High body mass index is a potential risk factor for persistent postoperative pain after breast cancer treatment

Background: risk factors associated with persistent pain after breast cancer treatment are needed to develop prevention and treatment strategies to improve the quality of life for patients with breast cancer. objectives: to identify factors associated with persistent pain in women undergoing breast cancer treatments. study design: retrospective study. setting: regional hospital in the netherlands. methods: the primary outcome was pain associated with surgery at more than 6 months postoperatively and patients were stratified based on the associated visual analog” scale score they reported: reporting no pain as “no pain,” pain 1 – 29 mm as “mild pain,” and pain 30 – 100 mm as “moderate/severe pain.” secondary outcomes were function,symptom,and total quality of life scores. predefined risk factors analyzed for association with outcomes included: age,smoking status,diabetes,body mass index (bmi),disease stage,surgery type,axillary lymph node dissection,reoperation,chemotherapy,radiotherapy,and hormone therapy. results: of the 718 patients who were approached,492 were included (follow-up 2.5 ± 1.8 years). thirty-five percent of patients developed persistent pain (n = 122 “mild pain,” n = 53 “moderate/severe pain’”). age,bmi,surgery type,axillary lymph node dissection,disease stage,reoperation,chemotherapy,and radiotherapy were identified as potential risk factors in univariate ordinal regression analyses (p < 0.10). age (p < 0.01) and bmi (p = 0.04) remained independently predictive in the multivariate model. bmi and age were associated with odds ratios (ors) of 1.04 (95% confidence intervals (ci): 1.00 – 1.08) and 0.97 (95% ci: 0.95 – 0.99),respectively per point and year increase. bmi was associated with a higher symptom score (r = 0.14,p < 0.01),a lower level of function (r = -0.11,p = 0.01),and lower total quality of life scores (r = -0.13,p < 0.01). limitations: the retrospective nature of this study makes it prone to response and misclassification bias. conclusion: bmi and age may be risk factors for persistent postoperative pain after breast cancer treatment. © 2017,american society of interventional pain physicians. all rights reserved.