Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jul;46(1):30-42.
doi: 10.1016/j.jpainsymman.2012.06.016. Epub 2012 Oct 25.

Alteration in pain modulation in women with persistent pain after lumpectomy: influence of catastrophizing

Robert R Edwards  1 , George Mensing, Christine Cahalan, Seth Greenbaum, Sanjeet Narang, Inna Belfer, Kristin L Schreiber, Claudia Campbell, Ajay D Wasan, Robert N Jamison
Affiliations

Alteration in pain modulation in women with persistent pain after lumpectomy: influence of catastrophizing

Robert R Edwards et al. J Pain Symptom Manage. 2013 Jul.

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.

PubMed Disclaimer

Conflict of interest statement

Disclosures

None of the authors have any financial or other conflicts of interest with regard to this study or its findings.

Figures

Fig. 1
Fig. 1
Pain ratings (0–100) for repetitive punctuate mechanical stimuli (data presented as means ± SEM). * Groups differ significantly at P< 0.05.
Fig. 2
Fig. 2
Cold pain ratings during and after cold pressor testing (data presented as means ± SEM). * Groups differ significantly at P≤ 0.01.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Perkins FM, Kehlet H. Chronic pain as an outcome of surgery. A review of predictive factors. Anesthesiology. 2000;93:1123–1133. - PubMed
    1. 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
    1. Vadivelu N, Schreck M, Lopez J, Kodumudi G, Narayan D. Pain after mastectomy and breast reconstruction. Am Surg. 2008;74:285–296. - PubMed
    1. 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
    1. 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