Section for Surgical Pathophysiology, 7621 Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
BMJ. 2013 Apr 11;346:f1865. doi: 10.1136/bmj.f1865.
To examine the development of persistent pain after treatment for breast cancer and to examine risk factors associated with continuing pain.
Repeated cross sectional study in a previously examined nationwide cohort. All eligible women who underwent surgery for primary breast cancer in Denmark in 2005 and 2006 and were examined in 2008 were surveyed again with the same questionnaire.
Surgical centres in Denmark.
Prevalence, location, and severity of persistent pain after treatment for breast cancer in well defined treatment groups and changes in pain reporting and sensory disturbances from 2008 to 2012.
In 2012, 2828 women were eligible in our database, and 108 were excluded. Exclusion criteria were death; new, recurrent, or other cancer; reconstructive breast surgery; and emigration.
2411 (89%) women returned the questionnaire. Prevalence of persistent pain after treatment for breast cancer ranged from 22% to 53% depending on treatment. In 2012, 903 (37%) women reported such pain, a fall from 45% in 2008. Of these, 378 (16%) reported pain of ≥ 4 on a numerical rating scale (scale 0-10), a fall from 19%. Among women reporting pain in 2008, 36% no longer reported it in 2012. In contrast, 15% of the women who did not report pain in 2008 reported it in 2012. Risk factors for having pain were axillary lymph node dissection rather than sentinel lymph node biopsy (odds ratio 2.04, 95% confidence interval 1.60 to 2.61; P<0.001) and age ≤ 49 (1.78, 1.25 to 2.54; P<0.001). No particular method of treatment or age was associated with an increase in pain from 2008 to 2012.
Persistent pain after treatment for breast cancer remains an important problem five to seven years later. The problem is not static as it can either progress or regress with time.
Clinicaltrials.gov NCT No 01543711.
探讨乳腺癌治疗后持续性疼痛的发展情况，并探讨与持续疼痛相关的危险因素。
对以前检查过的全国性队列进行重复横断面研究。所有符合条件的于 2005 年和 2006 年在丹麦接受原发性乳腺癌手术并于 2008 年接受相同问卷调查的女性再次接受调查。
丹麦外科中心。
在明确的治疗组中，乳腺癌治疗后持续性疼痛的发生率、部位和严重程度，以及 2008 年至 2012 年疼痛报告和感觉障碍的变化。
在我们的数据库中，2012 年有 2828 名女性符合条件，其中 108 名被排除在外。排除标准为死亡；新发、复发性或其他癌症；乳房重建手术；和移民。
2411 名（89%）女性返回了问卷。乳腺癌治疗后持续性疼痛的发生率为 22%至 53%，取决于治疗方法。2012 年，903 名（37%）女性报告有这种疼痛，比 2008 年的 45%有所下降。其中，378 名（16%）女性报告疼痛程度为数字评分量表（0-10 分）的≥4 分，比 19%有所下降。在 2008 年报告疼痛的女性中，36%在 2012 年不再报告疼痛。相比之下，2008 年没有报告疼痛的女性中有 15%在 2012 年报告了疼痛。有疼痛的危险因素是腋窝淋巴结清扫术而不是前哨淋巴结活检术（比值比 2.04，95%置信区间 1.60 至 2.61；P<0.001）和年龄≤49 岁（1.78，1.25 至 2.54；P<0.001）。没有特定的治疗方法或年龄与 2008 年至 2012 年疼痛的增加有关。
乳腺癌治疗后持续性疼痛仍然是五到七年后的一个重要问题。随着时间的推移，该问题并非一成不变，它可能会进展或缓解。
Clinicaltrials.gov NCT01543711。
