Widespread Mechanical Pain Hypersensitivity as a Sign of Central Sensitization after Breast Cancer Surgery: Comparison between Mastectomy and Lumpectomy

作者：Carolina Fernández‐Lao, Irene Cantarero‐Villanueva, César Fernández‐de‐las‐Peñas, Rosario Del‐Moral‐Ávila, Salomón Menjón-Beltrán, Manuel Arroyo‐Morales · 发表于：Pain Medicine · 年份：2010 · DOI：10.1111/j.1526-4637.2010.01027.x · 被引用次数：89 · 研究领域：Lymphatic System and Diseases、Anesthesia and Pain Management、Pain Management and Opioid Use

OBJECTIVE: To investigate the differences in widespread pressure pain hypersensitivity after two surgery approaches for breast cancer: mastectomy or lumpectomy. DESIGN: A cross-sectional blinded study. SETTING: Widespread pressure pain hypersensitivity has been suggested as a sign of central sensitization. No study has previously investigated the presence of widespread pain pressure hypersensitivity after breast cancer surgery. PATIENTS: Twenty-one women (age: 52±9 years old) who had received lumpectomy after breast cancer, 21 women (mean age: 50±10 years old) who had received mastectomy surgery after breast cancer, and 21 healthy women (age: 51±10 years old) participated. OUTCOME MEASURES: Pressure pain thresholds (PPT) were bilaterally assessed over C5-C6 zygapophyseal joint, deltoid muscle, second metacarpal, and the tibialis anterior muscle. RESULTS: Women with mastectomy had greater intensity of neck (t= -2.897; P=0.006) and shoulder/axillary (t= -2.609; P=0.013) pain as compared with those who received lumpectomy. The results showed that PPT were significantly decreased bilaterally over the C5-C6 zygapophyseal joint, deltoid muscle, second metacarpal, and tibialis anterior muscle in both lumpectomy and mastectomy groups as compared with healthy women in all points (P<0.001), without differences between both breast cancer groups (P=0.954). No significant differences in the magnitude of PPT levels between both breast cancer groups were found (all, P>0.450). PPT levels ove...