University of CopenhagenA latest study has discovered that nearly 50 percent of women surveyed seem to have indicated that they experienced pain symptoms 2 to 3 years after breast cancer treatment. In addition, women who were younger or who received supplemental radiation therapy appear to have been more prone to have suffered from pain.

Constant post surgical pain apparently has been shown to be clinically significant in many patients undergoing various common operations, including breast cancer surgery. With breast cancer, the pathogenic mechanisms may perhaps multiply, as well as nerve damage related to surgical technique.

Different types of sensory disturbances for instance, after sensations, burning, or sensory loss could occur after other surgical procedures. Also, it may be a crucial part of the pain characteristics in breast cancer. Pain appears to have also been associated with adjuvant or supplemental therapy, such as chemotherapy and radiotherapy.

For the purpose of the study, the authors examined 3,754 women, ages 18 to 70 years for the occurrence, associated factors, severity of chronic pain and sensory disturbances on an average of 26 months after surgery for breast cancer. Subsequently, the participants were given a questionnaire between January and April 2008. By June 2008, 87 percent i.e. 3,253 of eligible women were noted to have returned the questionnaire.

The findings of the study revealed that a total of 1,543 patients i.e. 47 percent seem to have reported pain in 1 or more areas, of which 13 percent reported severe pain, 39 percent stated moderate pain, and 48 percent reported light pain. Among women accounting severe pain, approximately 77 percent appear to have experienced pain every day, whereas only 36 percent of women suffered from light pain everyday.

“There was a significant association of age on reporting pain, where young age was associated with higher risk, especially for patients receiving breast-conserving surgery (BCS), the risk being highest for those women aged 18 to 39 years receiving BCS compared with women aged 60 to 69 years,” explains lead author of the study, Rune Gartner, M.D., of the University of Copenhagen, Denmark.

Moreover, adjuvant radiation therapy, but not chemotherapy was believed to have augmented the risk of reporting pain. Axillary lymph node dissection may have been associated with increased likelihood of pain or sensory disturbances in contrast with sentinel lymph node dissection.

Gartner further said that, “Based on the results of our study together with previously reported findings, chronic pain after breast cancer surgery and adjuvant therapy may predominantly be characterized as a neuropathic pain state and probably related to intraoperative injury of the intercostal-brachial nerve. In accordance with these findings, preliminary observations with nerve-sparing techniques may suggest such approaches to reduce the risk of developing a chronic neuropathic pain state. However, such studies need to be larger and more detailed, taking all the different subgroups as studied in our investigation into consideration.”

A total of 58 percent of the patients seem to have reported sensory disturbances or discomfort, with the most commonly reported areas the axilla or the underarm area, followed by arm, breast area and side of the body. Additionally, a total of 306 patients i.e. 20 percent with pain appear to have contacted a physician within the initial 3 months for pain complaints in the surgical area.

The findings of the study have been published in the Journal of the American Medical Association.