Breast cancer and chronic pain: a mixed methods review.

BACKGROUND: More patients are surviving breast cancer; however, many complain of persistent pain, which significantly impacts on their lives. Studies have predominantly examined risk factors alone. This mixed methods study will systematically compare prospective and retrospective studies of chronic pain following breast cancer treatment. A wider scope than risk factors alone is included in a narrative review element.

RESULTS: Common risk factors and themes were identified, and these were compared with some of the retrospective literature available. Several common themes arose in the literature such as common patient demographics, perioperative and postoperative management, treatment modalities and psychological factors. The variation in disease severity, treatment mode and symptom progression between participants in the studies made it difficult to draw conclusions from both the prospective and retrospective literature.

CONCLUSION: Chronic pain is common after breast cancer. The literature has focused predominantly on risk factors for the development of chronic pain. It may be more beneficial to focus on chronic pain mechanisms and to consider the patient's narrative and experience of their illness and how this has impacted on the perception and intensity of persistent pain. A shared understanding between the patient and professional is likely to have more beneficial outcomes.