University, said: “Women generally receive the same advice and treatment for pain relief following breast cancer surgery, but this study shows how factors such as a patient’s psychologica=
l state and whether they have a prior history of chronic pain can really affect their recovery.”
Liz Woolf, head of Cancer Research UK’s information website, said postoperative pain levels could have a “significant impact” on treatment by causing patients to miss appointments, or be unable to carry out important postoperative exercises that aid recovery.
“It’s so important to be able to identify in advance those who may be in need of extra pain relief or support,” she said. “Earlier studies suggest that up to half of women who undergo surgery for breast cancer may continue to suffer from pain for up to a year afterwards.”
- Bruce, J et al (2012) Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer. British Journal of Cancer, 107: 937-946.