Who’s Going to Hurt After Cancer Surgery?

Breast cancer surgery causes persistent pain in one in four women

(RxWiki News) While the most common types of breast cancer are usually not painful, treating the disease can be. A new study found that about one in four women being treated suffered persistent pain up to six months after treatment.

In a first of its kind study, researchers have classified women most at risk for experiencing pain following breast cancer surgery. Younger non-white women with less education and income were most likely to suffer severe pain for six months following treatment.

"Choose an experienced surgeon."

The University of California San Francisco researchers were led by Christine Miaskowski, RN, PhD, FAAN, professor in the Department of Physiological Nursing.

The research team studied 400 women who had undergone breast cancer surgery. Investigators followed the women for six months, surveying them monthly about the levels and types of pain they were experiencing.

Study members completed the Breast Symptom Questionnaire, which assesses the presence and intensity of pain.

About 32 percent of the women reported no breast pain, and just over 43 percent said they'd had mild pain.

A quarter of the women said they’d had either moderate (13.3 percent) or severe pain (11.6 percent) that lingered for six months.

The researchers learned that the women who experienced severe pain were younger in age, had less education and lower incomes and were of non-white ethnicity. As has been noted in previous studies, younger women were most likely to experience persistent pain.

Other modifiable factors that impacted post-operative pain included: experiencing breast pain prior to the surgery, changes in breast sensations, the number of lymph nodes removed and having undergone an axillary lymph node dissection (removing lymph nodes closest to the tumor).

Breast surgeon, Cary Kaufman, MD, told dailyRx News, “There are at least three situations that may be painful: breast surgery without radiation, breast surgery with radiation treatment and axillary lymph node surgery.

“Breast surgery followed by radiation includes the chronic tenderness of radiation treatment. Axillary surgery includes the tenderness of nerves located near the lymph nodes,” said Dr. Kaufman, who is a specialist at Bellingham Regional Breast Center in Washington state.

“Careful and experienced breast surgeons can avoid much of the pain described in this article, for experience improves results,” Dr. Kaufman told dailyRx.

“If breast surgery is needed, be sure to find an experienced breast surgeon," he recommended.

Study authors wrote that the data suggests improvements can be made in post-operative pain management to decrease persistent breast pain.

This study was published in the December issue of the Journal of Pain.

Review Date: 
January 23, 2013