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乳腺癌根治术后疼痛综合征的预防和治疗方法更新:全面的叙述性综述。

Updates on the preventions and management of post-mastectomy pain syndrome beyond medical treatment: a comprehensive narrative review.

机构信息

Department of Breast and Endocrine Surgery, NHO Takasaki General Medical Center, Gunma, Japan.

Department of Medical Oncology & Malignant Hematology, Sunnybrook Health Sciences Centre, Toronto, Canada.

出版信息

Ann Palliat Med. 2024 Sep;13(5):1258-1264. doi: 10.21037/apm-24-73. Epub 2024 Aug 16.

Abstract

BACKGROUND AND OBJECTIVE

With the significant advances in breast cancer treatment, the survival rates have improved. Consequently, improving the quality of life for breast cancer survivors has emerged an important issue. In this study, we examined the management of post-mastectomy pain syndrome (PMPS) in breast cancer patients thorough a comprehensive literature review. We introduce the preventive measures and pharmacotherapy for PMPS in breast cancer patients and discuss the effectiveness of psychosocial interventions.

METHODS

We conducted a literature search for relevant articles in Medline ALL, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, Embase, and nine other databases from October 2023 to January 2024. Chronic pain was defined as pain persisting for more than 3 months after breast cancer surgery. The search included terms related to PMPS, psychological interventions, and breast cancer. Data extraction was done independently by two reviewers, and any discrepancies will be discussed to ensure consensus or by a third reviewer.

KEY CONTENT AND FINDINGS

Studies have investigated surgical anesthetics, postoperative medications, and surgical procedures for PMPS prevention, but few have focused on treatment. Our literature search about the usefulness of psychosocial interventions yielded two articles, one was about the usefulness of mindfulness and the other was about the efficacy of yoga.

CONCLUSIONS

Mindfulness and yoga show potential efficacy for PMPS treatment, but the evidence is limited. More research is needed to confirm these findings and to explore other psychosocial interventions.

摘要

背景与目的

随着乳腺癌治疗的显著进展,生存率得到了提高。因此,提高乳腺癌幸存者的生活质量成为一个重要问题。本研究通过全面的文献回顾,探讨乳腺癌患者术后乳房切除术后疼痛综合征(PMPS)的管理。我们介绍了乳腺癌患者 PMPS 的预防措施和药物治疗,并讨论了心理社会干预的效果。

方法

我们在 2023 年 10 月至 2024 年 1 月期间,在 Medline ALL、Cochrane 系统评价数据库、Cochrane 中心、Embase 和其他九个数据库中进行了相关文章的文献检索。慢性疼痛定义为乳腺癌手术后持续 3 个月以上的疼痛。搜索包括与 PMPS、心理干预和乳腺癌相关的术语。两位评审员独立进行数据提取,如果存在分歧,将进行讨论以确保达成共识,或由第三位评审员决定。

主要内容和发现

研究已经探讨了预防 PMPS 的手术麻醉、术后药物和手术程序,但很少关注治疗。我们对心理社会干预有效性的文献检索得到了两篇文章,一篇是关于正念的有效性,另一篇是关于瑜伽的疗效。

结论

正念和瑜伽对 PMPS 的治疗有一定的疗效,但证据有限。需要进一步的研究来证实这些发现,并探索其他心理社会干预措施。

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