Prospective cohort study assessing chronic pain in patients following minor surgery for breast cancer

Abstract

Purpose: Pain after tumorectomy and sentinel lymph node dissection is poorly reported in the literature. We carried out a prospective survey aimed at assessing pain three months after such minor surgery for breast cancer.

Methods: The study was approved by the local ethics committee. Most surgeries followed a standard protocol involving general anesthesia with no regional analgesia technique, laryngeal mask, sufentanil and propofol for induction, and multimodal analgesia during the postoperative period. Three months after the surgery, a questionnaire was sent to the patients with a pre-stamped envelope for return. The questions probed responses required to calculate a Brief Pain Inventory score and modified neuropathic pain score (DN3).

Results: Over a 5-month period, 150 patients (aged 60 (11) years, body mass index of 25 (6) kg/m²) were included in the final analysis. In the recovery room, 43% of patients required morphine at a mean dose of 5.2 (1.8) mg. Three months post surgery, 60 patients (40%) reported persistent pain for which 62% took analgesic drugs. We found no risk factor associated with this persistent pain among our studied population. Neuropathic pain was noted in 61% of patients who reported persistent pain primarily associated with periareolar incision.

Conclusions: Pain persisted up to three months after minor surgery for breast cancer in 40% of patients with mostly a neuropathic component (61%).

Keywords: Cancer pain; Chronic pain; Neuropathic pain.