Chronic postsurgical pain following breast reconstruction: a commentary and critique
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In line with other major surgeries including breast cancer surgery (BCS), recent studies suggest a striking rate of chronic postsurgical pain (CPSP) following breast reconstruction. This commentary will critically examine evidence for the degree to which the prevalence of CPSP following breast reconstruction is directly attributable to reconstructive surgery. The discussion will trace similarities and distinctions between breast reconstruction and BCS in considering the risk for CPSP, and describe recent advances in the definition of CPSP, highlighting methodological limitations in the general investigation of CPSP, which also characterize the study of CPSP more specifically for breast reconstruction outcome. A convenience sample of relevant studies examining CPSP following breast reconstruction reveals inadequate evidence to support a serious concern for reconstruction-induced CPSP and further that these studies fail to adhere to recommended methodological standards to effectively isolate surgery as the etiology of persistent pain reported by women following reconstructive surgery. Suggestions for future exploration of problematic chronic pain after breast reconstruction are considered.
KeywordsBreast reconstruction Chronic postsurgical pain Breast cancer surgery Postoperative pain Persistent pain Chronic pain
Compliance with ethical standards
Conflict of interest
The author declares no conflict of interest.
Human and animal rights
This article contains studies with human participants performed by the author, and all procedures performed in the studies involving human participants were in accordance with the ethical standards and approval of the Institutional Review Board of the participating institutions.
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