Persistent Postmastectomy Pain in Breast Cancer Patients: Incidence, Pain Characteristics and Effects on Quality of Life

Abstract

Objectives: Persistent pain and sensory disturbances following surgical treatment for breast cancer is a significant clinical problem. The goal of this study was to investigate the incidence and clinical characteristics of persistent postmastectomy pain (PPMP) and its impact on quality of life. Methods: Between 1998 and 2013, one hundred thirty-five patients who had undergone a mastectomy operation for breast cancer by the same surgeons were evaluated. Patients who had more than one operation or died during follow up were excluded. All patients were contacted by telephone and were questioned about the presence of PPMP. Patients who had PPMP were invited for face to face interview and assessed with a Pain Questionnaire Form and LANSS Pain Scale. Results: 99 out of 135 patients (73.3%) were contacted by telephone. The incidence of PPMP was 16.2%. Pain Questionnaire revealed that 50% of the patients had mild pain, 37.5% had moderate pain, and 12.5% had severe pain. The rate of neuropathic pain symptoms varied between 25% and 81%. According to LANSS Pain Scale, neuropathic mechanisms were likely to be contributing to the patient’s pain in 56% of the patients. 56% of the patients with pain needed analgesia, 12.5% reported that their pain was their worst medical problem limiting their daily activities. Conclusion: The incidence of PPMP was 16.2% and the contribution of neuropathic mechanisms was 56% in our study. About 50% of the patients with PPMP had moderate to severe pain necessitating analgesia.