Article Commentary: Pain after Mastectomy and Breast Reconstruction

2008 ◽  
Vol 74 (4) ◽  
pp. 285-296 ◽  
Author(s):  
Nalini Vadivelu ◽  
Maggie Schreck ◽  
Javier Lopez ◽  
Gopal Kodumudi ◽  
Deepak Narayan
Keyword(s):  
Breast Cancer ◽  
Chronic Pain ◽  
Minimally Invasive ◽  
Breast Reconstruction ◽  
Sentinel Node ◽  
Breast Cancer Surgery ◽  
Phantom Pain ◽  
Preventative Measures ◽  
Pain Syndromes ◽  
Post Operative Pain

Breast cancer is a potentially deadly disease affecting one in eight women. With the trend toward minimally invasive therapies for breast cancer, such as breast conserving therapies, sentinel node biopsies, and early treatments of radiation and chemotherapy, life expectancy after breast cancer has increased. However, pain after breast cancer surgery is a major problem and women undergoing mastectomy and breast reconstruction experience postoperative pain syndromes in approximately one-half of all cases. Patients post mastectomy and breast reconstruction can suffer from acute nociceptive pain and chronic neuropathic pain syndromes. Several preventative measures to control acute post operative pain and chronic pain states such as post mastectomy pain and phantom pain have been tried. This review focuses on the recent research done to control acute and chronic pain in patients receiving minimally invasive therapies for breast cancer, such as breast conserving therapies of mastectomies and breast reconstruction, sentinel node biopsies, and early treatments of radiation and chemotherapy.

Immediate reconstruction in breast cancer surgery requires intensive post-operative pain treatment but the effects of axillary dissection may be more predictive of chronic pain

The Breast ◽  
2002 ◽  
Vol 11 (2) ◽  
pp. 156-162 ◽  
Author(s):  
M. Legeby ◽  
M. Segerdahl ◽  
K. Sandelin ◽  
M. Wickman ◽  
K. Östman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Chronic Pain ◽  
Axillary Dissection ◽  
Pain Treatment ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Immediate Reconstruction ◽  
Post Operative Pain

scholarly journals Effect of physical activity levels on oncological breast surgery recovery: a prospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ifat Klein ◽  
Leonid Kalichman ◽  
Noy Chen ◽  
Sergio Susmallian
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Chronic Pain ◽  
Self Efficacy ◽  
Breast Cancer Surgery ◽  
Activity Levels ◽  
Axillary Web Syndrome ◽  
Function Range ◽  
A Prospective Study ◽  
The Impact

AbstractAfter breast cancer (BC) surgery, women may experience a physical decline. The effect of physical activity (PA) on the course of recovery after BC surgery has not yet been thoroughly examined. To analyze the impact of physical activity performed by women undergoing breast cancer surgery on measures of function, range of motion, and self-efficacy. A prospective study was carried out in 157 patients who underwent surgery for BC between October 2018 and April 2019, divided into four groups according to the intensity of PA with 6 months follow-up. 50 sedentary patients and 107 active patients were enrolled; the mean age was 52.6. Women who performed physical activity, moderate to vigorous, demonstrated lower function disabilities (QuickDASH 2.22) compared with inactivity or light physical activity (QuickDASH 7.0, p < 0.001), with better shoulder flexion (159.0° vs. 150.7°, p = 0.007) and abduction (159.5° vs. 152.2°, p = 0.008). Higher PA levels, displayed in higher self-efficacy reports (9.5 vs. 8.8, p = 0.002), and return to prior job status (0.005). The PA level does not influence pain at one, three and 6 months postoperatively (p = 0.278, p = 0.304 and p = 0.304 respectively). High PA levels increase the risk of axillary web syndrome (p = 0.041), although, it reduces the incidence of chronic pain (p = 0.007). Women who practice physical activity recover better from BC surgery than sedentary women. The higher the intensity and frequency of training, the better the results. Vigorous activity cause axillary web syndrome, despite, it has a beneficial effect on lowering the rate of chronic pain.

scholarly journals Risk Factors for Chronic Pain Following Breast Cancer Surgery: A Prospective Study

2006 ◽  
Vol 7 (9) ◽  
pp. 626-634 ◽  
Author(s):  
Ellen L. Poleshuck ◽  
Jennifer Katz ◽  
Carl H. Andrus ◽  
Laura A. Hogan ◽  
Beth F. Jung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Chronic Pain ◽  
Prospective Study ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
A Prospective Study

Effect of Axillary Lymph Node Dissection on Prevalence and Intensity of Chronic and Phantom Pain After Breast Cancer Surgery

2008 ◽  
Vol 9 (9) ◽  
pp. 813-822 ◽  
Author(s):  
Monique A. Steegers ◽  
Bas Wolters ◽  
Andrea W. Evers ◽  
Luc Strobbe ◽  
Oliver H. Wilder-Smith
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Phantom Pain ◽  
Axillary Lymph ◽  
Node Dissection

scholarly journals Myofascial Massage for Chronic Pain and Decreased Upper Extremity Mobility After Breast Cancer Surgery

2018 ◽  
Vol 11 (3) ◽  
pp. 4-9 ◽  
Author(s):  
Jeanne Massingill, LMT, MLD, CST, KT, NMT ◽  
Cara Jorgensen, LMT ◽  
Jacqueline Dolata, MBA ◽  
Ashwini R. Sehgal, MD
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Chronic Pain ◽  
Upper Extremity ◽  
Outcome Measures ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Mobility Limitations ◽  
And Control

Background: Chronic localized pain and decreased upper extremity mobility commonly occur following breast cancer surgery and may persist despite use of pain medication and physical therapy.Purpose: We sought to determine the value of myofascial massage to address these pain and mobility limitations.Setting: The study took place at a clinical massage spa in the U.S. Midwest. The research was overseen by MetroHealth Medical Center’s Institutional Review Board and Case Center for Reducing Health Disparities research staff.Participants: 21 women with persistent pain and mobility limitations 3–18 months following breast surgery.Research Design: We conducted a pilot randomized controlled trial where intervention patients received myofascial massages and control patients received relaxation massages.Intervention: Intervention participants received 16 myofascial massage sessions over eight weeks that focused on the affected breast, chest, and shoulder areas. Control participants received 16 relaxation massage sessions over eight weeks that avoided the affected breast, chest, and shoulder areas. Participants completed a validated questionnaire at the beginning and end of the study that asked about pain, mobility, and quality of life.Main Outcome Measures: Outcome measures include change in self-reported pain, self-reported mobility, and three quality-of-life questions.Results: At baseline, intervention and control participants were similar in demographic and medical characteristics, pain and mobility ratings, and quality of life. Compared to control participants, intervention participants had more favorable changes in pain (-10.7 vs. +0.4, p < .001), mobility (-14.5 vs. -0.8, p < .001), and general health (+29.5 vs. -2.5, p = .002) after eight weeks. All intervention and control participants reported that receiving massage treatments was a positive experience.Conclusions: Myofascial massage is a promising treatment to address chronic pain and mobility limitations following breast cancer surgery. Further work in several areas is needed to confirm and expand on our study findings.

scholarly journals Analysis on the Effect of Application of the DIEP Flap in Breast Reconstruction Surgery

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Tan Jia Liang
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Chest Wall ◽  
Early Stage ◽  
Developed Countries ◽  
Breast Cancer Surgery ◽  
Sex Reassignment Surgery ◽  
Diep Flap ◽  
Breast Reduction Surgery ◽  
Reconstruction Surgery

Breast reconstruction surgery means using autologous tissue grafts and breast prosthesis to rebuild chest wall deformities and the absence of breast caused by post mastectomy, which are possibly due to burns, trauma, infections, congenital dysplasia and sex reassignment surgery etc., with the prevalence of unilateral breast reconstruction. After attempting to carry out breast reconstruction with latissimus dorsi, many surgeons constantly improved, designed, and modified multiple forms of operation programs and thus promote increasing improvement in repair and reconstruction of the breast after breast reduction surgery and mastectomy for breast cancer [1] Currently, breast reconstruction after breast cancer surgery is just in the early stage while it has occupied an important position in developed countries,therefore, the knowledge of breast reconstruction needs to be enhanced and publicized in our country. Some data show the quality of life in patients following breast reconstruction surgery is significantly higher than that in patients undergoing lumpectomy plus radiotherapy or simple mastectomy. More and more patients pursue breast reconstruction after mastectomy for breast cancer. Breast reconstruction is roughly divided into lost chest wall skin repair, hemispherical breast reconstruction, anterior axillary fold repair, plastic surgery for subclavian depression, nipple and areola reconstruction and asymmetrical breast repair. In the reconstruction of breasts, it is necessary to endeavor to make the rebuilt breast symmetrical to the healthy side so that future adjustment will be simple and easily feasible.

scholarly journals Prediction of total hospital expenses of patients undergoing breast cancer surgery in Shanghai, China by comparing three models

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Minjie Chen ◽  
Xiaopin Wu ◽  
Jidong Zhang ◽  
Enhong Dong
Keyword(s):  
Breast Cancer ◽  
Minimally Invasive ◽  
General Anesthesia ◽  
Medical Insurance ◽  
Cancer Surgery ◽  
Classification And Regression Tree ◽  
Breast Cancer Surgery ◽  
Total Hospital ◽  
Hospital Managers ◽  
Hospital Expenses

Abstract Background Breast cancer imposes a considerable burden on both the health care system and society, and becomes increasingly severe among women in China. To reduce the economic burden of this disease is crucial for patients undergoing the breast cancer surgery, hospital managers, and medical insurance providers. However, few studies have evidenced the prediction of the total hospital expenses (THE) for breast cancer surgery. The aim of the study is to predict THE for breast cancer surgery and identify the main influencing factors. Methods Data were retrieved from the first page of medical records of 3699 patients undergoing breast cancer surgery in one tertiary hospital from 2017 to 2018. Multiple liner regression (MLR), artificial neural networks (ANNs), and classification and regression tree (CART) were constructed and compared. Results The dataset from 3699 patients were randomly divided into training and test sets at a 70:30 ratio (2599 and 1100 records, respectively). The average total hospital expenses were 12520.54 ± 7844.88 ¥ (US$ 1929.20 ± 1208.11). MLR results revealed six factors to be significantly associated with THE: age, LOS, type of disease, having medical insurance, minimally invasive surgery, and receiving general anesthesia. After comparing three models, ANNs was the best model to predict THEs in patients undergoing breast cancer surgery, and its strong predictive performance was also validated. Conclusions To reduce the THEs, more attention should be paid to related factors of LOS, major and minimally invasive surgeries, and general anesthesia for these patient groups undergoing breast cancer surgery. This may reduce the information asymmetry between doctors and patients and provide more reliable cost, practical inpatient medical consumption standards and reimbursement standards reference for patients, hospital managers, and medical insurance providers ,respectively.

The difficult challenge of post-operative pain management in heroin addicted patients undergoing breast cancer surgery

2021 ◽  
Author(s):  
Thierry C. Bagaphou ◽  
Domenico P. Santonastaso ◽  
Francesca Scopetta ◽  
Vittorio Cerotto ◽  
Luciano Carli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pain Management ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Post Operative Pain ◽  
Difficult Challenge

Women's experience of acute and chronic pain following breast cancer surgery

2013 ◽  
Vol 22 (7-8) ◽  
pp. 1044-1052 ◽  
Author(s):  
Inger L Hovind ◽  
Inger S Bredal ◽  
Alfhild Dihle
Keyword(s):  
Breast Cancer ◽  
Chronic Pain ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Women's Experience
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