乳腺癌术后持续性疼痛及其康复治疗进展

doi:10.3969/j.issn.1006-9771.2018.02.002

摘要/Abstract

摘要： 乳腺癌术后持续性疼痛(PPBCS)是乳腺癌术后常见并发症。手术损伤、术前和术后疼痛、年龄、心理社会因素、遗传因素、神经敏化等均可对PPBCS的发生和发展产生影响。PPBCS的治疗包括药物防治、手术治疗、康复治疗等。康复治疗作为一种新兴的疼痛治疗方式,不仅副作用少,而且可以充分调动患者参与治疗的积极性,改善患者肢体功能和精神心理症状,有着良好的应用和发展前景。

关键词: 乳腺癌, 术后疼痛, 慢性疼痛, 康复, 综述

Abstract: Persistent pain after breast cancer surgery (PPBCS) is a common complication in patients suffering breast cancer surgery. There are varied factors related to PPBCS, such as surgical injuries, pre- and post-operative pain, age, psychosocial factors, genetic factors, and nerve sensitization, etc. Medicine, surgery and rehabilitation could be helpful for PPBCS. Rehabilitation can mobilize the enthusiasm of patients to participate in the treatment, and improve their physical and psychological function, with less side-effect, that could be applied widely.

Key words: breast cancer, post-operative pain, chronic pain, rehabilitation, review

中图分类号:

R737.9

邵芃, 贾杰. 乳腺癌术后持续性疼痛及其康复治疗进展[J]. 《中国康复理论与实践》, 2018, 24(2): 128-133.

SHAO Peng, JIA Jie. Persistent Pain after Breast Cancer Surgery and Rehabilitation (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2018, 24(2): 128-133.

参考文献

[1] Andersen KG, Kehlet H.Persistent pain after breast cancer treatment: a critical review of risk factors and strategies for prevention[J]. J Pain, 2011, 12(7): 725-746.
[2] 陈平. 乳腺癌术后慢性疼痛的相关因素分析[D]. 杭州:浙江大学, 2016.
[3] Gärtner R, Jensen MB, Nielsen J, et al.Prevalence of and factors associated with persistent pain following breast cancer surgery[J]. JAMA, 2009, 302(18): 1985-1992.
[4] Hojan K, Wojtysiak M, Huber J, et al.Clinical and neurophysiological evaluation of persistent sensory disturbances in breast cancer women after mastectomy with or without radiotherapy[J]. Eur J Oncol Nurs, 2016, 23: 8-14.
[5] Mejdahl MK, Andersen KG, Kroman N, et al.Persistent pain and sensory disturbances after treatment for breast cancer: six year nation wide follow-up study[J]. BMJ, 2013, 346: f1865.
[6] Juhl AA, Christiansen P, Damsgaard TE.Persistent pain after breast cancer treatment: a questionnaire-based study on the prevalence, associated treatment variables, and pain type[J]. J Breast Cancer, 2016, 19(4): 447-454.
[7] Starkweather A.Persistent pain after breast cancer surgery: risk factors and strategies to reduce incidence and severity[J]. Top Pain Manag, 2016, 32(1): 1-10.
[8] Schreiber KL, Kehlet H, Belfer I, et al.Predicting, preventing and managing persistent pain after breast cancer surgery: the importance of psychosocial factors[J]. Pain Manag, 2016, 4(6): 445-459.
[9] Torresan RZ, Cabello C, Conde DM, et al.Impact of the preservation of the intercostobrachial nerve in axillary lymphadenectomy due to breast cancer[J]. Breast J, 2003, 9(5): 389-392.
[10] Andersen KG, Duriaud HM, Kehlet H, et al.The relationship between sensory loss and persistent pain 1 year after breast cancer surgery[J]. J Pain, 2017, 18(9): 1129-1138.
[11] Andersen KG, Duriaud HM, Jensen HE, et al.Predictive factors for the development of persistent pain after breast cancer surgery[J]. Pain, 2015, 156(12): 2413-2422.
[12] Andersen KG, Jensen MB, Tvedskov TF, et al.Persistent pain, sensory disturbances and functional impairment after immediate or delayed axillary lymph node dissection[J]. Eur J Surg Oncol, 2013, 39(1): 31-35.
[13] Wang L, Guyatt GH, Kennedy SA, et al.Predictors of persistent pain after breast cancer surgery: a systematic review and meta-analysis of observational studies[J]. CMAJ, 2016, 188(14): E352-E361.
[14] Macdonald L, Bruce J, Scott NW, et al.Long-term follow-up of breast cancer survivors with post-mastectomy pain syndrome[J]. Br J Cancer, 2005, 92(2): 225-230.
[15] De Oliveira GS Jr, Chang R, Khan SA, et al. Factors associated with the development of chronic pain after surgery for breast cancer: a prospective cohort from a tertiary center in the United States[J]. Breast J, 2014, 20(1): 9-14.
[16] Shahbazi R, Akbari ME, Hashemian M, et al.High body mass index and young age are not associated with post-mastectomy pain syndrome in breast cancer survivors: a case-control study[J]. Iran J Cancer Prev, 2015, 8(1): 29-35.
[17] Roth RS, Qi J, Hamill JB, et al.Is chronic postsurgical pain surgery-induced? A study of persistent postoperative pain following breast reconstruction[J]. Breast, 2017, 37: 119-125.
[18] Ding YY, Yao P, Wu L, et al.Body mass index and persistent pain after breast cancer surgery: findings from the women's healthy eating and living study and a meta-analysis[J]. Oncotarget, 2017, 8(26): 43332-43343.
[19] van Helmond N, Timmerman H, van Dasselaar NT, et al. High body mass index is a potential risk factor for persistent postoperative pain after breast cancer treatment[J]. Pain Physician, 2017, 20(5): E661-E671.
[20] Meretoja TJ, Leidenius MH, Tasmuth T, et al.Pain at 12 months after surgery for breast cancer[J]. JAMA, 2014, 311: 90-92.
[21] Maass SW, Roorda C, Berendsen AJ, et al.The prevalence of long-term symptoms of depression and anxiety after breast cancer treatment: A systematic review[J]. Maturitas, 2015, 82(1): 100-108.
[22] Kim YS, Do H, Lee JW, et al.Patient reporting pain intensity immediately after surgery can be associated with underlying depression in women with breast cancer[J]. Psychooncology, 2016, 25(3): 308-315.
[23] Schreiber KL, Martel MO, Shnol H, et al.Persistent pain in postmastectomy patients: comparison of psychophysical, medical, surgical, and psychosocial characteristics between patients with and without pain[J]. Pain, 2013, 154(5): 660-668.
[24] Miaskowski C, Cooper B, Paul SM, et al.Identification of patient subgroups and risk factors for persistent breast pain following breast cancer surgery[J]. J Pain, 2012, 13(12): 1172-1187.
[25] Alkan A, Guc ZG, Senler FC, et al.Breast cancer survivors suffer from persistent postmastectomy pain syndrome and posttraumatic stress disorder (ORTHUS study): a study of the palliative care working committee of the Turkish Oncology Group (TOG)[J]. Support Care Cancer, 2016, 24(9): 3747-3755.
[26] Baudic S, Jayr C, Albi-Freldzer A, et al.Impact of alexithymia and emotional repression on postsurgical pain in women with breast cancer: a prospective longitudinal 12 months study[J]. J Pain, 2015, 17(1): 90-100.
[27] Mejdahl MK, Mertz BG, Bidstrup PE, et al.Preoperative distress predicts persistent pain after breast cancer treatment: a prospective cohort study[J]. J Natl Compr Canc Netw, 2015, 13(8): 995-1003.
[28] Johannsen M, Christensen S, Zachariae R, et al.Socio-demographic, treatment-related, and health behavioral predictors of persistent pain 15 months and 7-9 years after surgery: a nationwide prospective study of women treated for primary breast cancer[J]. Breast Cancer Res Treat, 2015, 152(3): 645-658.
[29] Werner MU, Bischoff JM.Persistent postsurgical pain: evidence from breast cancer surgery, groin hernia repair, and lung cancer surgery[J]. Curr Top Behav Neurosci, 2014, 20: 3-29.
[30] Bruce J, Thornton AJ, Scott NW, et al.Chronic preoperative pain and psychological robustness predict acute postoperative pain outcomes after surgery for breast cancer[J]. Br J Cancer, 2012, 107(6): 937-946.
[31] Langford DJ, Schmidt B, Levine JD, et al.Preoperative breast pain predicts persistent breast pain and disability after breast cancer surgery[J]. J Pain Symptom Manage, 2015, 49(6): 981-994.
[32] Stephens K, Cooper BA, West C, et al.Associations between cytokine gene variations and severe persistent breast pain in women following breast cancer surgery[J]. J Pain, 2014, 15(2): 169-180.
[33] Stephens KE, Levine JD, Aouizerat BE, et al.Associations between genetic and epigenetic variations in cytokine genes and mild persistent breast pain in women following breast cancer surgery[J]. Cytokine, 2017, 99: 203-213.
[34] Langford DJ, Paul SM, West CM, et al.Variations in potassium channel genes are associated with distinct trajectories of persistent breast pain after breast cancer surgery[J]. Pain, 2015, 156(3): 371-380.
[35] Caromorán E, Díazrodríguez L, Cantarerovillanueva I, et al.Nerve pressure pain hypersensitivity and upper limb mechanosensitivity in breast cancer survivors: a case-control study[J]. Pain Med, 2014, 15(10): 1715-1723.
[36] van Helmond N, Steegers MA, Filippini-de Moor GP, et al. Hyperalgesia and persistent pain after breast cancer surgery: a prospective randomized controlled trial with perioperative COX-2 inhibition[J]. PLoS One, 2016, 11(12): e0166601.
[37] Li YY, Kong SK.Persistent pain after breast cancer surgery in a Chinese population[J]. Clin J Pain, 2011, 27(6): 481-485.
[38] Cruto ME, Baricocchi E, Battistella M, et al.Treatment of persistent postmastectomy pain with 5% lidocaine medicated plaster[J]. Minerva Chir, 2015, 70(2): 147-153.
[39] Watson CP, Evans RJ.The postmastectomy pain syndrome and topical capsaicin: a randomized trial[J]. Pain, 1992, 51(3): 375-379.
[40] Hoseinzade H, Mahmoodpoor A, Agamohammadi D, et al.Comparing the effect of stellate ganglion block and gabapentin on the post mastectomy pain syndrome[J]. Shiraz E Med J, 2008, 33(1): 88-96.
[41] Kirvela O, Antila H.Thoracic paravertebral block in chronic postoperative pain[J]. Reg Anesth, 1992, 17(6): 348-350.
[42] Takimoto K, Nishijima K, Ono M.Serratus plane block for persistent pain after partial mastectomy and axillary node dissection[J]. Pain Physician, 2016, 19(3): E481-E486.
[43] Morel V, Joly D, Villatte C, et al.Memantine before mastectomy prevents post-surgery pain: a randomized, blinded clinical trial in surgical patients[J]. PLoS One, 2016, 11(4):e0152741.
[44] Cho AR, Kwon JY, Kim KH, et al.The effects of anesthetics on chronic pain after breast cancer surgery[J]. Anesth Analg, 2013, 116(3): 685-693.
[45] Lefebvre-Kuntz D, Dualé C, Albifeldzer A, et al.General anaesthetic agents do not influence persistent pain after breast cancer surgery: A prospective nationwide cohort study[J]. Eur J Anaesthesiol, 2015, 32(10): 697-704.
[46] 田志强,杨大平. 脂肪移植的最新研究进展[J]. 中国美容医学杂志, 2010, 19(2): 298-301.
[47] Caviggioli F, Maione L, Klinger F, et al.Autologous fat grafting reduces pain in irradiated breast: a review of our experience[J]. Stem Cell Int, 2016, 2016: 1-5.
[48] Caviggioli F, Maione L, Forcellini D, et al.Autologous fat graft in postmastectomy pain syndrome[J]. Plast Reconstr Surg, 2011, 128(2): 349-352.
[49] Maione L, Vinci V, Caviggioli F, et al.Autologous fat graft in postmastectomy pain syndrome following breast conservative surgery and radiotherapy[J]. Aesthetic Plast Surgery, 2014, 38(3): 528-532.
[50] Juhl AA, Karlsson P, Damsgaard TE.Fat grafting for alleviating persistent pain after breast cancer treatment: A randomized controlled trial[J]. J Plast Reconstr Aesthet Surg, 2016, 69(9): 1192-1202.
[51] Ducic I, Larson EE.Outcomes of surgical treatment for chronic postoperative breast and abdominal pain attributed to the intercostal nerve[J]. J Am Coll Surg, 2006, 203(3): 304-310.
[52] Cantarero-Villanueva I, Fernández-Lao C, Fernández-de- Las-Peñas C, et al. Effectiveness of water physical therapy on pain, pressure pain sensitivity, and myofascial trigger points in breast cancer survivors: a randomized, controlled clinical trial[J]. Pain Med, 2012, 13(11): 1509-1519.
[53] Tunay VB, Akbayrak T, Kaya S.The effect of multidimensional physiotherapy program on shoulder function, pain, and lymphedema after surgery in elderly breast cancer patients[J]. Top Geriatr Rehabil, 2012, 28(4): 281-286.
[54] Abdelaziz SHH, Mohammed HE.Effect of foot massage on postoperative pain and vital signs in breast cancer patient[J]. J Nurs Educ Prac, 2014, 4(8): 115-124.
[55] Korhan EA, Uyar M, Eyigör C, et al.The effects of music therapy on pain in patients with neuropathic pain[J]. Pain Manag Nurs, 2014, 15(1): 306-314.
[56] Li XM, Yan H, Zhou KN, et al.Effects of music therapy on pain among female breast cancer patients after radical mastectomy: results from a randomized controlled trial[J]. Breast Cancer Res Treat, 2011, 128(2): 411-419.
[57] Johannsen M, O'Connor M, O'Toole MS, et al. Efficacy of mindfulness-based cognitive therapy on late post-treatment pain in women treated for primary breast cancer: a randomized controlled trial[J]. J Clin Oncol, 2016, 34(28): 3390-3399.
[58] House G, Burdea G, Grampurohit N, et al.A feasibility study to determine the benefits of upper extremity virtual rehabilitation therapy for coping with chronic pain post-cancer surgery[J]. Br J Pain, 2016, 10(4): 186-197.
[59] Kerai S, Saxena KN, Taneja B, et al.Role of transcutaneous electrical nerve stimulation in post-operative analgesia[J]. Indian J Anaesth, 2014, 58(4): 388-393.
[60] Robb KA, Newham DJ, Williams JE.Transcutaneous electrical nerve stimulation vs. transcutaneous spinal electroanalgesia for chronic pain associated with breast cancer treatments[J]. J Pain Symptom Manage, 2007, 33(4): 410-419.
[61] Bauml J, Basal C, Mao JJ.Treatment of post-mastectomy pain syndrome with acupuncture: a case report[J]. Acupuncture Med, 2014, 32(2): 183-185.
[62] Tao WW, Jiang H, Tao XM, et al.Effects of acupuncture, Tuina, Tai Chi, Qigong, and Traditional Chinese Medicine five element music therapy on symptom management and quality of life for cancer patients: a meta-analysis[J]. J Pain Symptom Manage, 2016, 51(4): 728-747.