• Alexander Andersen Juhl, Peer Christiansen, and Tine Engberg Damsgaard.
• Plastic Surgery Research Unit, Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark.
• J Breast Cancer. 2016 Dec 1; 19 (4): 447-454.

PurposePersistent pain is a common side effect of breast cancer treatment. The present study aimed to assess the prevalence, associated treatment-related factors, and the type of pain (neuropathic or nociceptive) in patients who had undergone a unilateral mastectomy.MethodsAll women who underwent a unilateral mastectomy at a University Hospital between 2009 and 2013 were eligible for inclusion. Women with breast reconstruction or active cancer were excluded. Participants were mailed a questionnaire evaluating the prevalence, location, intensity, and frequency of surgical site pain. Additionally, the painDETECT®, a validated instrument to evaluate neuropathic pain, was mailed to all participants.ResultsA total of 305 women were included, and of them, 261 (85.6%) completed the study questionnaire. After a median follow-up period of 3.0 years, 100 women (38.3%) reported experiencing pain at the surgical site. Body mass index ≥30 kg/m2, radiation therapy, and axillary lymph node dissection were significantly associated with persistent pain in univariate models. However, only body mass index ≥30 kg/m2 was independently associated with persistent pain (odds ratio, 2.13; 95% confidence interval, 1.06-4.27; p=0.034) in a multivariate analysis. Of the patients reporting pain, 71.0% were unlikely to have a neuropathic pain component. A moderate, but highly significant, positive correlation was observed between the pain intensity and the painDETECT® score (rs=0.47, p<0.001).ConclusionPersistent pain after breast cancer treatment continues to have a high prevalence. Our results indicate that the largest proportion of patients experiencing persistent pain after breast cancer treatment do not have a clear neuropathic pain component.

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