Skip to main content

Advertisement

SpringerLink
Log in

Comprehensive visualization of paresthesia in breast cancer survivors

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

As breast cancer survivors are benefiting increasingly from advanced forms of therapy, the side effects of locoregional treatment in the adjuvant setting are becoming more and more important. This article presents a new method of assessing the spatial distribution of paresthesia in breast cancer survivors after different locoregional treatments.

Methods

A structured questionnaire assessing paresthesia, with body pictograms for marking paresthesia areas, was completed by 343 breast cancer survivors. The image information was digitized, generating gray-scale summation images with numbers from 0, indicating black (100 % of the patients had paresthesia), to 255, indicating white (none had paresthesia). The resulting map visualization showed the locations of paresthesia on body pictograms. The group included patients who had undergone breast-conserving surgery (BCS) and mastectomy, and also patients who had received percutaneous and interstitial radiation.

Results

A total of 56.5 % of the patients stated that they had paresthesia. The paresthesia areas were distributed within the range suggested by clinical experience. Most patients stated that they had paresthesia in the upper outer quadrant and axilla. Patients who had undergone mastectomy or percutaneous radiotherapy appeared to have more paresthesia on some areas of the body surface. Patients who had undergone mastectomy indicated larger areas of paresthesia than those with BCS—4,066 pixels (px) vs. 2,275 px. Radiotherapy did not appear to influence the spatial distribution of paresthesia.

Conclusions

Paresthesia is a common symptom after breast cancer treatment. This paper describes a new method of assessing this side effect to improve and individualize treatment for it in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Kolberg HC, Lüftner D, Lux M, Maass N, Schütz F, Fasching P, Fehm T, Janni W, Kummel S (2012) Breast cancer 2012—new aspects. Geburtshilfe Frauenheilkd 72:602–615. doi:10.1055/s-0032-1315131

    Article  Google Scholar 

  2. Lüftner D, Lux M, Maass N, Schütz F, Schwidde I, Fasching P, Fehm T, Janni W, Kummel S, Kolberg HC (2012) Advances in breast cancer—looking back over the year. Geburtshilfe Frauenheilkd 72:1117–1129. doi:10.1055/s-0032-1328084

    Article  Google Scholar 

  3. Bani HA, Fasching PA, Lux MM, Rauh C, Willner M, Eder I, Loehberg C, Schrauder M, Beckmann MW, Bani MR (2007) Lymphedema in breast cancer survivors: assessment and information provision in a specialized breast unit. Patient Educ Couns 66:311–318. doi:10.1016/j.pec.2007.01.004

    Article  PubMed  Google Scholar 

  4. Jud SM, Fasching PA, Maihöfner C, Heusinger K, Loehberg CR, Hatko R, Rauh C, Bani H, Lux MP, Beckmann MW, Bani MR (2010) Pain perception and detailed visual pain mapping in breast cancer survivors. Breast Cancer Res Treat 119:105–110. doi:10.1007/s10549-009-0485-z

    Article  PubMed  Google Scholar 

  5. Peuckmann V, Ekholm O, Rasmussen NK, Groenvold M, Christiansen P, Møller S, Eriksen J, Sjogren P (2009) Chronic pain and other sequelae in long-term breast cancer survivors: nationwide survey in Denmark. Eur J Pain 13:478–485. doi:10.1016/j.ejpain.2008.05.015

    Article  CAS  PubMed  Google Scholar 

  6. Bekes I, Wöckel A, Kreienberg R (2012) Versorgungsqualität an Brustkrebszentren. Geburtshilfe Frauenheilkd 72:987–989. doi:10.1055/s-0032-1315292

    Article  Google Scholar 

  7. Costa A, Zurrida S, Gatti G, Gatzemeier W, Orecchia R, Monti S, Regolo L, Luini A (2004) Less aggressive surgery and radiotherapy is the way forward. Curr Opin Oncol 16:523–528

    Article  PubMed  Google Scholar 

  8. Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, Jeong JH, Wolmark N (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233–1241. doi:10.1056/NEJMoa022152

    Article  PubMed  Google Scholar 

  9. Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, Aguilar M, Marubini E (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347:1227–1232. doi:10.1056/NEJMoa020989

    Article  PubMed  Google Scholar 

  10. Hsueh EC, Hansen N, Giuliano AE (2000) Intraoperative lymphatic mapping and sentinel lymph node dissection in breast cancer. CA Cancer J Clin 50:279–291

    Article  CAS  PubMed  Google Scholar 

  11. Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, Intra M, Veronesi P, Robertson C, Maisonneuve P, Renne G, De Cicco C, De Lucia F, Gennari R (2003) A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med 349:546–553. doi:10.1056/NEJMoa012782

    Article  PubMed  Google Scholar 

  12. Carpenter JS, Andrykowski MA, Sloan P, Cunningham L, Cordova MJ, Studts JL, McGrath PC, Sloan D, Kenady DE (1998) Postmastectomy/postlumpectomy pain in breast cancer survivors. J Clin Epidemiol 51:1285–1292

    Article  CAS  PubMed  Google Scholar 

  13. Carpenter JS, Sloan P, Andrykowski MA, McGrath P, Sloan D, Rexford T, Kenady D (1999) Risk factors for pain after mastectomy/lumpectomy. Cancer Pract 7:66–70

    Article  CAS  PubMed  Google Scholar 

  14. Macdonald L, Bruce J, Scott NW, Smith WCS, Chambers WA (2005) Long-term follow-up of breast cancer survivors with post-mastectomy pain syndrome. Br J Cancer 92:225–230. doi:10.1038/sj.bjc.6602304

    CAS  PubMed Central  PubMed  Google Scholar 

  15. Stevens PE, Dibble SL, Miaskowski C (1995) Prevalence, characteristics, and impact of postmastectomy pain syndrome: an investigation of women’s experiences. Pain 61:61–68

    Article  CAS  PubMed  Google Scholar 

  16. Maughan KL, Lutterbie MA, Ham PS (2010) Treatment of breast cancer. Am Fam Physician 81:1339–1346

    PubMed  Google Scholar 

  17. Mortimer JE (2010) Managing the toxicities of the aromatase inhibitors. Curr Opin Obstet Gynecol 22:56–60. doi:10.1097/GCO.0b013e328334e44e

    Article  PubMed  Google Scholar 

  18. Ruckhäberle E, Rody A, Kaufmann M (2010) Kongressbericht vom 32. Annual san antonio breast cancer symposium vom 10–13 Dec 2009. Geburtshilfe Frauenheilkd 70:177–183. doi:10.1055/s-0029-1240912

    Article  Google Scholar 

  19. Poleshuck EL, Katz J, Andrus CH, Hogan LA, Jung BF, Kulick DI, Dworkin RH (2006) Risk factors for chronic pain following breast cancer surgery: a prospective study. J Pain 7:626–634. doi:10.1016/j.jpain.2006.02.007

    Article  PubMed  Google Scholar 

  20. Tasmuth T, von Smitten K, Hietanen P, Kataja M, Kalso E (1995) Pain and other symptoms after different treatment modalities of breast cancer. Ann Oncol 6:453–459

    CAS  PubMed  Google Scholar 

  21. Schug SA, Manopas A (2007) Update on the role of non-opioids for postoperative pain treatment. Best Pract Res Clin Anaesthesiol 21:15–30

    Article  CAS  PubMed  Google Scholar 

  22. Rauchfuss M, Listing M, Klapp B, Reisshauer A (2010) Massage therapy reduces pain, fatigue and stress in patients with breast cancer. Geburtshilfe Frauenheilkd 70:817–824. doi:10.1055/s-0030-1250400

    Article  Google Scholar 

  23. Ashikaga T, Krag DN, Land SR, Julian TB, Anderson SJ, Brown AM, Skelly JM, Harlow SP, Weaver DL, Mamounas JP (2010) Morbidity results from the NSABP B-32 trial comparing sentinel lymph node dissection versus axillary dissection. J Surg Oncol 102:111–118. doi:10.1002/jso.21535

    Article  PubMed Central  PubMed  Google Scholar 

  24. Luo C, Guo W, Yang J, Sun Q, Wei W, Wu S, Fang S, Zeng Q, Zhao Z, Meng F, Huang X, Zhang X, Li R, Ma X, Luo C, Yang Y (2012) Comparison of mastoscopic and conventional axillary lymph node dissection in breast cancer: long-term results from a randomized, multicenter trial. Mayo Clin Proc 87:1153–1161. doi:10.1016/j.mayocp.2012.07.022

    Article  PubMed Central  PubMed  Google Scholar 

  25. Taira N, Shimozuma K, Ohsumi S, Kuroi K, Shiroiwa T, Watanabe T, Saito M (2012) Impact of preservation of the intercostobrachial nerve during axillary dissection on sensory change and health-related quality of life 2 years after breast cancer surgery. Breast Cancer. [Epub ahead of print]

  26. Wernicke AG, Shamis M, Sidhu KK, Turner BC, Goltser Y, Khan I, Christos J, Komarnicky-Kocher LT (2013) Complication rates in patients with negative axillary nodes 10 years after local breast radiotherapy after either sentinel lymph node dissection or axillary clearance. Am J Clin Oncol 36:12–19. doi:10.1097/COC.0b013e3182354bda

    Article  PubMed  Google Scholar 

  27. Bani MR, Beckmann K, Engel J, Lux MP, Rauh C, Eder I, Bani HA, Breuel C, Bach A, Beckmann MW, Fasching PA (2008) Correlates of the desire for improved cosmetic results after breast-conserving therapy and mastectomy in breast cancer patients. Breast 17:640–645. doi:10.1016/j.breast.2008.05.004

    Article  PubMed  Google Scholar 

  28. Ververs JM, Roumen RM, Vingerhoets AJ, Vreugdenhil G, Coebergh JW, Crommelin MA, Luiten EJ, Repelaer van Driel OJ, Schijven M, Wissing JC, Voogd AC (2001) Risk, severity and predictors of physical and psychological morbidity after axillary lymph node dissection for breast cancer. Eur J Cancer 37:991–999

    Article  CAS  PubMed  Google Scholar 

  29. Lundstedt D, Gustafsson M, Steineck G, Alsadius D, Sundberg A, Wilderäng U, Holmberg E, Johannsson KA, Karlsson P (2012) Long-term symptoms after radiotherapy of supraclavicular lymph nodes in breast cancer patients. Radiother Oncol 103:155–160. doi:10.1016/j.radonc.2011.12.017

    Article  PubMed  Google Scholar 

  30. Bajrovic A, Rades D, Fehlauer F, Tribius S, Hoeller U, Rudat V, Jung H, Alberti A (2004) Is there a life-long risk of brachial plexopathy after radiotherapy of supraclavicular lymph nodes in breast cancer patients? Radiother Oncol 71:297–301. doi:10.1016/j.radonc.2004.03.005

    Article  PubMed  Google Scholar 

  31. Johannsen M, Farver I, Beck N, Zachariae R (2013) The efficacy of psychosocial intervention for pain in breast cancer patients and survivors: a systematic review and meta-analysis. Breast Cancer Res Treat 138:675–690. doi:10.1007/s10549-013-2503-4

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors are grateful to Hassan Bani for his support with the data management.

Conflict of interest

The authors hereby declare that they do not have any conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Gynecology and Obstetrics, University Breast Center for Franconia, Erlangen University Hospital, Universitaetsstrasse 21–23, 91054, Erlangen, Germany

    Sebastian M. Jud, Mayada R. Bani, Michael G. Schrauder, Michael P. Lux, Matthias W. Beckmann, Gassan Bani, Irina Eder, Peter A. Fasching, Christian R. Loehberg, Claudia Rauh & Alexander Hein

  2. Department of Artificial Intelligence and Applied Computer Science, University of Würzburg, Würzburg, Germany

    Reinhard Hatko

  3. Department of Neurology, University Breast Center for Franconia, Erlangen University Hospital, Erlangen, Germany

    Christian Maihöfner

Authors
  1. Sebastian M. Jud
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Reinhard Hatko
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christian Maihöfner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mayada R. Bani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael G. Schrauder
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michael P. Lux
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Matthias W. Beckmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gassan Bani
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Irina Eder
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Peter A. Fasching
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Christian R. Loehberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Claudia Rauh
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Alexander Hein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sebastian M. Jud.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 61 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jud, S.M., Hatko, R., Maihöfner, C. et al. Comprehensive visualization of paresthesia in breast cancer survivors. Arch Gynecol Obstet 290, 135–141 (2014). https://doi.org/10.1007/s00404-014-3164-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-014-3164-1

Keywords

Search

Navigation