Department of Anesthesia, Critical Care and Pain, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India.
Department of Surgery, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India.
Indian J Cancer. 2023 Apr-Jun;60(2):275-281. doi: 10.4103/ijc.ijc_861_21.
Literature on Post mastectomy pain in the Indian population is scarce. Most literature is from the West. The current study aimed to identify the incidence of post-mastectomy pain syndrome (PMPS), pain severity, and its impact on quality of life in Indian patients.
Prospective observational study of 120 women undergoing mastectomy between March and December 2017, followed until 6 months after surgery. The Brief Pain Inventory (BPI) questionnaire and the quality of life questionnaire (QLQ) by the European Organization for Research and Treatment of Cancer (EORTC) and known as (EORTC-QLQ 30) were used to identify the impact on function and quality of life.
A 35.8% PMPS incidence was identified at 6 months after mastectomy. Pain was located in the anterior chest wall (41.8%), axilla (32.6%), and medial upper arm (25.6%). Most (48.8%) patients described it as dull aching and of mild intensity (55.8%). No significant association of age, BMI, surgery, Intercostobrachial nerve (ICBN) dissection, postoperative pain severity, pain history {dysmenorrhea, headache}, and postoperative radiotherapy with PMPS was found. Pain interfered with daily activities and quality of life in those with PMPS, as deduced from BPI and EORTC-QLQ.
PMPS is very much a problem affecting the quality of life in our set of patients. Most women tried to cope and accept the pain as part of the treatment process. This shows the need for creating awareness about PMPS among healthcare providers and patients alike. Early identification and treatment of post mastectomy pain should be an essential aspect of patient care.
印度人群中关于乳腺癌根治术后疼痛的文献很少。大多数文献来自西方。本研究旨在确定印度患者乳腺癌根治术后疼痛综合征(PMPS)的发生率、疼痛严重程度及其对生活质量的影响。
对 2017 年 3 月至 12 月期间接受乳腺癌根治术的 120 名女性进行前瞻性观察研究,随访至术后 6 个月。使用简短疼痛量表(BPI)问卷和欧洲癌症研究与治疗组织(EORTC)的生活质量问卷(EORTC-QLQ30),评估对功能和生活质量的影响。
在乳腺癌根治术后 6 个月时,发现 35.8%的患者发生 PMPS。疼痛位于前胸壁(41.8%)、腋窝(32.6%)和上臂内侧(25.6%)。大多数(48.8%)患者描述为钝痛,强度为轻度(55.8%)。未发现年龄、BMI、手术、肋间臂神经(ICBN)解剖、术后疼痛严重程度、疼痛史(痛经、头痛)和术后放疗与 PMPS 之间存在显著关联。PMPS 患者的 BPI 和 EORTC-QLQ 评估结果显示,疼痛干扰了日常活动和生活质量。
PMPS 是一个严重影响我们这组患者生活质量的问题。大多数女性试图应对并接受疼痛,将其视为治疗过程的一部分。这表明需要在医疗保健提供者和患者中提高对 PMPS 的认识。早期识别和治疗乳腺癌根治术后疼痛应成为患者护理的重要组成部分。