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Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients

Background: Pain after breast cancer surgery remains largely unexplained and inconsistently quantified. This study aims to describe the perioperative pain patterns in patients with breast cancer, up to two years after surgery. Methods: This is a pre-planned sub-study of the Ketorolac in Breast Cance...

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Autores principales: Forget, Patrice, Sitter, Taalke M., Hollick, Rosemary J., Dixon, Diane, van Maanen, Aline, Dekleermaker, Alain, Duhoux, Francois P., De Kock, Marc, Berliere, Martine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7759784/
https://www.ncbi.nlm.nih.gov/pubmed/33256031
http://dx.doi.org/10.3390/jcm9123831
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author Forget, Patrice
Sitter, Taalke M.
Hollick, Rosemary J.
Dixon, Diane
van Maanen, Aline
Dekleermaker, Alain
Duhoux, Francois P.
De Kock, Marc
Berliere, Martine
author_facet Forget, Patrice
Sitter, Taalke M.
Hollick, Rosemary J.
Dixon, Diane
van Maanen, Aline
Dekleermaker, Alain
Duhoux, Francois P.
De Kock, Marc
Berliere, Martine
author_sort Forget, Patrice
collection PubMed
description Background: Pain after breast cancer surgery remains largely unexplained and inconsistently quantified. This study aims to describe the perioperative pain patterns in patients with breast cancer, up to two years after surgery. Methods: This is a pre-planned sub-study of the Ketorolac in Breast Cancer (KBC) trial. The KBC trial was a multicentre, prospective, double-blind, placebo-controlled, randomised trial of a single dose of 30 mg of ketorolac just before breast cancer surgery, aiming to test its effect on recurrences. This sub-study focuses only on pain outcomes. From 2013 to 2015, 203 patients were randomised to ketorolac (n = 96) or placebo (n = 107). Structured questionnaires were delivered by telephone after one and two years, exploring the presence, location, permanence, and frequency of pain. Patients’ perceptions of pain were captured by an open-ended question, the responses to which were coded and classified using hierarchical clustering. Results: There was no difference in pain between the ketorolac and the placebo group. The reported incidence of permanent pain was 67% and 45% at one and two years, respectively. The largest category was musculoskeletal pain. Permanent pain was mainly described in patients with musculoskeletal pain. The description of pain changed in most patients during the second postoperative year, i.e., moved from one category to another (no pain, permanent, or non-permanent pain, but also, the localisation). This phenomenon includes patients without pain at one year. Conclusions: Pain is a complex phenomenon, but also a fragile and unstable endpoint. Pain after breast cancer surgery does not necessarily mean breast pain but also musculoskeletal and other pains. The permanence of pain and the pain phenotype can change over time.
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spelling pubmed-77597842020-12-26 Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients Forget, Patrice Sitter, Taalke M. Hollick, Rosemary J. Dixon, Diane van Maanen, Aline Dekleermaker, Alain Duhoux, Francois P. De Kock, Marc Berliere, Martine J Clin Med Article Background: Pain after breast cancer surgery remains largely unexplained and inconsistently quantified. This study aims to describe the perioperative pain patterns in patients with breast cancer, up to two years after surgery. Methods: This is a pre-planned sub-study of the Ketorolac in Breast Cancer (KBC) trial. The KBC trial was a multicentre, prospective, double-blind, placebo-controlled, randomised trial of a single dose of 30 mg of ketorolac just before breast cancer surgery, aiming to test its effect on recurrences. This sub-study focuses only on pain outcomes. From 2013 to 2015, 203 patients were randomised to ketorolac (n = 96) or placebo (n = 107). Structured questionnaires were delivered by telephone after one and two years, exploring the presence, location, permanence, and frequency of pain. Patients’ perceptions of pain were captured by an open-ended question, the responses to which were coded and classified using hierarchical clustering. Results: There was no difference in pain between the ketorolac and the placebo group. The reported incidence of permanent pain was 67% and 45% at one and two years, respectively. The largest category was musculoskeletal pain. Permanent pain was mainly described in patients with musculoskeletal pain. The description of pain changed in most patients during the second postoperative year, i.e., moved from one category to another (no pain, permanent, or non-permanent pain, but also, the localisation). This phenomenon includes patients without pain at one year. Conclusions: Pain is a complex phenomenon, but also a fragile and unstable endpoint. Pain after breast cancer surgery does not necessarily mean breast pain but also musculoskeletal and other pains. The permanence of pain and the pain phenotype can change over time. MDPI 2020-11-26 /pmc/articles/PMC7759784/ /pubmed/33256031 http://dx.doi.org/10.3390/jcm9123831 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Forget, Patrice
Sitter, Taalke M.
Hollick, Rosemary J.
Dixon, Diane
van Maanen, Aline
Dekleermaker, Alain
Duhoux, Francois P.
De Kock, Marc
Berliere, Martine
Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients
title Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients
title_full Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients
title_fullStr Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients
title_full_unstemmed Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients
title_short Characterization of Preoperative, Postsurgical, Acute and Chronic Pain in High Risk Breast Cancer Patients
title_sort characterization of preoperative, postsurgical, acute and chronic pain in high risk breast cancer patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7759784/
https://www.ncbi.nlm.nih.gov/pubmed/33256031
http://dx.doi.org/10.3390/jcm9123831
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