Article Text

Download PDFPDF

OP017 Peri-operative cognitive behavioural therapy compared with pain education and mindfulness for chronic post-surgical pain in breast cancer patients with high pain catastrophising characteristics: A randomised, controlled, double-blind clinical trial
  1. Damien Lowry1,
  2. Aneurin Moorthy2,
  3. Carla Edgely2,
  4. Margarita Blajeva2,
  5. Máire Brid Casey3 and
  6. Donal Buggy2, 4, 5
  1. 1Department of Psychology, Mater University Hospital, Dublin, Dublin, Ireland
  2. 2Department of Anaesthesiology and Perioperative Medicine, Mater University Hospital, School of Medicine, University College Dublin, Dublin, Ireland
  3. 3Department of Physiotherapy, School of Medicine, University College Dublin, Dublin, Ireland
  4. 4ESA-JC Onco-Anaesthesiology Research Group, Dublin, Ireland
  5. 5Outcomes Research, Cleveland Clinic, OH, USA, Cleveland, USA


Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission

Application for ESRA Abstract Prizes: I apply as a Trainee/Resident/Fellow (no age limit)

Background and Aims The incidence of Chronic Post-Surgical Pain (CPSP) is relatively high after breast cancer surgery. Psychological factors, especially high pain catastrophising, are predictive of CPSP. Cognitive Behavioural Therapy (CBT) can reduce anxiety and depression and help emotional self-regulation. We tested the hypothesis that perioperative CBT is more effective than a Pain Education and Mindfulness (PEM) programme at reducing CPSP intensity at 3-months after breast cancer surgery in high pain-catastrophising patients.

Methods Women having primary breast cancer surgery were screened for pain-catastrophising characteristics using the Pain Catastrophising Scale (PCS). Patients scoring >24 received 4 one-hour sessions with the same psychologist, randomised 1:1 to receive either CBT or PEM. The primary outcome was Brief Pain Inventory (BPI) average pain severity measured at 3-months. Secondary outcomes included BPI composite pain-interference scores, PCS scores, and Hospital Anxiety and Depression Scale Score (HADS).

Results Among CBT patients, BPI average pain intensity (95% CI) significantly decreased from baseline 2.5(1.4-3.6) to 1.3(0.4-2.3) at 3months (P=0.035), but not in PEM group who measures 2.9(1.8-4.0) at baseline, decreasing to 2.5(1.5-3.4) at 3-months (P=0.375). However, there was no statistically significant between-group difference at 3-months. Similarly, there were significant within-group improvements in pain-interference, catastrophising and mood scores across both study arms after 3-months, but no between-group differences were found at 3-months.

Abstract OP017 Table 1

Efficacy analysis for primary and key secondary outcomes

Conclusions Four one-to-one, perioperative CBT or PEM sessions to patients with high pain catastrophising characteristics, achieved comparable reductions in pain-intensity at 3-months after breast cancer surgery. Perioperative psychology might help to reduce the incidence of CPSP in breast cancer surgery.

  • breast cancer
  • postoperative pain
  • chronic persistent post-surgical pain
  • neuropathic pain
  • cognitive behaviour therapy.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.