Pain and quality of life after surgery for breast cancer
Pain and quality of life after surgery for breast cancer
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DOI：
10.1023/a:1024435101619
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发表时间：
2003-07-01
影响因子：
3.8
通讯作者：
Galligioni, E
中科院分区：
文献类型：
--
作者：
Caffo, O;Amichetti, M;Galligioni, E
背景在乳腺癌（BC）患者中，保守性手术（CS）后放疗或立即乳房再造（IBR）改良根治性乳房切除术（MRM）后已被提出，试图避免MRM对女性身体形象的负面影响。无论何种手术方式，乳腺癌患者即使没有复发也会感到疼痛，生活质量（QL）调整较差。我们采用了一份问卷，包括麦吉尔疼痛问卷的简短形式，和先前验证的问卷能够确定四个分量表探索身体健康，身体自主，关系生活和心理健康。调查表于1999年邮寄至1995年3月至1998年3月间连续治疗的757例无病BC患者（CS：481例; MRM+ IBR+皮肤扩张器：93例; MRM：183例）。最终分析评估了与529例接受腋窝淋巴结清扫术的患者相关的数据。39.7%的女性报告疼痛，接受CS的患者的发生率高于接受MRM +/- IBR的患者，但该差异未达到统计学显著性（p = 0.07）。手术组之间唯一的统计学显著差异（p < 0.05）是CS患者较早出现疼痛，而MRM+ IBR患者较晚出现疼痛。未观察到其他差异。有疼痛的妇女在所有分量表上的QL评分均显著低于无疼痛的妇女。无论治疗类型如何，几乎三分之一的患者在BC手术后疼痛，并对患者的QL产生负面影响。不同的外科手术可能会轻微影响疼痛的定量特征。
Background. In breast cancer (BC) patients, conservative surgery (CS) followed by irradiation or immediate breast reconstruction (IBR) after modified radical mastectomy (MRM) has been proposed in the attempt to avoid the negative impact of MRM on feminine body image. Regardless of the type of operation, BC patients may feel pain even without recurrent disease with poor adjustment in terms of quality of life (QL).Methods. We adopted a questionnaire comprising the short form of the McGill Pain questionnaire, and a previously validated questionnaire able to identify four subscales exploring physical well-being, physical autonomy, relational life and psychological well-being. The questionnaire was mailed in 1999 to a consecutive series of 757 (CS: 481 cases; MRM+ IBR with skin expander: 93 cases; MRM: 183 cases) disease-free patients treated for BC between March 1995 and March 1998.Results. The final analysis assessed the data relating to 529 patients who underwent axillary dissection. Pain was reported by 39.7% of women with higher incidence in patients who underwent CS than in those who underwent MRM +/- IBR, but this difference did not reach statistical significance (p = 0.07). The only statistically significant difference (p < 0.05) between the surgical groups was the pain appearance that occurred earlier in the CS patients and later in the MRM+ IBR patients. No other differences were observed. The women with pain had significantly worse QL scores on all of the subscales than those without.Conclusion. Pain after surgery for BC distress almost one-third of patients, regardless of the type of treatment, and had a negative effect on patients' QL. The different surgical procedures may marginally influence the quantitative characteristics of pain.