Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer

Bruce, Julie, Thornton, Alison J, Scott, N W, Marfizo, S, Powell, Rachael, Johnston, Marie, Wells, M, Heys, S.D. and Thompson, A.M. (2012). Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer. British Journal of Cancer, 107 (6), pp. 937-946.

Abstract

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.

Publication DOI: https://doi.org/10.1038/bjc.2012.341
Divisions: Life & Health Sciences > Psychology
Life & Health Sciences
Life & Health Sciences > Chronic and Communicable Conditions
Additional Information: This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License.
Uncontrolled Keywords: Cancer Research,Oncology
Full Text Link: http://www.natu ... jc2012341a.html
Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
Published Date: 2012-07-31
Authors: Bruce, Julie
Thornton, Alison J
Scott, N W
Marfizo, S
Powell, Rachael
Johnston, Marie
Wells, M
Heys, S.D.
Thompson, A.M.

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