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Characterising post-mastectomy pain syndrome in 111 Scottish women

Characterising post-mastectomy pain syndrome in 111 Scottish women. David Sheridan, Irwin Foo , Halia O’Shea, David Gillanders , Linda Williams, Marie Fallon, Lesley Colvin The University of Edinburgh. Post-mastectomy pain syndrome. Intercostal brachial neuralgia Neuroma pain

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Characterising post-mastectomy pain syndrome in 111 Scottish women

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  1. Characterising post-mastectomy pain syndrome in 111 Scottish women David Sheridan, Irwin Foo, Halia O’Shea, David Gillanders, Linda Williams, Marie Fallon, Lesley Colvin The University of Edinburgh

  2. Post-mastectomy pain syndrome Intercostal brachial neuralgia Neuroma pain Phantom breast pain Other

  3. Studies have consistently shown the incidence of PMPS to be ~50% between 24 and 36 months post-operatively1,2 1 MacDonald et al; Br J cancer 2005 2 Gartner et al; JAMA 2009

  4. Possible risk factors Younger age Pre-operative pain Increased pre-op anxiety Severe post-operative pain Invasiveness of surgery (Individual histology?)

  5. The Aim To ascertain the prevalence of PMPS in the Edinburgh Breast Unit characterise its nature and severity and screen patients for the KPS. KPS=Ketamine in Pain Study

  6. Methods: cross-sectional questionnaire based design Medical, surgical and demographic data Do you still experience pain as a result of your treatment? YES Pain questions NO McGill pain questionnaire short form (MPQ-SF) Leeds Assessment of Neuropathic symptoms and signs (LANSS) Chronic pain acceptance questionnaire (CPAQ) Hospital anxiety and depression scale (HADs)

  7. Results Do you still feel you experience pain as a result of your treatment? Mean age Time since surgery NS (t109=1.864 p=0.065) Mean=64.43,St Dev= 10.957 NS (t108=0.145 p=0.885) Mean=64.51, St Dev=39.418

  8. Radiotherapy, chemotherapy and pre-op pain

  9. Logistic Regression Backwards Forwards Exp(B)=risk estimate

  10. Hospital anxiety depression scale T25=-3.460, p=0.002 T25=-2.739 P=0.011 NS NS NS NS n=6

  11. Characteristics Mean VAS 3.23 40% of patients scored 12+ on the LANSS

  12. Key points 29% of long term breast cancer patients have chronic pain at a mean time of 64 months post-op The pain is mild to moderate (VAS 3.23) Pre-op pain and chemotherapy seriously increase risk chronic pain The pain is extremely variable

  13. Questions? David Sheridan s0791682@sms.ed.ac.uk

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