학술논문

Characteristics and distribution of chronic pain after mastectomy and breast reconstruction: a long-term prospective cohort study
Document Type
Original Paper
Source
Surgery Today: Official Journal of the Japan Surgical Society. 53(8):957-963
Subject
Chronic postoperative pain
Breast reconstruction
Tissue expander
Breast implant
Deep inferior epigastric perforator (DIEP) flap
Language
English
ISSN
0941-1291
1436-2813
Abstract
Purpose: Chronic pain following breast surgery is a concern for breast cancer survivors; however, few studies have investigated the localization of persistent postoperative pain. We conducted this study to identify the location of pain following breast reconstruction.Methods: A total of 213 Japanese women undergoing mastectomy only or breast reconstruction with a tissue expander/implant (TE/Imp) or a deep inferior epigastric perforator (DIEP) flap were enrolled in the study. Questionnaires related to pain location were sent to patients at the end of postoperative year (POY) 1 and POY 5. Multiple comparisons of the types of operation and cross-tabulation were made between the two time points.Results: Surveys were completed by 107 of the women. Severe pain in the upper medial breast was significantly more common in POY 1 after DIEP reconstruction than after mastectomy only (P = 0.01), whereas abdominal pain was worse in POY 5 after DIEP reconstruction than after mastectomy only (P = 0.04). Pain in the medial arm and axilla had resolved better after TE/Imp (P = 0.03) and DIEP reconstruction (P = 0.01) than after mastectomy only by POY 5, but the difference between TE/Imp and DIEP reconstruction was not significant.Conclusions: These results show that localization of prolonged postoperative pain following breast reconstruction differs depending on the surgical strategy.