Acute and subacute postsurgical pain in women with breast cancer: incidence and associations with biopsychosocial predictors-a secondary analysis of a randomized controlled trial

Alice Munk, Henrik Børsting Jacobsen, Julie Schnur, Guy Montgomery, Silje Endresen Reme, Alice Munk, Henrik Børsting Jacobsen, Julie Schnur, Guy Montgomery, Silje Endresen Reme

Abstract

Introduction: Women who undergo breast cancer surgery risk suffering from postsurgical pain long after their surgery. Still, research on postsurgical pain in the subacute phase has been neglected.

Objective: This study aims to investigate the incidence, intensity, unpleasantness, and presurgical predictors of acute and subacute postsurgical pain after breast cancer surgery.

Methods: The study used an observational design through secondary analyses of the control group in a randomized controlled trial. Data from 102 women undergoing breast cancer surgery were included. Levels of acute and subacute pain intensity and unpleasantness were measured using 100 mm Visual Analogue Scales on the day of surgery and 4 weeks postsurgery. Linear regression analyses were performed to identify presurgical biopsychosocial predictors of acute and subacute postsurgical pain.

Results: Average levels of postsurgical pain intensity and unpleasantness were as follows: 22.7 mm for acute pain intensity, 19.0 mm for acute pain unpleasantness, 10.3 mm for subacute pain intensity, and 11.7 mm for subacute pain unpleasantness. Pain expectancy predicted acute pain intensity (R2 = 0.04, p = 0.047) and acute unpleasantness (R2 = 0.06, p = 0.02). Perceived social support inversely predicted acute pain unpleasantness (R2 = 0.04, p = 0.014).

Conclusion: Mild and moderate acute pain intensity and unpleasantness are common after breast cancer surgery, whereas levels of subacute pain intensity and unpleasantness are low. Pain expectancy predicts acute postsurgical pain intensity and unpleasantness, whereas expected social support inversely predicts acute postsurgical pain unpleasantness.

Keywords: Biopsychosocial; Breast cancer; Pain expectancy; Postsurgical pain; Psychosocial factors; Social support.

Conflict of interest statement

The authors have no conflicts of interest to declare. The randomized controlled trial that was basis for these secondary analyses was funded by the Norwegian Cancer Society (201906-2019). The funding sources do not have any role in the design of the study, data collection, analysis and interpretation of data, or decisions

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.

Figures

Figure 1.
Figure 1.
(A) Acute pain intensity after breast cancer surgery. (B) Acute pain unpleasantness after breast cancer surgery. (C) Subacute pain intensity after breast cancer surgery. (D) Subacute pain unpleasantness after breast cancer surgery.

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