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The prevalence of neuropathic pain is high after treatment for breast cancer: a systematic review

Ilhan, Emre*; Chee, Edwin; Hush, Julia; Moloney, Niamh

doi: 10.1097/j.pain.0000000000001004
Systematic Review and Meta-Analysis

Pain is common, but often poorly managed after breast cancer treatment. Screening questionnaires and the Neuropathic Pain Special Interest Group (NeuPSIG) criteria are 2 clinical approaches used to determine whether pain has neuropathic components, which may enable better pain management. The aims of this review were (1) to synthesise data from the literature on neuropathic pain prevalence in women after breast cancer treatment; (2) to investigate whether the prevalence of neuropathic pain differed between studies using screening questionnaires and the NeuPSIG criteria. We searched for studies that administered a validated neuropathic pain screening questionnaire and/or the NeuPSIG criteria to women treated for early-stage (I-III) breast cancer. Thirteen studies using screening questionnaires (N = 3792) and 3 studies using components of the NeuPSIG criteria (N = 621) were included. Meta-analyses were conducted for questionnaire data but not for NeuPSIG criteria data because of inadequate homogeneity. Among all participants treated for early-stage breast cancer, pooled prevalence estimates (95% confidence interval) ranged between 14.2% (8.3-21.4) and 27.2% (24.7-88.4) for studies using screening questionnaires; studies using NeuPSIG criteria reported prevalence rates from 24.1% to 31.3%. Among those who reported pain after treatment, the pooled prevalence estimate (95% confidence interval) of neuropathic pain from screening questionnaires ranged from 32.6% (24.2-41.6) to 58.2% (24.7-88.4); studies using NeuPSIG criteria reported prevalence rates from 29.5% to 57.1%. These prevalence estimates are higher than those reported for other types of cancer, and emphasise the need to assess the contribution of neuropathic pain after breast cancer treatment. Trial registration: PROSPERO registration CRD42015029987.

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Faculty of Medicine and Health Sciences, Department of Health Professions, Macquarie University, Sydney, Australia

Corresponding author. Address: Faculty of Medicine and Health Sciences, Macquarie University, 75 Talavera Rd, Macquarie Park, 2109 Sydney, Australia. Tel.: +61 2 9850 6630. E-mail address: (E. Ilhan).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Received March 07, 2017

Received in revised form May 31, 2017

Accepted June 26, 2017

© 2017 International Association for the Study of Pain
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