Alexithymia Associated with Post-Op Pain Risk in Breast Cancer

Alexithymia, the inability to identify and verbalize feelings--but not emotional repression--may be a predictor of chronic pain after breast cancer surgery, according to a recent French study.

This result may be important in developing further understanding of the mechanics of post-operative pain and "facilitate identification of the patients who are in need of therapeutic intervention," Sophie Baudic, PhD from the Ambroise Pare Hospital in Boulogne-Billancourt and colleagues at three other French hospitals reported.

While psychological factors such as anxiety, depression, and catastrophizing have long-been associated with acute and chronic pain, this is the first prospective study to look at alexithymia and emotional represssion as predictors of pain after breast cancer operations, the researchers said.

However, their results showed that emotional represssion, the process of avoiding or inhibiting feelings about threatening or unpleasant experiences, did not turn out to predict chronic pain or an increased risk of pain for breast surgery patients. Alexithymia did.

"Separate multivariate analyses identified anxiety as a significant predictor of postsurgical pain at 3 months, alexithymia at 3, 6, and 12 months, and body image and catastrophizing predicted acute or subacute pain at 2 months," the team noted.

The study noted that "Persistent pain is a major complication of surgery for breast cancer with up to 25-60% of women affected..."

The researchers followed a group of 100 Caucasian, middle-aged and educated women with breast cancer from pre-op to two, three and six months after surgery and 96 of them at 12 months after surgery.

The women, who ranged in age from 18 to 85 years old all had mastectomies or lumpectomies with axillary lymph node dissections over a three-year period at Rene Huguenin Hospital-Curie Institute at St. Cloud, France.

The study appears in the December 7, 2015, The Journal of Pain.