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Objectives: To assess the long-term outcome of breast reconstructions with special focus on chronic postsurgical pain (CPSP) in a larger cohort of breast cancer survivors.

Methods: A cross-sectional study on 121 women with mastectomy and breast reconstruction after mean 2 years 4 months follow up. The mean time from breast reconstruction to the follow-up visit was 4 years 2 months. We studied surveys on pain (Brief Pain Inventory, BPI and Douleur Neuropathique 4, DN4), quality of life (RAND-36 health survey), sleep (insomnia severity questionnaire, ISI), mood (Beck's Depression Index, BDI; Hospital Anxiety and Depression Scale, HADS), and a detailed clinical sensory status. Patients were divided into three groups: abdominal flap (Deep inferior epigastric perforator flap, DIEP; Free transverse rectus abdominis flap, fTRAM, and Pedicled transverse rectus abdominis flap, pTRAM), dorsal flap (Latissimus dorsi flap, LD and Thoracodorsal artery perforator flap, TDAP), and other (Transverse myocutaneous gracilis flap, TMG; implant). Clinically meaningful pain was defined ≥ 4/10 on a numeric rating scale (NRS). We used patients' pain drawings to localize the pain. We assessed preoperative pain NRS from previous data.

Results: 106 (87.6%) of the patients did not have clinically meaningful persistent pain. We found no statistically significant difference between different reconstruction types with regards to persistent pain ( p =0.40), mood (BDI-II, p =0.41 and HADS A, p =0.54) or sleep ( p =0.14), respectively. Preoperative pain prior to breast reconstruction surgery correlated strongly with moderate or severe CPSP.

Conclusions: Moderate to severe CPSP intensity was present in 14% of patients. We found no significant difference in the prevalence of pain across different reconstruction types. Preoperative pain associated significantly with postoperative persistent pain.

Titel:	Breast reconstruction after breast cancer surgery - persistent pain and quality of life 1-8 years after breast reconstruction.
Autor/in / Beteiligte Person:	Honkanen, N ; Mustonen, L ; Kalso, E ; Meretoja, T ; Harno, H
Link:	Zum Volltext
Zeitschrift:	Scandinavian journal of pain, Jg. 21 (2021-06-07), Heft 3, S. 522
Veröffentlichung:	2018- : [Berlin] : De Gruyter ; <i>Original Publication</i>: [Maryland Heights, MO] : Elsevier Science, c2010-, 2021
Medientyp:	academicJournal
ISSN:	1877-8879 (electronic)
DOI:	10.1515/sjpain-2021-0026
Schlagwort:	Cross-Sectional Studies Female Humans Mastectomy Pain Postoperative Complications Quality of Life Breast Neoplasms surgery Mammaplasty Perforator Flap
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Research Support, Non-U.S. Gov't Language: English [Scand J Pain] 2021 Jun 07; Vol. 21 (3), pp. 522-529. <i>Date of Electronic Publication: </i>2021 Jun 07 (<i>Print Publication: </i>2021). MeSH Terms: Breast Neoplasms* / surgery ; Mammaplasty* ; Perforator Flap* ; Cross-Sectional Studies ; Female ; Humans ; Mastectomy ; Pain ; Postoperative Complications ; Quality of Life References: Metcalfe, KA, Semple, J, Quan, ML, Vadaparampil, ST, Holloway, C, Brown, M, et al.. Changes in psychosocial functioning 1 year after mastectomy alone, delayed breast reconstruction, or immediate breast reconstruction. Ann Surg Oncol 2012;19:233–41. https://doi.org/10.1245/s10434-011-1828-7. ; Meyerowitz, BE. Psychosocial correlates of breast cancer and its treatments. Psychol Bull 1980;87:108–31. ; Eltahir, Y, Werners, LLCH, Dreise, MM, Van Emmichoven, IAZ, Jansen, L, Werker, PMN, et al.. 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Breast reconstruction after breast cancer surgery - persistent pain and quality of life 1-8 years after breast reconstruction.