Saxena Ashok K R, Kumar Sanjeev
Pain Clinic, Department of Anesthesiology, University College of Medical Sciences & G.T.B. Hospital, Delhi, India.
Pain Pract. 2007 Jun;7(2):163-77. doi: 10.1111/j.1533-2500.2007.00125.x.
Breast cancer is the most frequently encountered carcinoma in women worldwide. Pain is the most distressing symptom in patients with breast carcinoma and can occur at all stages of the disease due to the cancer per se as well as due to various diagnostic and treatment modalities. A proper pain assessment helps in identification of pain syndromes and guides in formulating analgesic strategies. Primary therapies of breast carcinoma like surgery, chemotherapy, and radiotherapy for bony metastases can cause substantial pain relief. However, multimodal analgesic approaches incorporating pharmacological, interventional as well as non-conventional techniques should be employed prior to, in conjunction with, and after primary therapies of breast cancer. The prevalence of chronic neuropathic pain following breast cancer surgery may exceed 50% by current estimates, and with the increase in life expectancy of these patients, providing adequate pain relief is of paramount importance to improve their quality of life. In this review, we discuss prevailing methods of evaluation and management of pain in patients of breast carcinoma and the new techniques that may become the mainstay of pain management protocols in future.
乳腺癌是全球女性中最常见的癌症。疼痛是乳腺癌患者最痛苦的症状，在疾病的各个阶段都可能出现，这是由于癌症本身以及各种诊断和治疗方式所致。恰当的疼痛评估有助于识别疼痛综合征，并指导制定镇痛策略。乳腺癌的主要治疗方法，如手术、化疗以及针对骨转移的放疗，都能显著缓解疼痛。然而，在乳腺癌的主要治疗之前、期间和之后，都应采用包括药物、介入以及非常规技术在内的多模式镇痛方法。据目前估计，乳腺癌手术后慢性神经性疼痛的患病率可能超过50%，并且随着这些患者预期寿命的增加，提供充分的疼痛缓解对于提高他们的生活质量至关重要。在本综述中，我们讨论了乳腺癌患者疼痛评估和管理的现行方法以及未来可能成为疼痛管理方案支柱的新技术。
