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

J. Bruce; A. J. Thornton; Neil William Scott; S. Marfizo; R. Powell; M. Johnston; M. Wells; S. D. Heys; A. M. Thompson; Recovery Study Group

doi:10.1038/bjc.2012.341

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

J. Bruce^*, A. J. Thornton, Neil William Scott, S. Marfizo, R. Powell, M. Johnston, M. Wells, S. D. Heys, A. M. Thompson, Recovery Study Group

^*Corresponding author for this work

University of Dundee

Research output: Contribution to journal › Article › peer-review

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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. British Journal of Cancer (2012) 107, 937-946. doi:10.1038/bjc.2012.341 www.bjcancer.com Published online 31 July 2012 (C) 2012 Cancer Research UK

Original language	English
Pages (from-to)	937-946
Number of pages	10
Journal	British Journal of Cancer
Volume	107
Issue number	6
Early online date	31 Jul 2012
DOIs	https://doi.org/10.1038/bjc.2012.341
Publication status	Published - 4 Sept 2012

Bibliographical note

PMID: 22850552 [PubMed - indexed for MEDLINE] PMCID: PMC3464763 Free PMC Article

Keywords

postoperative pain
acute pain
breast cancer surgery
psychological factors
persistent postsurgical pain
lymph-node dissection
neuropathic pain
risk-factors
dispositional optimism
questionnaire
prevalence
survivors
cohort
validation

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title = "Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer",

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. British Journal of Cancer (2012) 107, 937-946. doi:10.1038/bjc.2012.341 www.bjcancer.com Published online 31 July 2012 (C) 2012 Cancer Research UK",

keywords = "postoperative pain, acute pain, breast cancer surgery, psychological factors, persistent postsurgical pain, lymph-node dissection, neuropathic pain, risk-factors, dispositional optimism, questionnaire, prevalence, survivors, cohort, validation",

author = "J. Bruce and Thornton, {A. J.} and Scott, {Neil William} and S. Marfizo and R. Powell and M. Johnston and M. Wells and Heys, {S. D.} and Thompson, {A. M.} and {Recovery Study Group}",

note = "PMID: 22850552 [PubMed - indexed for MEDLINE] PMCID: PMC3464763 Free PMC Article",

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doi = "10.1038/bjc.2012.341",

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T1 - Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer

AU - Bruce, J.

AU - Thornton, A. J.

AU - Scott, Neil William

AU - Marfizo, S.

AU - Powell, R.

AU - Johnston, M.

AU - Wells, M.

AU - Heys, S. D.

AU - Thompson, A. M.

AU - Recovery Study Group

N1 - PMID: 22850552 [PubMed - indexed for MEDLINE] PMCID: PMC3464763 Free PMC Article

PY - 2012/9/4

Y1 - 2012/9/4

N2 - 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. British Journal of Cancer (2012) 107, 937-946. doi:10.1038/bjc.2012.341 www.bjcancer.com Published online 31 July 2012 (C) 2012 Cancer Research UK

AB - 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. British Journal of Cancer (2012) 107, 937-946. doi:10.1038/bjc.2012.341 www.bjcancer.com Published online 31 July 2012 (C) 2012 Cancer Research UK

KW - postoperative pain

KW - acute pain

KW - breast cancer surgery

KW - psychological factors

KW - persistent postsurgical pain

KW - lymph-node dissection

KW - neuropathic pain

KW - risk-factors

KW - dispositional optimism

KW - questionnaire

KW - prevalence

KW - survivors

KW - cohort

KW - validation

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U2 - 10.1038/bjc.2012.341

DO - 10.1038/bjc.2012.341

M3 - Article

AN - SCOPUS:84865863360

SN - 0007-0920

VL - 107

SP - 937

EP - 946

JO - British Journal of Cancer

JF - British Journal of Cancer

IS - 6

ER -

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

Abstract

Bibliographical note

Keywords

UN SDGs

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