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Neuropathic pain after breast cancer treatment: Characterization and risk factors

Journal of Pain and Symptom Management Aug 16, 2017

Pereira S, et al. – Researchers planned this investigation to evaluate the incidence of neuropathic pain (NP) in the first year after diagnosis of breast cancer and to distinguish its main determinants. In this population, NP and chronic NP were frequent, being correlated with anxiety and arm symptoms prior to breast cancer treatments, as well as the type of surgical management. These outcomes emphasized the need for monitoring the occurrence of this neurological side effect of treatments and to develop strategies for reducing the morbidity burden of breast cancer.

Methods
  • The researchers conducted a prospective cohort study including 506 patients with incident breast cancer, recruited at the Portuguese Institute of Oncology of Porto, and followed for 1 year.
  • To identify chronic NP, patients with incident NP were additionally assessed when this condition was diagnosed and after six months.

Results
  • 156 patients were diagnosed with NP during the first year [30.8%, 95% confidence interval (95%CI): 27.0-35.0].
  • Factors predictors of a higher risk of NP were anxiety [relative risk (RR)=1.50; 95%CI: 1.06-2.13], arm symptoms (RR=1.44; 95%CI: 1.02-2.05), cancer stage III/IV (RR=2.47; 95%CI: 1.66-3.66), breast-conserving surgery with axillary lymph node dissection (ALND) (RR=3.13; 95%CI: 1.51-6.48), mastectomy with ALND (RR=2.52; 95%CI: 1.25-5.11) and damaging of the intercostobrachial nerve (RR=2.05; 95%CI:1.25-3.37).
  • After 6 months, 97 patients (62.2%, 95%CI: 54.4-69.4) diagnosed with NP remained symptomatic.
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