Table 7 Pain
Author Year Country | Study design | Number of patients | Withdrawals-dropouts | Intervention Breast reduction Mean (SD) | Control No surgery Mean (SD) P values denote intergroup difference if not otherwise depicted | Comments | Directness* | Study limitations* | Precision* |
|---|---|---|---|---|---|---|---|---|---|
Iwuagwu 2006 UK [31] | RCT | 73 I: 36 C: 37 | 0 | EQ-5D Pain: Baseline: 1.88 (0.46) 4 months: 1.46 (0.57) | EQ-5D Pain: Baseline: 1.94 (0.52) 4 months: 2.05 (0.52) p < 0.001 MD 0.59 | EuroQol EQ-5D: The European Quality of Life-5 Dimensions Pain assessment scores are part of the questionnaire. Lower score = less pain, range 1–3 | ? | ? | ? |
Saariniemi 2008 Finland [34] | RCT | 82 I: 40 C: 42 | 18 I: 11 C: 7 | FBAS 11.8 (SD NR) | FBAS 57.9 (SD NR) MD − 46.1 (95% CI − 49.8 to − 40.7), p < 0.0001 | FBAS: Finnish Breast Associated Symptoms questionnaire (Higher scores = more symptoms, range 0–100) | ?/ +  | ? |  +  |
|  |  |  |  | FPQ 7.0 (SD NR) | FPQ 26.5 (SD NR) MD − 19.5 (95% CI − 25.2 to − 14.3), p < 0.0001 | FPQ: Finnish Pain Questionnaire (Higher scores = more pain, range 0–100) |  |  |  |
Freire 2007 Brazil [37] | RCT | 100 I: 50 C: 50 | 8 I: 4 C: 4 | VAS: Lower back Baseline: 5.7 (2.7) 6 months: 1.3 (2.5) | VAS: Lower back pain Baseline: 6.0 (3.3) 6 months: 5.3 (2.8) p < 0.001 | VAS: Visual analogue scale (0: No pain, 10: Intense pain Same cohort as Neto et al. [36]. Lower back pain data identical |  +  | ?/− | ? |
|  |  |  |  | Shoulders Baseline: 6.1 (2.7) 6 months: 1.1 (1.8) p < 0.001 (intragroup difference) | Shoulders Baseline: 6.2 (3.2) 6 months: 6.9 (2.6) p < 0.001 NS (intragroup difference) | A MID of 0.9 has been suggested for VAS [66] |  |  |  |
|  |  |  |  | Neck Baseline: 5.2 (2.9) 6 months: 0.9 (1.3) p < 0.001 (intragroup difference) | Neck Baseline: 4.7 (3.6) 6 months: 5.1 (3.1) p < 0.001 NS (intragroup difference) |  |  |  |  |
Hermans 2005 Netherlands [43] | Non-randomized controlled study | 165 I: 94 C: 71 | 10 I: 10 C: 0 | SF-36 Pain: 77.65 | SF-36 Pain: 57.00 p < 0.001 MD 21 | SF-36: Short Form-36 Health survey (higher score = better health, range 0–100) | ? | ?/− | ? |
|  |  |  |  | EQ-5D Pain: No problems: 51.2% Some problems: 44.0% Many problems: 4.8% | EQ-5D Pain: No problems: 14.1% Some problems: 78.9% Many problems: 7.0% p < 0.001 | EQ-5D: The European Quality of Life-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression). Only 2 dimensions stated in article |  |  |  |
|  |  |  |  | DAS-59 Pain: Almost never: 68% Sometimes: 22% Always/Often: 10% | DAS-59 Pain: Almost never: 2% Sometimes: 18% Always/Often: 80% p < 0.001 | DAS-59: Derriford Appearance Scale 59. Higher scores indicate greater problems Pain scores were all part of QoL-questionnaires |  |  |  |