Prospective Observational Study of Post Surgical Pain in Women undergoing Mastectomy Surgery: Post Surgical Pain After Mastectomy (PPAM) Study
- 1Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Grossman School of Medicine
Abstract
ObjectivesBreast cancer survivors who have undergone mastectomy are at risk of developing Post Mastectomy Pain Syndrome (PMPS), and socio-demographic factors such as race, ethnicity, and neighborhood disadvantage have been posited as risk factors for the development of PMPS. This observational study assessed development of PMPS across different racial/ethnic and socio-demographic categories for women undergoing mastectomy.
MethodsThis prospective, observational study included women between 18 and 85 years of age, undergoing mastectomy surgery. The primary outcomes were the Brief Pain Inventory (BPI) pain severity subscale and the presence of PMPS, defined as the binary indicator of BPI average item score > 0, at 3 months post-surgery. Outcomes were assessed across different racial/ethnic and socio-demographic categories. Associations were evaluated using covariate-adjusted robust and logistic regression.
ResultsOne hundred women were enrolled, and 89 completed the primary outcome assessment. Mean BPI pain severity at 3 months was higher in the non-White group (mean 0.99, SD 1.37) than in the White group (mean 0.60, SD 1.03; p=0.062). After multivariable adjustment, the difference was not statistically significant (regression coefficient for the White vs non-White group, -0.24; 95% CI, -0.78 to 0.19; p=0.263). PMPS was present in 51.5% of the non-White group and 35.1% of the White group. Adjusted odds of PMPS were lower in the White group but not statistically significant (OR 0.39, 95% CI 0.12 to1.17; p=0.099). BPI pain severity did not differ significantly by income, education, insurance type, or marital status.
ConclusionThis prospective observational study of pain after mastectomy surgery shows that there were no statistically significant adjusted differences in pain scores or the rate of development of PMPS at 3 months between White and non-White participants. The direction and uncertainty of the estimates support further investigation in larger, more diverse cohorts.
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BibTeX
@misc{umeh2026prospective,
title = {{Prospective Observational Study of Post Surgical Pain in Women undergoing Mastectomy Surgery: Post Surgical Pain After Mastectomy (PPAM) Study}},
author = {U. O. Umeh and H. G. Park and R. Cuevas and H. Martinez and R. Perez and J. P. Cata and J. Wang and L. V. Doan},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.19.26363470},
url = {https://www.medrxiv.org/content/10.64898/2026.09.19.26363470v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Prospective Observational Study of Post Surgical Pain in Women undergoing Mastectomy Surgery: Post Surgical Pain After Mastectomy (PPAM) Study
AU - U. O. Umeh
AU - H. G. Park
AU - R. Cuevas
AU - H. Martinez
AU - R. Perez
AU - J. P. Cata
AU - J. Wang
AU - L. V. Doan
PY - 2026
DA - 2026/09/19
PB - medRxiv
DO - 10.64898/2026.09.19.26363470
UR - https://www.medrxiv.org/content/10.64898/2026.09.19.26363470v1
AB - ObjectivesBreast cancer survivors who have undergone mastectomy are at risk of developing Post Mastectomy Pain Syndrome (PMPS), and socio-demographic factors such as race, ethnicity, and neighborhood disadvantage have been posited as risk factors for the development of PMPS. This observational study assessed development of PMPS across different racial/ethnic and socio-demographic categories for women undergoing mastectomy. MethodsThis prospective, observational study included women between 18 and 85 years of age, undergoing mastectomy surgery. The primary outcomes were the Brief Pain Inventory (BPI) pain severity subscale and the presence of PMPS, defined as the binary indicator of BPI average item score > 0, at 3 months post-surgery. Outcomes were assessed across different racial/ethnic and socio-demographic categories. Associations were evaluated using covariate-adjusted robust and logistic regression. ResultsOne hundred women were enrolled, and 89 completed the primary outcome assessment. Mean BPI pain severity at 3 months was higher in the non-White group (mean 0.99, SD 1.37) than in the White group (mean 0.60, SD 1.03; p=0.062). After multivariable adjustment, the difference was not statistically significant (regression coefficient for the White vs non-White group, -0.24; 95% CI, -0.78 to 0.19; p=0.263). PMPS was present in 51.5% of the non-White group and 35.1% of the White group. Adjusted odds of PMPS were lower in the White group but not statistically significant (OR 0.39, 95% CI 0.12 to1.17; p=0.099). BPI pain severity did not differ significantly by income, education, insurance type, or marital status. ConclusionThis prospective observational study of pain after mastectomy surgery shows that there were no statistically significant adjusted differences in pain scores or the rate of development of PMPS at 3 months between White and non-White participants. The direction and uncertainty of the estimates support further investigation in larger, more diverse cohorts.
ER -