Chronic pain evaluation in breast cancer patients using the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS): a single center cross-sectional retrospective study

Abstract

Background: Breast cancer is the most common cancer in India, and the number of survivors has increased over the last few years. Pain is one of the most common symptoms during cancer treatment due to either the disease itself or the adverse effects of treatment. The available data suggests that breast cancer patients have a high prevalence of neuropathic pain.

Patients and methods: A cross-sectional observational study was done at the Department of Radiation Oncology, between November 2021 to June 2022. The patients were admitted and screened for participation, non-metastatic post-operative breast cancer on regular follow-up for 2 years after their last chemotherapy or radiotherapy and not having any chronic neuropathy disease and the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale was used to assess the neuropathy pain status of patients. Patients’ demographics, clinical characteristics, and treatment of surgery, radiation therapy, and chemotherapy were collected and the comparison of the pain scores between the patients was analysed.

Results: A total of 149 patients were included in the study. S-LANSS score was calculated in the study population and more than 61% of participants reported a score equal to or greater than 12, suggesting a predominant neuropathic pain component. Autonomic dysfunction, thermal pain, and allodynia were more prevalent in patients who underwent mastectomies compared to breast-conserving surgery. Whereas the dysesthesia and autonomic dysfunction score was higher in only the anthracycline group.

Conclusions: The most important index for quality of life in cancer patients is the presence of persistent chronic pain and it is important to classify it accordingly in order to provide the best management. Using the S-LANSS score, the pattern of neuropathic pain can be determined early which leads to early intervention.