Persistent arm pain is distinct from persistent breast pain following breast cancer surgery.

Abstract

UNLABELLED:

Persistent pain following breast cancer surgery is well documented. However, it is not well characterized in terms of the anatomic site affected (ie, breast, arm). In 2 separate growth mixture modeling analyses, we identified subgroups of women (N = 398) with distinct breast pain and arm pain trajectories. The fact that these latent classes differed by anatomic site, types of tissue affected, and neural innervation patterns suggests the need for separate evaluations of these distinct persistent pain conditions. The purposes of this companion study were to identify demographic and clinical characteristics that differed between the 2 arm pain classes and determine if differences existed over time in sensitivity in the upper inner arm and axillary lymph node dissection sites, pain qualities, pain interference, and hand and arm function, as well as to compare findings with persistent breast pain. Higher occurrence rates for depression and lymphedema were found in the moderate arm pain class. Regardless of pain group membership, sensory loss was observed in the upper inner arm and axillary lymph node dissection site. Arm pain was described similarly to neuropathic pain and interfered with daily functioning. Persistent arm pain was associated with sustained impairments in shoulder mobility.

PERSPECTIVE:

For persistent breast and arm pain, changes in sensation following breast cancer surgery were notable. Persistent arm pain was associated with sustained interference with daily functioning and upper body mobility impairments. Long-term management of persistent pain following breast cancer surgery is warranted to improve the quality of survivorship for these women.

• Authors: Dale J Langford, Steven M Paul, Claudia West, Gary Abrams, Charles Elboim, Jon D Levine, Deborah Hamolsky, Judith A Luce, Kord M Kober, John M Neuhaus, Bruce A Cooper, Bradley E Aouizerat, Christine Miaskowski
• Journal: The journal of pain (J Pain) Vol. 15 Issue 12 Pg. 1238-47 (Dec 2014) ISSN: 1528-8447 [Electronic] United States
• PMID: 25439319 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S.)
• Copyright: Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.

Topics

• Arm (physiopathology)
• Breast (physiopathology, surgery)
• Breast Neoplasms (physiopathology, surgery)
• Female
• Hand Strength (physiology)
• Humans
• Middle Aged
• Motor Activity (physiology)
• Pain Measurement
• Pain, Postoperative (physiopathology)
• Range of Motion, Articular (physiology)
• Shoulder (physiopathology)
• Time Factors