| Objective:This study investigated the incidence of postmastectomy pain syndrome in patients with breast cancer,studied the risk factors of chronic pain,and put forward suggestions for the treatment of pain in patients with breast cancer.Method:This study was a multicenter cross-sectional study initiated by the National Cancer Center of China.All the patients included breast cancer patients who received surgical treatment at the Cancer Hospital of the Chinese Academy of Medical Sciences,Henan Provincial people’s Hospital or Hubei Yichang Central people’s Hospital from 2017 to 2021.First of all,we interview patients by telephone or Internet to find out whether they have long-term pain after operation,and calculate the incidence of chronic pain after breast cancer operation.If the patient has long-term pain symptoms and agrees to participate in the study,further research can be conducted.Then the clinical baseline information statistics of patients were completed,and a questionnaire including postmastectomy pain syndrome score,postoperative quality of life assessment and mental status assessment was designed and completed.Trained professionals send questionnaires to patients through the Internet and instruct them to fill them out.According to the results of the investigation,patients were divided into two groups:postmastectomy pain syndrome group and non-chronic pain group.The clinical baseline data of the two groups were compared and analyzed to explore the risk factors of postmastectomy pain syndrome in breast cancer.According to the pain score during rest and exercise,the patients in the postmastectomy pain syndrome group were further divided into no mild pain group and moderate to severe pain group,and continued to explore the risk factors of chronic pain aggravation in different states.At the same time,the treatment plans of patients with postmastectomy pain syndrome were investigated,and the management and treatment of postmastectomy pain syndrome in breast cancer were analyzed according to the results.Results:According to the enrollment and exclusion conditions,2000 patients with breast cancer were followed up,including Cancer Hospital of Chinese Academy of Medical Sciences,Henan Provincial people’s Hospital or Yichang Central people’s Hospital.Of these,210 patients lost contact or refused to participate in the survey.Of the remaining 1790 patients,1488(87.0%)patients with no persistent pain after breast surgery were classified as non-chronic pain group,and 302(13.0%)patients with longterm pain were considered to be affected by chronic pain.Age,breast operation type,axillary operation type and radiotherapy are the risk factors of postoperative chronic pain in breast cancer.Age,radiotherapy and chemotherapy can affect the degree of chronic pain during exercise.In our study,we found that the HADS-A score of patients with painless or mild pain was much lower than that of patients with moderate and severe hemiplegia,indicating that pain has a significant impact on the psychology of patients.At the same time,moderate and severe pain can lead to a decrease in breast satisfaction and psychosocial well-being.However,only about 10%of our patients with chronic pain have received related pain treatment,while other patients have not received standardized treatment,causing long-term pain and affecting their lives.Conclusion:This is the first multicenter study on the occurrence of postmastectomy pain syndrome in breast cancer in China,which should be paid more attention by doctors.For breast cancer patients with high risk factors,perioperative pain should be actively prevented.At present,the number of patients receiving chronic pain treatment is still very small.Therefore,clinicians should inform patients with chronic pain of more treatment options and actively provide effective treatment.Investigation on the Changes of Perioperative Psychological State of Young Patients with Early Breast CancerObjective:To explore the differences and changes of mental state of young patients with early breast cancer in different perioperative periods,and to analyze the effects of different surgical methods on the mental state of young patients with early breast cancer.Methods:A prospective observational study was conducted on young patients with early breast cancer who underwent surgery from March 2021 to March 2022.From selfevaluation scale(Self-Concept),self-esteem scale(RSES),mobility autonomy scale,positive emotion and negative emotion scale(PANAS),hospital anxiety and depression scale(HADS-A),epidemic center depression scale(CES-D),subjective well-being(SWLS),death anxiety scale(T-DAS),cancer recurrence fear scale(CARS),Economic stress scale and optimism scale and other multi-dimensional and multi-angle design to complete the mental state questionnaire.And test its evaluation effectiveness.The clinical baseline data of the patients included in this study were collected 1-2 days before operation,including the mode of operation,age,marital status,child status,education,place of residence,religious belief,basic diseases,surgical history and malignant tumor history.Mental status questionnaires were distributed before operation,1 month after operation,6 months after operation and 1 year after operation,and the mental state scores of young patients with early breast cancer in different periods were collected and counted.The data were statistically analyzed to reflect the changes of psychological state of young patients with early breast cancer in different perioperative periods.The patients were divided into breast conserving group and mastectomy group according to the mode of operation,and the mental state scores of the two groups in each period were statistically analyzed to explore the effects of different surgical methods on the psychological state of young patients with early breast cancer.Results:During the period of this study,a total of 149 young patients with early breast cancer completed the four-phase questionnaire survey,99(66.44%)patients entered the breast-conserving group and 50(33.56%)patients entered the total mastectomy group.There were statistical differences in the scores of self-evaluation,self-esteem,physiological state,fear of death,economic stress,negative emotion,anxiety and depression among young early breast cancer patients in different periods.In the clinical baseline data,there were differences in marriage history,place of residence and previous tumor history between breast-conserving group and total mastectomy group.There were significant differences in self-evaluation,depression,self-esteem and positive emotion between breast-conserving group and total mastectomy group.Conclusion:Breast cancer is a painful experience both physically and psychologically from diagnosis to treatment.In our study,young patients with early breast cancer have more or less psychological disorders in all periods of perioperative period,which will affect the choice of surgery and postoperative recovery of patients.This study found that the psychological state of young early female breast cancer patients after breastconserving surgery was better than that of patients who received mastectomy,especially in patients’ self-evaluation,self-esteem,positive emotion and depression. |
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