AAAPT Diagnostic Criteria for Acute Pain Following Breast Surgery.

Journal Article (Journal Article)

Acute pain after breast surgery decreases the quality of life of cancer survivors. Previous studies using a variety of definitions and methods report prevalence rates between 10% and 80%, which suggests the need for a comprehensive framework that can be used to guide assessment of acute pain and pain-related outcomes after breast surgery. A multidisciplinary task force with clinical and research expertise performed a focused review and synthesis and applied the 5 dimensional framework of the AAAPT (Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks [ACTTION], American Academy of Pain Medicine [AAPM], American Pain Society [APS] Pain Taxonomy) to acute pain after breast surgery. Application of the AAAPT taxonomy yielded the following: 1) Core Criteria: Location, timing, severity, and impact of breast surgery pain were defined; 2) Common Features: Character and expected trajectories were established in relevant surgical subgroups, and common pain assessment tools for acute breast surgery pain identified; 3) Modulating Factors: Biological, psychological, and social factors that modulate interindividual variability were delineated; 4) Impact/Functional Consequences: Domains of impact were outlined and defined; 5) Neurobiologic Mechanisms: Putative mechanisms were specified ranging from nerve injury, inflammation, peripheral and central sensitization, to affective and social processing of pain. PERSPECTIVE: The AAAPT provides a framework to define and guide improved assessment of acute pain after breast surgery, which will enhance generalizability of results across studies and facilitate meta-analyses and studies of interindividual variation, and underlying mechanism. It will allow researchers and clinicians to better compare between treatments, across institutions, and with other types of acute pain.

Full Text

Duke Authors

Cited Authors

  • Schreiber, KL; Belfer, I; Miaskowski, C; Schumacher, M; Stacey, BR; Van De Ven, T

Published Date

  • 2020

Published In

Volume / Issue

  • 21 / 3-4

Start / End Page

  • 294 - 305

PubMed ID

  • 31493489

Pubmed Central ID

  • PMC8290886

Electronic International Standard Serial Number (EISSN)

  • 1528-8447

Digital Object Identifier (DOI)

  • 10.1016/j.jpain.2019.08.008


  • eng

Conference Location

  • United States