A Review of Pain and Sleep Problems After Breast Cancer Surgery for Designing Post-Surgery Supportive Pillows

Vollständiger Abstract

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30-50% of women have lasting pain and poor sleep after breast cancer surgery, as reported in different medical studies. Pain can affect the chest wall, armpit, side of the body, and upper arm of women and can be intense in many cases. When women experience persistent chest wall and chronic pain after breast cancer surgery, this is often referred to as post-mastectomy pain syndrome (PMPS). This review covers 82 papers found through different online search engines -Google Scholar and PubMed and grouped into pain after surgery (15 papers), sleep problems (52 papers), existing products and positioning aids (13 papers), user testing methods (1 paper) and unresolved gaps (1 paper). Reported prevalence of post-mastectomy pain syndrome ranges from about 20% to 60%, and this difference comes from differences in how studies define the condition. One study of 420 women found that 36.2% had experienced it, but only 11.8% of those had sought treatment. Sleep problems are reported in half to nine out of ten patients depending on the measure used. In one cohort, the rate was 57% before diagnosis and 61% two years later. The link between pain and sleep runs both ways. Insomnia measured one month after surgery was associated with pain at 21 months, and a trial that treated poor sleep before surgery reduced pain afterwards. In a survey of 110 women after mastectomy, 89.1% had poor sleep quality and 81.8% had changed their sleeping position, without any product made to support that change. The products found in this review are for prone radiotherapy positioning, or for daytime bras and prostheses. Patients user-tested the products for repeated use in the weeks after surgery. A passive pillow that can provide sufficient support for the chest, upper arm, side of the body, armpit and the affected arm during rest and activities has not been reported in the literature. Therefore, the purpose of this review is to study pain and sleep problems post breast cancer surgery for designing supportive pillows for women suffering from PMPS.