Survey finds pain is common years after breast cancer surgery
(21 November 2009: VIDYYA MEDICAL NEWS SERVICE) -- A nationwide study of women who had breast cancer surgery in Denmark found that 47 percent of participants reported chronic pain 2 to 3 years after breast cancer treatment. Of these, 13 percent indicated severe pain, 39 percent moderate pain, and 48 percent light pain. In addition, 58 percent of participants experienced sensory disturbances or discomfort.
These results, which appeared November 11 in the Journal of the American Medical Association, could help doctors identify patients at high risk of chronic pain and may lead to progress in chronic pain prevention and treatment, the researchers said.
Women with the highest risk of both chronic pain and sensory disturbances were those ages 18 to 39 years who had undergone breast-conserving surgery, the researchers found. Adjuvant radiotherapy, but not chemotherapy, was also associated with chronic pain. Axillary lymph node dissection was associated with a greater likelihood of pain compared with sentinel lymph node biopsy.
The study included 3,253 Danish women who underwent surgery for unilateral primary breast cancer in 2005 and 2006. The large sample size and standardized treatment approaches required by national protocols make this study the first of its kind.
“We think that our results, based on a very large study in very well-defined nationwide treatment, help to understand what the most important risk factors are for chronic pain after breast cancer surgery,” said senior author Dr. Henrik Kehlet of the University of Copenhagen.
The co-author of an accompanying editorial, Dr. Loretta Loftus of the University of South Florida H. Lee Moffitt Cancer Center, agreed, saying the findings “alert us to patients more prone to pain so that we might identify them earlier on, even prior to surgery, to develop a multidisciplinary approach to treatment that helps patients avoid long-term suffering.”
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