Persistent Arm Pain Is Distinct From Persistent Breast Pain Following Breast Cancer Surgery |
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| Affiliation: | 1. School of Nursing, University of California, San Francisco, California;2. School of Medicine, University of California, San Francisco, California;3. Redwood Regional Medical Group, Santa Rosa, California;4. Institute for Human Genetics, University of California, San Francisco, California;1. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;2. Athinoula A. Martinos Center for Biomedical Imaging, Boston, Massachusetts;3. Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital, Göttingen, Germany;4. National Clinical Guideline Centre, Royal College of Physicians, London, United Kingdom;5. School of Medicine, Cardiff University, Cardiff, United Kingdom;6. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden;7. Center for Neurosensory Disorders, University of North Carolina, Chapel Hill, North Carolina;11. Pierre Fabre, Boulogne, France;12. Department of Anesthesiology and Postoperative Intensive Care Medicine, University of Cologne, Germany;8. Centre for Neuroimaging Science, Institute of Psychiatry, King''s College, London, United Kingdom;9. Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden;1. Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut;2. Yale School of Medicine, New Haven, Connecticut;1. U.S. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, United States;2. Emory University, Rollins School of Public Health, United States;1. Department of Anesthesia, Division of Pain Management, Cincinnati Children''s Hospital Medical Center, Cincinnati, Ohio;2. Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio |
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| Abstract: | Persistent pain following breast cancer surgery is well documented. However, it is not well characterized in terms of the anatomic site affected (ie, breast, arm). In 2 separate growth mixture modeling analyses, we identified subgroups of women (N = 398) with distinct breast pain and arm pain trajectories. The fact that these latent classes differed by anatomic site, types of tissue affected, and neural innervation patterns suggests the need for separate evaluations of these distinct persistent pain conditions. The purposes of this companion study were to identify demographic and clinical characteristics that differed between the 2 arm pain classes and determine if differences existed over time in sensitivity in the upper inner arm and axillary lymph node dissection sites, pain qualities, pain interference, and hand and arm function, as well as to compare findings with persistent breast pain. Higher occurrence rates for depression and lymphedema were found in the moderate arm pain class. Regardless of pain group membership, sensory loss was observed in the upper inner arm and axillary lymph node dissection site. Arm pain was described similarly to neuropathic pain and interfered with daily functioning. Persistent arm pain was associated with sustained impairments in shoulder mobility.PerspectiveFor persistent breast and arm pain, changes in sensation following breast cancer surgery were notable. Persistent arm pain was associated with sustained interference with daily functioning and upper body mobility impairments. Long-term management of persistent pain following breast cancer surgery is warranted to improve the quality of survivorship for these women. |
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| Keywords: | Arm pain breast cancer surgery pain qualities pain interference range of motion grip strength sensory changes persistent pain chronic pain |
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