Post‐surgical events and persistent pain after breast cancer surgery: a reply
Bibliographic record
Abstract
We thank Dr Subedi [1] for commenting on our article [2]. Subedi pointed out that neuropathic symptoms, such as painful cold sensation at 2 weeks following general, orthopaedic or vascular surgery [3] and scar hyperesthesia at 6 weeks after augmentation mammoplasty [4] were independently associated with chronic post-surgical pain. Furthermore, previous studies have shown that neuropathic pain is highly prevalent in breast cancer survivors [5]. While we assessed and reported data related to pain in the immediate postoperative period, and at 4 months, our follow-up at 4 months included questions adapted from the neuropathic pain subscale of the short-form McGill pain questionnaire-2 (SF-MPQ-2). We found that 129 of 135 patients (95.6%) with persistent pain experienced at least one of these symptoms, compared with 51 of 75 patients (68.0%) without persistent pain (p < 0.001). In addition, the median number of neuropathic pain symptoms was higher in patients with persistent pain (3) than those without (1), p < 0.001 (Table 1). Subedi also suggested that differences in pain trajectories, rather than pain intensity, may be predictive of persistent pain after breast cancer surgery. Utilising subject-wise linear model analyses [6], we determined the pain trajectory of each participant within 72 h of breast cancer surgery and classified them into decreasing, no change or increasing trajectories (Table 2). Our analysis found no significant difference in pain trajectories between patients who developed persistent pain at 4 months compared with those who did not experience persistent pain. Lastly, Subedi noted that postoperative chemotherapy may be associated with persistent pain. Our data showed no significant difference in postoperative chemotherapy between patients with persistent pain (41%), compared with those without (36%), p = 0.500. Similarly, we found no significant difference in postoperative radiation therapy between the groups (persistent pain 45% vs no persistent pain 36%, p = 0.196). In summary, we found that a significantly greater proportion of patients with persistent pain after breast cancer surgery also had neuropathic pain symptoms compared with those who did not develop persistent pain. However, we did not find a significant association between postoperative pain trajectories within 72 h, or chemotherapy and radiation therapy with persistent pain at 4 months. Nonetheless, it should be noted that our study was not designed or powered for these analyses, and the potential association of these factors with persistent pain should be investigated in future studies.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.047 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.003 | 0.007 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.016 | 0.028 |
| Insufficient payload (model declined to judge) | 0.004 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".