Pain After Breast Cancer Surgery is Predicted by Pre-Operative Immunological and Psychological Factors

This study identified risk factors for pain intensity at rest and with movement, pain qualities and neuropathic pain 24 hours post-breast cancer surgery (BCS). Before surgery 86 women completed demographic, health status, and psychological questionnaires and blood was drawn to measure baseline cytokine levels. Numeric Rating Scale-Rest (NRS-R), NRS-Movement (NRS-M), Short-Form McGill Pain Questionnaire (SF-MPQ) and Short-Form Neuropathic Pain Questionnaire (SF-NPQ) were completed 24 hours post-BCS. Backward regression models found significant correlates for NRS-R: younger age, increased pain catastrophizing and bilateral surgery; NRS-M: younger age, increased trait anxiety, bilateral surgery, and mastectomy; SF-MPQ: increased pain catastrophizing, bilateral surgery, and previous breast surgery; and SF-NPQ: decreased interleukin-10 and increased pain catastrophizing. These results support the biopsychosocial model of pain and the importance of measuring multiple pain outcomes. Variables accounting for the most variance in each outcome (pain catastrophizing [NRS-R; SF-MPQ], trait anxiety [NRS-M] and baseline IL-10 [SF-NPQ]) are potentially modifiable.