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Risk factors associated with chronic pain after mastectomy: a prospective study with a 5-year follow-up in Japan

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Abstract

Background

Chronic pain is a major complication following breast surgery including breast reconstruction. We previously examined prospective patient-specific and medical/surgical factors that predict chronic pain a year after breast surgery in the Japanese population. Five-year survivorship is essential for breast cancer patients. This report is a 4-year follow-up study following the previous research.

Methods

A follow-up observation study was performed 5 years after breast operations. The subjects were patients who underwent breast surgery, including tissue expander/implant (TE/implant), DIEP procedures and mastectomy only. Pain at 5 years was assessed using the Japanese Version of the Short-Form McGill Pain Questionnaire (SF-MPQ-JV). A multiple linear regression model was used to examine the relationships of clinical factors with chronic pain.

Results

Questionnaires were completed by 132 subjects. No factor related to chronic pain was significantly related to the MPQ pain ratings. Among patient characteristics, a psychotic or neurological medical history was related to significantly lower visual analog scale (p = 0.02) and present pain index (p = 0.04) scores. A history of chemotherapy and/or hormone therapy was significantly associated with the frequency of use of pain medication postoperatively (p = 0.05) and effect on the social life of the patients (p = 0.02).

Conclusions

A psychotic or neurological history and a history of chemotherapy and/or hormone therapy were identified as risk factors for chronic pain after breast surgery, but the type of operation was not associated with chronic pain.

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Data availability

Data for this study are available upon request.

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Acknowledgements

We thank Toru Ogura, PhD. and Satoshi Tamaru, MD, PhD. from Clinical Research Support Center, Mie University Hospital, Tsu, Japan for their valuable assistance in the bio-statistical analysis.

Funding

Costs related to statistical analysis and manuscript publication were funded by the Department of Plastic and Reconstructive Surgery, Kyoto Prefectural University of Medicine.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 54 Shogoin Kawahara-cho, Sakyou-ku, Kyoto, 606-8507, Japan

    Makoto Shiraishi, Yoshihiro Sowa, Akiko Shiraishi & Naoki Inafuku

  2. Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan

    Makoto Shiraishi

  3. Department of Plastic and Reconstructive Surgery, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Kyoto, Japan

    Yoshihiro Sowa, Itaru Tsuge & Naoki Morimoto

  4. Department of Breast Surgery, Kyoto Miniren Chuo Hospital, Kyoto, Japan

    Ichiro Nakayama

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  1. Makoto Shiraishi
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  4. Akiko Shiraishi
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  5. Naoki Inafuku
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  7. Naoki Morimoto
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Contributions

MS and YS designed the study. MS, YS, AS, and NI participated in the acquisition of data. MS, YS, IT, AS, NI, IN, and NM participated in the analysis and interpretation of the data. MS drafted the manuscript. MS, YS, IT, AS, NI, IN, and NM revised the manuscript. All authors approved the final version of the manuscript, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Yoshihiro Sowa.

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Conflict of interest

The authors state that they have no conflict of interest.

Ethics statement

The involvement of human participants in the study was reviewed and approved by the KPUM Institutional Review Board and the study was conducted in accordance with the ethical standards of institutional and national research committees (Kyoto Prefectural University of Medicine IRBMED Number ERB-C-563–1). Participants provided written informed consent.

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Shiraishi, M., Sowa, Y., Tsuge, I. et al. Risk factors associated with chronic pain after mastectomy: a prospective study with a 5-year follow-up in Japan. Breast Cancer 29, 1133–1139 (2022). https://doi.org/10.1007/s12282-022-01392-8

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  • DOI: https://doi.org/10.1007/s12282-022-01392-8

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