Chronic Pain in Breast Cancer Survivors: Nociceptive, Neuropathic, or Central Sensitization Pain?
INTRODUCTION
The differentiation between acute and chronic pain can be insufficient for appropriate pain management. The aim of this study was to evaluate the prevalence of the predominant pain type (nociceptive, neuropathic, or central sensitization [CS] pain) in breast cancer survivors (BCS) with chronic pain. The secondary aims were to examine (1) differences in health-related quality of life (HRQoL) between the different pain groups; and (2) the associations between patient-, disease-, and treatment-related factors and the different pain types.


METHODS
To determine the prevalence of the predominant type of pain, a recently proposed classification system was used. BCS were asked to complete the VAS for pain, Douleur Neuropathique 4 Questionnaire, Margolis Pain Diagram, Central Sensitization Inventory, and Short Form 36 (SF-36).


RESULTS
Ninety-one BCS participated, among whom 25.3% presented neuropathic pain, 18.7% nociceptive pain, and 15.4% CS pain. Mixed pain was found in 40.6%. A significant intergroup difference in HRQoL was found for SF-36 "general health" (P = 0.04). The odds for the presence of CS rather than nociceptive pain are 26 times higher in patients exposed to hormone therapy in comparison to the nonexposed (odds ratio 25.95, 95% confidence interval 1.33 to 504.37, P = 0.03).


CONCLUSION
Neuropathic pain is most frequent in BCS. Strong associations were found between CS pain and hormone therapy.
['Leysen|Laurence|L|0000-0003-0246-7002', 'Adriaenssens|Nele|N|', 'Nijs|Jo|J|', 'Pas|Roselien|R|0000-0001-7784-6942', 'Bilterys|Thomas|T|', 'Vermeir|Sofie|S|', 'Lahousse|Astrid|A|', 'Beckwée|David|D|']
D000328:Adult D000368:Aged D001943:Breast Neoplasms D000073116:Cancer Survivors D059333:Central Nervous System Sensitization D059350:Chronic Pain D003430:Cross-Sectional Studies D005260:Female D006801:Humans D008875:Middle Aged D009437:Neuralgia D059226:Nociceptive Pain D015995:Prevalence D011788:Quality of Life D011795:Surveys and Questionnaires
chronic pain nociceptive neuropathic central sensitization quality of life breast cancer (survivors)