Comparison of central sensitization-related symptoms and health-related quality of life between breast cancer survivors with and without chronic pain and healthy controls

• DOI: 10.1007/s12282-019-00979-y
• Publication Date: 2019-05-24T17:57:12Z
• Authors: Masahiro Manfuku; Tomohiko Nishigami; Akira Mibu; Katsuyoshi Tanaka; Kazufumi Kitagaki; Kazuhiro Sumiyoshi
• Keywords: Adult; Central Nervous System Sensitization; Depression; Breast Neoplasms; Anxiety; Middle Aged; 3. Good health; Cohort Studies; 03 medical and health sciences; Cross-Sectional Studies; 0302 clinical medicine; Cancer Survivors; Japan; Linear Models; Quality of Life; Humans; Female; Self Report; Chronic Pain; Aged

In breast cancer survivors, multiple risk factors for health-related quality of life (HRQoL) and chronic pain, including cancer treatment-related factors, psychosocial factors, and central sensitization (CS), have been suggested; however, there has been no comparative study between breast cancer survivors with and without pain. This study aimed to compare the demographic characteristics, psychological factors, and CS-related symptoms between breast cancer survivors with pain, those without pain, and healthy controls, and to investigate the relationships of these factors with HRQoL.We conducted a cross-sectional survey of 218 women, including patients who underwent breast cancer surgery and adjuvant therapy and healthy women.Patients were divided into the pain group (n = 42), without-pain group (n = 51), and healthy group (n = 47); thus, among breast cancer survivors, 45% reported chronic pain. The proportion of participants who received breast cancer treatments, such as axillary lymph node dissection and chemotherapy, was higher in the pain group than in the without-pain group (p < 0.05). The Central Sensitization Inventory (CSI) and psychosocial factors in the pain group were higher than those in the without-pain group and healthy group (p < 0.01). The CSI and PCS showed larger effect sizes than treatment-related factors. Moreover, HRQoL was significantly correlated with CSI, PCS, Patient Health Questionnaire-2, and Generalized Anxiety Disorder-2 scale (all, p < 0.01). On multiple linear regression analysis, CSI accounted for 43% of the variance in HRQoL.CS and pain catastrophizing may be more associated with the development and/or maintenance of persistent pain than treatment-related factors.