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Persistent pain a problem year after breast cancer surgery

NEW YORK -- Lingering pain after breast cancer surgery remains a significant problem for many women, new data suggest.

One year after treatment for localized breast cancer, 50 percent of women had mild pain and 16 percent had moderate to severe pain in a study from Finland.

"I believe many doctors do know of the possibility of persistent pain after surgery. Perhaps the surprise here is just how common such persistent pain is in breast cancer patients at 12 months from surgery," Dr. Tuomo J. Meretoja of Helsinki University Central Hospital told Reuters Health by email.

In a prospective study, Dr. Meretoja and colleagues examined the prevalence and severity of factors associated with chronic pain after surgery and treatment for localized breast cancer in 860 women treated at the Helsinki University Central Hospital between 2006 and 2010. The average age was 57.

Nearly three quarters (73 percent) of the women received radiotherapy and 57 percent received chemotherapy.

On a questionnaire 12 months after surgery, 34.5 percent of the women said they were pain free, 49.7 percent reported mild pain, 12.1 percent moderate pain, and 3.7 percent severe pain, the investigators reported in a  

} Research Letter in JAMA January 1, 2014.

"Luckily most of the patients with persistent pain only have mild pains and the most severe and hardest to treat persistent pains are much less frequent," Dr. Meretoja commented.

Factors associated with pain one year after treatment were chronic preoperative pain, preoperative pain in the area to be operated, axillary lymph node dissection, preoperative depression, chemotherapy and radiotherapy.

"A limitation of the study is that we did not perform a detailed clinical investigation at one year to diagnose the type of persistent pain," Dr. Meretoja and colleagues note.

The researchers hope their findings may prove "useful in developing strategies for preventing persistent pain following breast cancer treatment.

"At the present, we have no tools to recognize patients at risk of developing persistent pain. However, we hope to develop a risk prediction tool in the future on the basis of the current study," Dr. Meretoja told Reuters Health.

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