The relationship between persistent pain and tactile sensory and pain pressure thresholds in postmastectomy breast cancer patients: A preliminary report.

Abstract

AbstractIntroduction:Persistent postmastectomy pain is common among breast cancer patients. The relationship of persistentpostmastectomy pain (PPP) with sensory loss and increased pain sensitization remains unclear. In this study, we investigated therelationship between PPP and tactile sensory thresholds and pain pressure thresholds in postmastectomy breast cancer patients.Materials and Methods: Patients were divided into two groups according to the presence and absence of PPP. On both the operatedand non non-operated sides, pa in pressure thresholds (breast, arm, and forearm) were assessed using an algometer, and tactile sensorythresholds (scar region, breast upper outer quadrant, axillary region, median cutaneous nerve and intercostobrachial nerve re gions,forearm, and hand) w ere measured using the Semmes Semmes–Weinstein monofilament test. The differences between the operated andnonoperated sides were calculated to investigate whether there was a relation between pain sensitivity and sensory loss and P PPP.Results:PPP was detected i n 31 (64.6%) of 48 patients. There was a statistically significant difference in the tactile sensory thresholdsand pain pressure thresholds of the operated and non non-operated sides ( P < 0.001). There was no statistically significant differencebetween the p ain pressure thresholds and tactile sensory thresholds of the groups with and without PPP. There was a weak positivecorrelation between the mean pain intensity and side to side difference in tactile sensory thresholds measured from the axill aryregion ( P = 0.046, r = 0.289).Conclusion: Axillary region sensorial loss and PPP may be linked in postmastectomy cancer patients. Pain sensitization and loss ofsensation do not seem to be associated with PPP.Keywords:Persistent postmastectomy pain syndrome, ta ctile sensory threshold, pain pressure threshold, pain sensitization, sensorialdeficit