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Identification of Patient Subgroups and Risk Factors for Persistent Breast Pain Following Breast Cancer Surgery
Authors:Christine Miaskowski  Bruce Cooper  Steven M. Paul  Claudia West  Dale Langford  Jon D. Levine  Gary Abrams  Deborah Hamolsky  Laura Dunn  Marylin Dodd  John Neuhaus  Christina Baggott  Anand Dhruva  Brian Schmidt  Janine Cataldo  John Merriman  Bradley E. Aouizerat
Affiliation: School of Nursing, University of California, San Francisco, California; School of Medicine, University of California, San Francisco, California;§ Institute for Human Genetics, University of California, San Francisco, California; School of Dentistry, New York University, New York, New York
Abstract:Study purposes were to determine the prevalence of persistent pain in the breast; characterize distinct persistent pain classes using growth mixture modeling; and evaluate for differences among these pain classes in demographic, preoperative, intraoperative, and postoperative characteristics. In addition, differences in the severity of common symptoms and quality of life outcomes measured prior to surgery, among the pain classes, were evaluated. Patients (n = 398) were recruited prior to surgery and followed for 6 months. Using growth mixture modeling, patients were classified into no (31.7%), mild (43.4%), moderate (13.3%), and severe (11.6%) pain groups based on ratings of worst breast pain. Differences in a number of demographic, preoperative, intraoperative, and postoperative characteristics differentiated among the pain classes. In addition, patients in the moderate and severe pain classes reported higher preoperative levels of depression, anxiety, and sleep disturbance than the no pain class. Findings suggest that approximately 25% of women experience significant and persistent levels of breast pain in the first 6 months following breast cancer surgery.
Keywords:Breast pain   persistent postsurgical pain   risk factors   breast cancer surgery   growth mixture modeling   latent class analysis
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