Chronic Pain in Breast Cancer Survivors: Nociceptive, Neuropathic, or Central Sensitization Pain?

<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>The differentiation between acute and chronic pain can be insufficient for appropriate pain management. The aim of this study was to evaluate the prevalence of the predominant pain type (nociceptive, neuropathic, or central sensitization [CS] pain) in breast cancer survivors (<jats:styled-content style="fixed-case">BCS</jats:styled-content>) with chronic pain. The secondary aims were to examine (1) differences in health‐related quality of life (<jats:styled-content style="fixed-case">HRQoL</jats:styled-content>) between the different pain groups; and (2) the associations between patient‐, disease‐, and treatment‐related factors and the different pain types.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>To determine the prevalence of the predominant type of pain, a recently proposed classification system was used. <jats:styled-content style="fixed-case">BCS</jats:styled-content> were asked to complete the VAS for pain, Douleur Neuropathique 4 Questionnaire, Margolis Pain Diagram, Central Sensitization Inventory, and Short Form 36 (<jats:styled-content style="fixed-case">SF</jats:styled-content>‐36).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Ninety‐one <jats:styled-content style="fixed-case">BCS</jats:styled-content> participated, among whom 25.3% presented neuropathic pain, 18.7% nociceptive pain, and 15.4% CS pain. Mixed pain was found in 40.6%. A significant intergroup difference in <jats:styled-content style="fixed-case">HRQoL</jats:styled-content> was found for <jats:styled-content style="fixed-case">SF</jats:styled-content>‐36 “general health” (<jats:italic>P</jats:italic> = 0.04). The odds for the presence of <jats:styled-content style="fixed-case">CS</jats:styled-content> rather than nociceptive pain are 26 times higher in patients exposed to hormone therapy in comparison to the nonexposed (odds ratio 25.95, 95% confidence interval 1.33 to 504.37, <jats:italic>P</jats:italic> = 0.03).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Neuropathic pain is most frequent in <jats:styled-content style="fixed-case">BCS</jats:styled-content>. Strong associations were found between <jats:styled-content style="fixed-case">CS</jats:styled-content> pain and hormone therapy.</jats:p></jats:sec>