Feeney Lorraine R, Tormey Shona M, Harmon Dominic C
Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
Department of Surgery, Limerick University Hospital, Dooradoyle, Limerick, Ireland.
Ir J Med Sci. 2018 Nov;187(4):877-885. doi: 10.1007/s11845-018-1760-y. Epub 2018 Feb 5.
More patients are surviving breast cancer; however, many complain of persistent pain, which significantly impacts on their lives. Studies have predominantly examined risk factors alone. This mixed methods study will systematically compare prospective and retrospective studies of chronic pain following breast cancer treatment. A wider scope than risk factors alone is included in a narrative review element.
Common risk factors and themes were identified, and these were compared with some of the retrospective literature available. Several common themes arose in the literature such as common patient demographics, perioperative and postoperative management, treatment modalities and psychological factors. The variation in disease severity, treatment mode and symptom progression between participants in the studies made it difficult to draw conclusions from both the prospective and retrospective literature.
Chronic pain is common after breast cancer. The literature has focused predominantly on risk factors for the development of chronic pain. It may be more beneficial to focus on chronic pain mechanisms and to consider the patient's narrative and experience of their illness and how this has impacted on the perception and intensity of persistent pain. A shared understanding between the patient and professional is likely to have more beneficial outcomes.
越来越多的乳腺癌患者存活下来;然而,许多患者抱怨持续疼痛,这对他们的生活产生了重大影响。以往研究主要单独考察风险因素。这项混合方法研究将系统比较乳腺癌治疗后慢性疼痛的前瞻性研究和回顾性研究。叙述性综述部分纳入的范围比单纯的风险因素更广泛。
确定了常见的风险因素和主题,并与一些现有回顾性文献进行了比较。文献中出现了几个常见主题,如常见的患者人口统计学特征、围手术期和术后管理、治疗方式以及心理因素。研究参与者之间疾病严重程度、治疗方式和症状进展的差异使得难以从前瞻性和回顾性文献中得出结论。
乳腺癌后慢性疼痛很常见。文献主要集中在慢性疼痛发生的风险因素上。关注慢性疼痛机制、考虑患者对疾病的叙述和体验以及这如何影响持续性疼痛的感知和强度可能更有益。患者与专业人员之间达成共同理解可能会产生更有益的结果。