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Predictors of persistent post-surgical pain intensity and interference at 1 year after breast cancer surgery: assessing central sensitization, central sensitivity symptoms, and psychological factors

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Abstract

Background

Persistent post-surgical pain (PPSP) is associated with upper limb dysfunction and decreased quality of life and causes long-term suffering for breast cancer survivors after surgery. However, the predictors of PPSP remain unclear. The purpose of this study was to examine predictors of PPSP intensity and interference at 1 year postoperatively, focusing on treatment-related factors, pre- and postoperative central sensitization (CS), CS-related symptoms (e.g., muscle stiffness, fatigue, sleep disturbances), and psychological factors.

Methods

Eighty-eight women with planned unilateral breast cancer surgery were included in this longitudinal study. CS, CS-related symptoms, and psychological factors were assessed preoperatively, 1 month postoperatively, and 1 year postoperatively. Analysis of covariance was used to compare the groups with and without PPSP, accounting for treatment-related factors. Multiple regression analysis was performed to identify predictors of PPSP intensity and interference at 1 year postoperatively.

Results

Even after adjusting for covariates, preoperative and 1-month postoperative Central Sensitization Inventory scores in the PPSP group were significantly higher than scores in the group without PPSP. Multiple regression analysis showed that axillary lymph node dissection (ALND) and 1-month postoperative CS-related symptoms were independent predictors of PPSP intensity and interference at 1 year postoperatively (p < 0.01).

Conclusion

We found that ALND and 1-month postoperative CS-related symptoms were predictors of PPSP intensity and interference at 1 year postoperatively.

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Availability of data and materials

The datasets are available from the corresponding author on reasonable request.

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Acknowledgements

The authors are extremely grateful to the survivors who participated in this study and Izumi Kameyama, Yumi Nakakura, Yasuko Tanaka, and Naoko Takahashi for assistance with data collection. We thank the Edanz for editing a draft of this manuscript.

Funding

The authors declare no funding sources directly relevant to the study.

Author information

Authors and Affiliations

  1. Department of Rehabilitation, Breast Care Sensyu Clinic, Osaka, Japan

    Masahiro Manfuku

  2. Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, Hiroshima, Japan

    Masahiro Manfuku

  3. Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara , Hiroshima, Japan

    Tomohiko Nishigami

  4. Department of Physical Therapy, Konan Women’s University, Hyogo, Japan

    Akira Mibu

  5. Department of Rehabilitation, Nozomi Orthopaedic Clinic Saijo, Hiroshima, Japan

    Hirofumi Yamashita

  6. Graduate School of Rehabilitation, Osaka Kawasaki Rehabilitation University, Osaka, Japan

    Ryota Imai

  7. Department of Breast Surgery, Breast Care Sensyu Clinic, Osaka, Japan

    Hiroe Kanamori & Kazuhiro Sumiyoshi

Authors
  1. Masahiro Manfuku
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  2. Tomohiko Nishigami
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  3. Akira Mibu
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  4. Hirofumi Yamashita
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  5. Ryota Imai
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  7. Kazuhiro Sumiyoshi
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Contributions

All authors contributed significantly to the preparation of this manuscript. Concept/idea/research design: M.M, T.N. Writing: M.M, T.N, A.M, H.Y, R.I, Data collection: M.M, H.K, K.S. Data analysis: M.M, T.N, R.I. Project management: T.N. Providing participants: K.S.

Corresponding author

Correspondence to Tomohiko Nishigami.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval, consent to participate, and consent for publication

This study was ethical approval by the Institutional Ethics Committee of Konan Women’s University (2017006). All participants have provided written informed consent to participate in the study and to present or publish anonymized data before the study and consent has been obtained. The study was conducted according to the Declaration of Helsinki.

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Manfuku, M., Nishigami, T., Mibu, A. et al. Predictors of persistent post-surgical pain intensity and interference at 1 year after breast cancer surgery: assessing central sensitization, central sensitivity symptoms, and psychological factors. Breast Cancer 30, 271–281 (2023). https://doi.org/10.1007/s12282-022-01420-7

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  • DOI: https://doi.org/10.1007/s12282-022-01420-7

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