Characterising post-mastectomy pain syndrome in 111 Scottish women - PowerPoint PPT Presentation

Loading...

PPT – Characterising post-mastectomy pain syndrome in 111 Scottish women PowerPoint presentation | free to download - id: 535556-OWVmY



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Characterising post-mastectomy pain syndrome in 111 Scottish women

Description:

Characterising post-mastectomy pain syndrome in 111 Scottish women David Sheridan, Irwin Foo, Halia O Shea, David Gillanders, Linda Williams, Marie Fallon, Lesley ... – PowerPoint PPT presentation

Number of Views:104
Avg rating:3.0/5.0
Slides: 16
Provided by: Gareth98
Learn more at: http://www.knowledge.scot.nhs.uk
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Characterising post-mastectomy pain syndrome in 111 Scottish women


1
Characterising post-mastectomy pain syndrome in
111 Scottish women
  • David Sheridan, Irwin Foo, Halia OShea, 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.
  • KPSKetamine 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 (t1091.864 p0.065) Mean64.43,St Dev
10.957
NS (t1080.145 p0.885) Mean64.51, St Dev39.418
8
Radiotherapy, chemotherapy and pre-op pain
9
Logistic Regression
Backwards
Sig. Exp(B) 95 C.I.for EXP(B) 95 C.I.for EXP(B)
Sig. Exp(B) Lower Upper
Lumpect(1) .041 15.4 1.12 212
mastect(1) .082 8.21 .768 87.7
Chemo(1) .027 2.92 1.13 7.54
Preoppain(1) .002 5.47 1.86 16.1
Constant .001 .012
Forwards
Sig. Exp(B) 95 C.I. for EXP(B) 95 C.I. for EXP(B)
Sig. Exp(B) Lower Upper
Chemo(1) .017 3.00 1.22 7.40
Preoppain(1) .002 5.17 1.78 14.9
Constant .000 .183
Exp(B)risk estimate
10
Hospital anxiety depression scale
T25-3.460, p0.002
T25-2.739 P0.011
NS
NS
NS
NS
n6
11
Characteristics
Mean VAS 3.23
40 of patients scored 12 on the LANSS
12
Time of onset Time of onset Time of onset Time of onset
Responses Responses
N Percent
Pre-op 5 17.2
Immediatley post-op 10 34.5
Weeks post-op 3 10.3
Months post-op 9 31.0
Years post-op 2 6.9
Total Total 29 100.0
Pain duration Pain duration Pain duration Pain duration
Responses Responses
N Percent
  Seconds 7 29.2
  Minutes 4 16.7
  Hours 5 20.8
  Weeks 3 12.5
  Varies 5 20.8
Total Total 24 100.0
Characteristics Characteristics Characteristics Characteristics
Responses Responses
N Percent
Constant 7 23.3
Comes and goes 23 76.7
Total Total 30 100.0
13
Exacerbation Exacerbation Exacerbation Exacerbation
Responses Responses
N Percent
  Exercise 7 18.9
  Lifting 9 24.3
  Dressing 2 5.4
  Writing 1 2.7
  Other 6 16.2
  None 12 32.4
Total Total 37 100.0
Pain location Pain location Pain location Pain location
Responses Responses
N Percent
Same breast all over 7 14.6
Same breast specific place 10 20.8
Scar 10 20.8
Chest Wall 2 4.2
Armpit 7 14.6
Arm 3 6.3
Shoulder 4 8.3
Neck 2 4.2
Other 3 6.3
Total Total 48 100.0
14
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

15
Questions?
David Sheridan s0791682_at_sms.ed.ac.uk
About PowerShow.com