Aura Rhea Lanaban
Southern Philippines Medical Center, Philippines
Biography:
Aura Rhea Lanaban is a Family and Community Medicine Physician as well as a Hospice and Palliative Care Specialist. Aside from her clinical practice both in public and private hospitals, she is also active in academic institutions. One of her passion and commitment is to make Hospice and Palliative Care accessible to all. Hence, she has actively participated in the orientation and basic training of medical practitioners and primary health care workers.
Abstract:
Statement of the problem: Postmastectomy pain syndrome (PMPS) is the chronic neuropathic pain in the anterior aspect of the thorax, axilla, and/or upper half of the arm that persists beyond three months after mastectomy. Although psychosocial factors have been known to affect the perception of pain, the relationship of PMPS and the psychosocial characteristics of the patient’s family has not been explored. If psychosocial factors indeed play a role in pain perception in PMPS, psychosocial management can be added to the present pharmacologic interventions in order to improve the overall biopsychosocial care of patients with breast cancer. Objective: To determine the proportion of patients with PMPS among those who underwent mastectomy for breast cancer and identify factors associated with the syndrome. Design: Cross-sectional study. Setting: Outpatient Unit in Southern Philippines Medical Center. Participants: 45 women who had mastectomy for breast cancer. Main outcome measures: Proportion of patients with PMPS; prevalence odds ratios (POR) of having PMPS for selected factors. Main results: The patients had a mean age of 53.18 ± 8.09 years, mean BMI of 23.57 ± 2.65, and--on average--were 27.09 ± 35.76 months postmastectomy upon entry into the study. Of the 45 patients, 22 (48.89%) had PMPS. Univariate POR of having PMPS were significantly high for patients who: had distant metastasis (POR=5.56; 95% CI 1.27 to 24.29; p=0.0227), experienced premastectomy breast pain (POR=35.70; 95% CI 6.14 to 207.52; p<0.0001), were in late-stage family life cycle (POR=9.18; 95% CI 1.02 to 82.22; p=0.0476), and were in late-stage family illness trajectory (POR=4.96; 95% CI 1.39 to 17.70; p=0.0137). Conclusion: In this study, 48.89% of patients had PMPS. Factors associated with PMPS include: having distant metastases, having premastectomy breast pain, being in late-stage family life cycle, and being in late-stage family illness trajectory.