Breast cancer surgery: Psychological distress and expectations of
pain are risk factors for postoperative pain
Severe psychological distress and the expectation of suffering from pain after surgery increase the
probability of acute pain after breast cancer surgery. This is shown by a Finnish study presented at the
Congress of the European Pain Federation EFIC in Vienna. Study author PhD student psychologist
Reetta Sipilä recommends that particularly stressed patients with negative expectations should be
identified prior to surgery, and provided with intensified support.
Vienna, 05 September 2015 – Breast cancer patients who are subjected to severe psychological
distress have a higher risk of suffering from pain after breast cancer surgery. Acute postoperative pain
also occurs more commonly in women who already expect pain prior to the surgical intervention. This
is shown by a Finnish study presented today at the 9th Congress of the European Pain Federation
EFIC „Pain in Europe IX“ in Vienna. More than 4,000 experts from all over the world discuss the
newest developments in pain medicine at this major scientific event. „Our work shows how important it
is to take the patients' emotional state into account to save them persistent severe pain after surgery.
This continues to represent a major medical problem“, study author PhD student psychologist Reetta
Sipilä (University Hospital of Helsinki) told the EFIC Congress. „It would be ideal if, with a few simple
questions, we could identify those women who suffer from particular emotional pressure or have
negative expectations. Suitable support for these patients could reduce at least some of the risk
factors for postoperative pain.“
563 breast cancer patients who received surgery at the University Hospital of Helsinki participated in
the study, whose aim was to identify possible risk factors for postoperative pain. Their demographic
factors and emotional state were recorded before surgery. The patients evaluated the pain intensity in
the area receiving surgery on a scale from zero to ten on the day before and seven days after the
surgery. The following factors were shown to constitute risk factors for acute postoperative pain
persisting throughout the entire first week: severe psychological distress on the patients before
surgery, preoperative pain at the area receiving surgery, and removal of lymph nodes in the axillary
regions. A pessimistic attitude by the patients that they should expect severe pain after surgery was
shown to be a risk factor for acute pain during the first three days after surgery.
Source: EFIC IX “Pain in Europe”, Abstracts Volume, Abstract 5-0167, R. M. Sipilä et al: Risk factors for acute
postoperative pain after breast cancer
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