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Annals of Surgical Oncology

, Volume 21, Issue 1, pp 113–117 | Cite as

Immediate Breast Reconstruction Does Not Increase Postmastectomy Pain

  • Julia R. Henderson
  • Amy Tao
  • Cliona C. Kirwan
  • Lester Barr
Reconstructive Oncology

Abstract

Background

Postmastectomy pain syndrome (PMPS) is a recognized complication of breast surgery, with a reported prevalence of 20–52 %. We investigated whether patients having immediate reconstruction (IR) reported more long-term pain compared to those having mastectomy alone (MA). We also investigated treatment factors influencing PMPS.

Methods

In a single center, all patients who underwent MA or IR between January 2009 and June 2011 and attended for follow-up between February 2012 and July 2012 were identified. Patients were invited to complete two questionnaires, a pain intensity visual analog scale (VAS, scored 0 to 10) and the PainDetect screening tool for neuropathic pain.

Results

Of 318 patients due to attend, 272 (86 %) submitted complete questionnaires. Of these, 134 (49 %) women had IR (implant based n = 93, pedicled flaps n = 33, free flaps n = 8). The overall point prevalence pain was low, with 221 (81 %) reporting VAS current pain as zero. Only 8 (3 %) patients reported a VAS score above 4. Six (2 %) patients had a positive PainDetect score. The percentage of patients reporting VAS scores greater than zero and positive or borderline PainDetect scores was similar for MA and IR (VAS: 13 and 14 %, respectively; PainDetect: 6 and 11 %, respectively). Radiotherapy was the strongest predictor of neuropathic pain.

Conclusions

In this cohort, the prevalence of PMPS was lower than historic reports. We find no evidence of increased overall pain intensity or chronic neuropathic pain after IR compared to MA despite additional tissue dissection and potential donor site morbidity. This adds support to the positive benefits of breast reconstruction.

Keywords

Neuropathic Pain Visual Analog Scale Score Breast Reconstruction Current Pain Average Pain Intensity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

We are grateful to the Genesis Breast Cancer Prevention Appeal for a grant to support this study, and to Sigrid White of UHSM Department of Medical Statistics for the statistical analysis. We acknowledge the support of A. Gandhi, N. Bundred, R. Johnson, G. Byrne, A. Zeiton, A. Baildam, and V. Rose for providing patient data for the study.

Conflict of interest

The authors declare no conflict of interest.

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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Julia R. Henderson
    • 1
  • Amy Tao
    • 1
  • Cliona C. Kirwan
    • 1
    • 2
  • Lester Barr
    • 1
  1. 1.Nightingale Centre and Genesis Prevention CentreUniversity Hospital of South ManchesterManchesterUK
  2. 2.Institute of Cancer SciencesUniversity of ManchesterManchesterUK

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