Influence of neuropathic and central sensitization-related pain on the quality of life of women after breast cancer surgery in a military hospital in Rio de Janeiro – cross-sectional study

Abstract

Introduction: Breast cancer is the most incident neoplasm in the world. Cancer pain has a mixed character, but the influence that neuropathic pain and central sensitization symptoms have on the quality of life of patients undergoing surgical treatment for breast cancer is still unclear. Objective: This study aimed to investigate the occurrence of neuropathic pain, central sensitization and the quality of life of women undergoing treatment for breast cancer. Methods: A cross-sectional observational study was carried out with women aged over 18 years who underwent surgical treatment for breast cancer. Participants completed a self-reported questionnaire consisting of clinical and sociodemographic variables. A multidimensional pain assessment (Brief Pain Inventory) was performed. Neuropathic symptoms (PainDETECT) and central sensitization (Central Sensitization Inventory, CSI), conditioned pain modulation (Cold Pressor Test, CPT), and quality of life (EORTC-C30 and EORTC-BR23) were also investigated. A comparison between the quality of life and the presence or absence of pain was performed using the Mann-Whitney test. Results: Sixty-eight patients were included, of which 37 had pain (scores >40 points on the CSI, >18 points on the painDETECT, pain in the treated breast region, or with myalgia/arthralgia after the start of hormone therapy). Women who experienced pain had higher total CSI scores (pain
group: mean = 39,1, SD= 19,2; no pain group: mean = 16,7, SD = 11,8; p<0,001). Participants with pain had lower scores on the functional scales of the EORTC QLQC30 and EORTC QLQ-BR23 questionnaires, and on the global health scale of the EORTC QLQ-C30 questionnaire, with a statistically significant difference (Mann-Whitney test, p=0,002, p =0,005 and p=0,040, respectively) about the group without pain, which shows a greater impairment of quality of life. Conclusion: Women undergoing surgical treatment for breast cancer who experienced pain had a greater impairment of quality of life compared to their peers.