Sensory profiles in women with neuropathic pain after breast cancer surgery

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Mustonen , L , Vollert , J , Rice , A S C , Kalso , E & Harno , H 2020 , ' Sensory profiles in women with neuropathic pain after breast cancer surgery ' , Breast Cancer Research and Treatment , vol. 182 , no. 2 , pp. 305-315 .

Title: Sensory profiles in women with neuropathic pain after breast cancer surgery
Author: Mustonen, L.; Vollert, J.; Rice, A. S. C.; Kalso, E.; Harno, H.
Contributor organization: HUS Perioperative, Intensive Care and Pain Medicine
Anestesiologian yksikkö
University of Helsinki
Helsinki University Hospital Area
HUS Neurocenter
Neurologian yksikkö
Eija Kalso / Principal Investigator
Department of Diagnostics and Therapeutics
Date: 2020-07
Language: eng
Number of pages: 11
Belongs to series: Breast Cancer Research and Treatment
ISSN: 0167-6806
Abstract: Purpose We performed a detailed analysis of sensory function in patients with chronic post-surgical neuropathic pain (NP) after breast cancer treatments by quantitative sensory testing (QST) with DFNS (German Research Network on Neuropathic Pain) protocol and bed side examination (BE). The nature of sensory changes in peripheral NP may reflect distinct pathophysiological backgrounds that can guide the treatment choices. NP with sensory gain (i.e., hyperesthesia, hyperalgesia, allodynia) has been shown to respond to Na+-channel blockers (e.g., oxcarbazepine). Methods 104 patients with at least "probable" NP in the surgical area were included. All patients had been treated for breast cancer 4-9 years ago and the handling of the intercostobrachial nerve (ICBN) was verified by the surgeon. QST was conducted at the site of NP in the surgical or nearby area and the corresponding contralateral area. BE covered the upper body and sensory abnormalities were marked on body maps and digitalized for area calculation. The outcomes of BE and QST were compared to assess the value of QST in the sensory examination of this patient group. Results Loss of function in both small and large fibers was a prominent feature in QST in the area of post-surgical NP. QST profiles did not differ between spared and resected ICBN. In BE, hypoesthesia on multiple modalities was highly prevalent. The presence of sensory gain in BE was associated with more intense pain. Conclusions Extensive sensory loss is characteristic for chronic post-surgical NP several years after treatment for breast cancer. These patients are unlikely to respond to Na+-channel blockers.
Subject: Post-surgical pain
Neuropathic pain
Quantitative sensory testing
Sensory mapping
3122 Cancers
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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