Chronic post-treatment symptoms in patients with breast cancer operated indifferent surgical units

Aims: This study was designed to find out whether women operated in high vo lume surgical units have less chronic symptoms than women operated in small er volume units. Methods: A questionnaire was sent to 265 consecutive women treated at the D epartment of Oncology, Helsinki University Central Hospital, from January t o June 1996. Of the patients, 129 were operated in hospitals experienced in breast cancer surgery (high volume units = HVU) and 92 patients in distric t hospitals with less experience in breast surgery (low volume units = LVU) . Results: Chronic symptoms were less common in HVU than in LVU: chronic pain (56 vs 43%, P<0.05) or strange sensations (45 vs 26%, P<0.01) in the ipsil ateral arm or phantom sensations in the removed breast (66 vs 26%, P<0.001) . The risk factors included in the multivariate model for chronic pain in t he breast area were: intensity of acute post-operative pain, radiotherapy a nd depression and for the chronic arm pain: low volume unit and depression. Conclusions: More careful surgical technique seems to reduce the risk of ch ronic pain following treatment of breast cancer. Chronic pain is associated with more intense post-operative pain and depression.