Alteration in pain modulation in women with persistent pain after lumpectomy: influence of catastrophizing
- PMID: 23102562
- PMCID: PMC3713099
- DOI: 10.1016/j.jpainsymman.2012.06.016
Alteration in pain modulation in women with persistent pain after lumpectomy: influence of catastrophizing
Abstract
Context: Persistent pain is common after surgical treatment of breast cancer, but fairly little is known about the changes in sensory processing that accompany such pain syndromes.
Objectives: This study used quantitative sensory testing to compare psychophysical responses to standardized noxious stimulation in two groups of women who had previously undergone breast cancer surgery: women with (n=37) and without (n=34) persistent postoperative pain.
Methods: Participants underwent a single testing session in which responses to a variety of noxious stimuli were assessed.
Results: Findings suggested that women with chronic pain after breast cancer surgery display enhanced temporal summation of mechanical pain, deficits in endogenous pain inhibition, and more intense painful aftersensations compared with those without long-term pain. Some of these group differences were mediated by higher levels of pain catastrophizing in the group of women with persistent pain.
Conclusion: These findings suggest that persistent postoperative pain is associated with alterations in central nervous system pain-modulatory processes. Future treatment studies might benefit from targeting these pain-modulatory systems, and additional studies using functional neuroimaging methods might provide further valuable information about the pathophysiology of long-term postsurgical pain in women treated for breast cancer.
Keywords: Hyperalgesia; catastrophizing; conditioned pain modulation; lumpectomy; quantitative sensory testing; temporal summation.
Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Conflict of interest statement
None of the authors have any financial or other conflicts of interest with regard to this study or its findings.
Figures
Similar articles
-
Effect of Alexithymia and Emotional Repression on Postsurgical Pain in Women With Breast Cancer: A Prospective Longitudinal 12-Month Study.J Pain. 2016 Jan;17(1):90-100. doi: 10.1016/j.jpain.2015.10.001. Epub 2015 Oct 23. J Pain. 2016. PMID: 26476266
-
From breast cancer diagnosis to survivorship: Analyzing perioperative biopsychosocial phenotypes and their relationship to pain on long term.J Pain. 2025 Jan;26:104709. doi: 10.1016/j.jpain.2024.104709. Epub 2024 Oct 16. J Pain. 2025. PMID: 39419367 Clinical Trial.
-
The effect of catastrophizing self-statements on pain perception and the nociceptive flexor reflex (RIII reflex).Clin J Pain. 2013 Aug;29(8):725-32. doi: 10.1097/AJP.0b013e318272ec0c. Clin J Pain. 2013. PMID: 23835766
-
Why look in the brain for answers to temporomandibular disorder pain?Cells Tissues Organs. 2005;180(1):69-75. doi: 10.1159/000086200. Cells Tissues Organs. 2005. PMID: 16088135 Review.
-
Catastrophizing: a predictive factor for postoperative pain.Am J Surg. 2011 Jan;201(1):122-31. doi: 10.1016/j.amjsurg.2010.02.007. Epub 2010 Sep 15. Am J Surg. 2011. PMID: 20832052 Review.
Cited by
-
Sex differences in the stability of conditioned pain modulation (CPM) among patients with chronic pain.Pain Med. 2013 Nov;14(11):1757-68. doi: 10.1111/pme.12220. Epub 2013 Aug 7. Pain Med. 2013. PMID: 23924369 Free PMC article.
-
Effects of testosterone replacement in men with opioid-induced androgen deficiency: a randomized controlled trial.Pain. 2015 Feb;156(2):280-288. doi: 10.1097/01.j.pain.0000460308.86819.aa. Pain. 2015. PMID: 25599449 Free PMC article. Clinical Trial.
-
Validation of pain catastrophizing scale on breast cancer survivor.Pain Pract. 2022 Nov;22(8):711-717. doi: 10.1111/papr.13163. Epub 2022 Oct 7. Pain Pract. 2022. PMID: 36136052 Free PMC article.
-
Dynamic Pain Phenotypes are Associated with Spinal Cord Stimulation-Induced Reduction in Pain: A Repeated Measures Observational Pilot Study.Pain Med. 2015 Jul;16(7):1349-60. doi: 10.1111/pme.12732. Epub 2015 Mar 20. Pain Med. 2015. PMID: 25800088 Free PMC article.
-
EduCan trial: study protocol for a randomised controlled trial on the effectiveness of pain neuroscience education after breast cancer surgery on pain, physical, emotional and work-related functioning.BMJ Open. 2019 Jan 4;9(1):e025742. doi: 10.1136/bmjopen-2018-025742. BMJ Open. 2019. PMID: 30612114 Free PMC article.
References
-
- Perkins FM, Kehlet H. Chronic pain as an outcome of surgery. A review of predictive factors. Anesthesiology. 2000;93:1123–1133. - PubMed
-
- Andersen KG, Kehlet H. Persistent pain after breast cancer treatment: a critical review of risk factors and strategies for prevention. J Pain. 2011;12:725–746. - PubMed
-
- Vadivelu N, Schreck M, Lopez J, Kodumudi G, Narayan D. Pain after mastectomy and breast reconstruction. Am Surg. 2008;74:285–296. - PubMed
-
- Katz J, Poleshuck EL, Andrus CH, et al. Risk factors for acute pain and its persistence following breast cancer surgery. Pain. 2005;119:16–25. - PubMed
-
- Gartner R, Jensen MB, Nielsen J, et al. Prevalence of and factors associated with persistent pain following breast cancer surgery. JAMA. 2009;302:1985–1992. - PubMed
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical