Prospective study of pain outcomes associated with breast surgery in women with nonhereditary breast cancer Journal Article


Authors: Smith-Graziani, D. J.; Parker, P. A.; Peterson, S. K.; Bedrosian, I.; Shen, Y.; Black, D. M.; DeSnyder, S. M.; Hunt, K. K.; Dong, W.; Brewster, A. M.
Article Title: Prospective study of pain outcomes associated with breast surgery in women with nonhereditary breast cancer
Abstract: Objective: To assess pain severity and interference with life in women after different types of breast cancer surgery and the demographic, treatment-related, and psychosocial variables associated with these pain outcomes. Summary of Background Data: Data are conflicting regarding pain outcomes and quality of life (QOL) among women who undergo different types of breast surgery. Methods: Women with nonhereditary breast cancer completed the brief pain inventory before surgery and at 1, 6, 12, and 18 months postsurgery. We assessed associations between pain outcomes and CPM status and mastectomy status using multivariable repeated measures models. We assessed associations between pain outcome and QOL and decision satisfaction. Results: Of 288 women (mean age 56 years, 58% non-Hispanic White), 50 had CPM, 75 had unilateral mastectomy, and 163 had BCS. Mean pain severity scores were higher at one (2.78 vs 1.9, P = 0.016) and 6 months (2.79 vs 1.96, P = 0.031) postsurgery in women who had CPM versus those who did not, but there was no difference at 12 and 18 months. Comparing mastectomy versus BCS, pain severity was higher at 1 and 12 months. There was a significant interaction between pain severity and time point for CPM (P = 0.006), but not mastectomy status (P = 0.069). Regardless of surgery type, Black women had higher pain severity (P = 0.004) than White women. Higher pain interference was associated with lower QOL (P < 0.001) and lower decision satisfaction (P = 0.034). Conclusions: Providers should counsel women considering mastectomy about the potential for greater acute pain and its impact on overall well-being. Racial/ethnic disparities in pain exist and influence pain management in breast surgical patients. © 2023 Lippincott Williams and Wilkins. All rights reserved.
Keywords: adult; cancer chemotherapy; controlled study; middle aged; patient satisfaction; cancer surgery; major clinical study; cancer radiotherapy; comparative study; cancer staging; outcome assessment; antineoplastic agent; cancer diagnosis; prospective study; prospective studies; quality of life; pain; breast cancer; breast; mastectomy; breast neoplasms; breast tumor; analgesia; postoperative pain; breast surgery; longitudinal study; demographics; brief pain inventory; disparities; functional assessment of cancer therapy breast; cancer; humans; human; female; article; pain severity; ductal breast carcinoma in situ; pain severity score
Journal Title: Annals of Surgery
Volume: 277
Issue: 3
ISSN: 0003-4932
Publisher: Lippincott Williams & Wilkins  
Date Published: 2023-03-01
Start Page: e617
End Page: e623
Language: English
DOI: 10.1097/sla.0000000000004925
PUBMED: 33938495
PROVIDER: scopus
PMCID: PMC10657557
DOI/URL:
Notes: Article -- Export Date: 1 March 2023 -- Source: Scopus
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  1. Patricia Ann Parker
    91 Parker