Rogowsky Larissa, Illmann Caroline F, Macadam Sheina A, Lennox Peter A, Van Laeken Nancy, Bovill Esta S, Doherty Christopher, Isaac Kathryn V
Division of Plastic Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
Plast Surg (Oakv). 2024 Aug;32(3):415-422. doi: 10.1177/22925503221128985. Epub 2022 Oct 19.
Breast cancer is the most frequently diagnosed cancer worldwide. For those undergoing mastectomy, the choice of alloplastic immediate breast reconstruction (IBR) is increasingly favored. Post-operative chronic pain is an important consideration in this decision, but there is a paucity of data for those undergoing alloplastic IBR. We sought to examine the prevalence, severity, and risk factors for the development of chronic pain in this cohort using validated patient-reported outcome measures. A cross-sectional survey study was conducted among patients receiving mastectomy with alloplastic IBR. Participants completed 3 surveys querying chronic pain, specifically the Breast Cancer Pain Questionnaire (BCPQ), Brief Pain Inventory (BPI), and BREAST-Q. Participant medical records were reviewed for demographic and surgical variables. A total of 118 patients participated in the study-a response rate of 33.6%. Chronic pain prevalence was high (52.5%), and only 29.0% of these patients had consulted a physician regarding their pain. Among those reporting chronic pain ( = 62), the median severity of pain was 3.1 on an 11-point scale. Chronic pain was associated with radiation ( = .018), bilateral reconstruction ( = .05), worse emotional health ( = .0003), less self ( = .022), and sexual confidence ( = .044). Inter-tool reliability was high, with no significant difference in responses between the 3 surveys. In this cohort, chronic pain is supported as a significant concern among patients who have undergone mastectomy with alloplastic IBR. Given the burden of chronic pain, there is an opportunity to intervene with preventative measures and support for its management.
乳腺癌是全球诊断最频繁的癌症。对于那些接受乳房切除术的患者,异体即刻乳房重建(IBR)的选择越来越受到青睐。术后慢性疼痛是这一决策中的重要考虑因素,但对于接受异体IBR的患者,相关数据较少。我们试图使用经过验证的患者报告结局指标,来研究该队列中慢性疼痛发生的患病率、严重程度和风险因素。对接受异体IBR乳房切除术的患者进行了一项横断面调查研究。参与者完成了3项关于慢性疼痛的调查,具体为乳腺癌疼痛问卷(BCPQ)、简明疼痛量表(BPI)和BREAST-Q。查阅参与者的病历以获取人口统计学和手术变量信息。共有118名患者参与了研究,应答率为33.6%。慢性疼痛患病率很高(52.5%),这些患者中只有29.0%就其疼痛咨询过医生。在报告慢性疼痛的患者中(n = 62),疼痛的中位严重程度在11分制量表上为3.1。慢性疼痛与放疗(P = 0.018)、双侧重建(P = 0.05)、较差的情绪健康(P = 0.0003)、较低的自我(P = 0.022)和性自信(P = 0.044)相关。工具间的可靠性很高,3项调查之间的应答无显著差异。在这个队列中,慢性疼痛被证实是接受异体IBR乳房切除术患者的一个重大问题。鉴于慢性疼痛的负担,有机会采取预防措施并提供管理支持进行干预。