{"title":"Non-Surgical Site Pain in Women following Breast Cancer Surgery: A Systematic Review and Meta-Analysis.","authors":"George Burton, Yazan A Masannat, Patrice Forget","doi":"10.1159/000531621","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Chronic pain after breast cancer surgery affects up to 60% of patients. Evidence supports the fact that pain outwith the surgical site is a significant issue. This systematic review and meta-analysis sought to evaluate the prevalence of non-surgical site pain (NSSP) in women after breast cancer surgery at 6 months post-operatively.</p><p><strong>Methods: </strong>Adult women with a confirmed breast cancer diagnosis who had undergone breast cancer surgery were identified. The outcome pursued was pain outwith the surgical site measured on either NRS/VRS or VAS rating scale. CENTRAL, Embase, PubMed, MEDLINE, CINAHL, PsycInfo, Web of Science, and Scopus were searched to identify studies that examined NSSP after breast cancer surgery at 6 months. Data were gathered via pre-piloted Excel forms and analysed both quantitively and qualitatively. Meta-analysis was carried out using a random-effects model to assess risk difference with 95% confidence interval (CI).</p><p><strong>Results: </strong>A total of sixteen studies were identified for inclusion. Eleven studies failed to provide sufficient data and consequently were analysed qualitatively. Five studies were adequate for quantitative analysis, including a total of 995 patients. Meta-analysis identified a risk difference of 18% (95% CI: 5-31%) between patients who had breast cancer surgery and a reference, however, this is low-quality evidence.</p><p><strong>Conclusion: </strong>This review has highlighted that breast cancer surgery increases the risk of pain outwith the surgical site postoperatively. It was additionally identified that NSSP data are often gathered in research yet rarely presented in results or highlighted as a primary outcome. As the quality of evidence was low, research specifying NSSP as a primary outcome is required to provide more certainty.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601695/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Breast Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000531621","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/6/21 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Chronic pain after breast cancer surgery affects up to 60% of patients. Evidence supports the fact that pain outwith the surgical site is a significant issue. This systematic review and meta-analysis sought to evaluate the prevalence of non-surgical site pain (NSSP) in women after breast cancer surgery at 6 months post-operatively.
Methods: Adult women with a confirmed breast cancer diagnosis who had undergone breast cancer surgery were identified. The outcome pursued was pain outwith the surgical site measured on either NRS/VRS or VAS rating scale. CENTRAL, Embase, PubMed, MEDLINE, CINAHL, PsycInfo, Web of Science, and Scopus were searched to identify studies that examined NSSP after breast cancer surgery at 6 months. Data were gathered via pre-piloted Excel forms and analysed both quantitively and qualitatively. Meta-analysis was carried out using a random-effects model to assess risk difference with 95% confidence interval (CI).
Results: A total of sixteen studies were identified for inclusion. Eleven studies failed to provide sufficient data and consequently were analysed qualitatively. Five studies were adequate for quantitative analysis, including a total of 995 patients. Meta-analysis identified a risk difference of 18% (95% CI: 5-31%) between patients who had breast cancer surgery and a reference, however, this is low-quality evidence.
Conclusion: This review has highlighted that breast cancer surgery increases the risk of pain outwith the surgical site postoperatively. It was additionally identified that NSSP data are often gathered in research yet rarely presented in results or highlighted as a primary outcome. As the quality of evidence was low, research specifying NSSP as a primary outcome is required to provide more certainty.
背景：癌症手术后的慢性疼痛影响高达60%的患者。有证据支持这样一个事实，即手术部位以外的疼痛是一个重要问题。这项系统综述和荟萃分析旨在评估癌症手术后6个月女性非手术部位疼痛（NSSP）的患病率。方法：对经诊断为乳腺癌症并接受癌症手术的成年女性进行鉴定。所追求的结果是在NRS/VRS或VAS评分量表上测量的手术部位外的疼痛。检索CENTRAL、Embase、PubMed、MEDLINE、CINAHL、PsycInfo、Web of Science和Scopus，以确定在乳腺癌症手术6个月后检查NSSP的研究。通过预先试行的Excel表格收集数据，并进行定量和定性分析。使用随机效应模型进行荟萃分析，以评估95%置信区间（CI）的风险差异。结果：共有16项研究被纳入。11项研究未能提供足够的数据，因此进行了定性分析。五项研究足以进行定量分析，其中包括995名患者。Meta-analysis确定了癌症手术患者与参考患者之间18%（95%CI:5-31%）的风险差异，然而，这是低质量的证据。结论：这篇综述强调了癌症手术增加了术后手术部位以外疼痛的风险。此外，还发现NSSP数据经常在研究中收集，但很少在结果中显示或作为主要结果突出显示。由于证据质量较低，需要将NSSP作为主要结果进行研究，以提供更多确定性。
期刊介绍：
''Breast Care'' is a peer-reviewed scientific journal that covers all aspects of breast biology. Due to its interdisciplinary perspective, it encompasses articles on basic research, prevention, diagnosis, and treatment of malignant diseases of the breast. In addition to presenting current developments in clinical research, the scope of clinical practice is broadened by including articles on relevant legal, financial and economic issues.
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