TABLE 1.

Patient characteristics and univariate association with pain outcomes 12 months after surgery

Variable	Baseline Values		Univariate Association with Pain Outcomes at 12 months after surgery
			Surgery Specific Pain Outcomes: Breast Cancer Pain Questionnaire (BCPQ)								General Pain Outcomes: Brief Pain Inventory (BPI)
			Pain Severity Index		Cognitive & Emotional Impact of Pain		Physical Impact of Pain		Sensory Disturbance		BPI Mean		BPI Impairment
	n	mean ± SD, median (Q1, Q3), n (%)	n=201 (0–200, higher is worse)		n=186 (14–56, higher is worse)		n=183 (0–38, higher is worse)		n=181 (0–8, higher is worse)		n=200 (0–10, higher is worse)		n=183 (0–100, higher is worse)
			β (95% CI)	P value	β (95% CI)	P value	β (95% CI)	P value	β (95% CI)	P value	β (99% CI)	P value	β (99% CI)	P value
Demographics
Age, mean ± SD	259	55.5 (12.4)	−1.03 (−2.15, 0.09)	0.071	−0.77 (−1.17, −0.38)	< 0.001	−0.33 (−0.58, −0.07)	0.012	−0.27 (−0.38, −0.17)	< 0.001	−0.02 (−0.12, 0.07)	0.626	−0.31 (−1.3, 0.68)	0.541
Body Mass Index (BMI), mean ± SD	259	27.4 (6.2)	0.37 (−0.05, 0.79)	0.085	0.19 (0.03, 0.35)	0.023	0.1 (−0.01, 021)	0.065	0.04 (−0.01, 0.08)	0.097	0.06 (0.02, 0.1)	0.005	0.71 (0.19, 1.23)	0.007
Education College graduate n (%)	257	196 (76.3)	−6.81 (−14.41, 0.79)	0.079	−1.84 (−4.16, 0.48)	0.121	−2.96 (−4.82, −1.1)	0.002	−0.47 (−1.17, 0.23)	0.187	−1.08 (−1.69, −0.46)	0.001	−8.83 (−15.85, −1.8)	0.014
Race/ethnicity*, n (%)	258
Caucasian		223 (86.4)	Reference	---	Reference	---	Reference	---	Reference	---	Reference	---	Reference	---
African American		7 (2.7)	29.78 (−4.43, 63.98)	0.088	6.24 (0.07, 12.4)	0.047	7.33 (1.55, 13.11)	0.013	1.13 (−0.57, 2.82)	0.192	1.56 (−0.45, 3.58)	0.129	34.69 (9.16, 60.22)	0.008
Hispanic/Latina		5 (1.9)	−5.25 (−12.52, 2.01)	0.156	−1.71 (−7.84, 4.42)	0.585	−0.04 (−4.03, 3.94)	0.982	1.18 (−1.13, 3.49)	0.316	−0.62 (−1.5, 0.26)	0.169	−4.82 (−15.6, 5.97)	0.379
Asian		11 (4.3)	−1.07 (−14.98, 12.83)	0.88	3.5 (−1.16, 8.15)	0.141	0.56 (−2.72, 3.84)	0.736	−0.53 (−2.09, 1.04)	0.506	−0.35 (−1.47, 0.77)	0.544	−2.64 (−14.54, 9.26)	0.663
Mixed race		8 (3.1)	−3.45 (−14.08, 7.19)	0.524	3.26 (−2.6, 9.12)	0.275	2 (−1.94, 5.94)	0.319	1.06 (−0.55, 2.68)	0.196	−0.63 (−1.38, 0.13)	0.104	−5.33 (−11.17, 0.51)	0.074
Other		4 (1.6)	1.47 (−20.66, 23.6)	0.896	−0.99 (−8.05, 6.07)	0.782	2.36 (−3.92, 8.63)	0.462	−0.34 (−2.65, 1.98)	0.775	0.85 (−1.59, 3.29)	0.493	5.35 (−16.8, 27.5)	0.635
Lifestyle
Alcoholic beverages per week, n (%)	259
None		97 (37.5)	Reference	---	Reference	---	Reference	---	Reference	---	Reference	---	Reference	---
1–4		105 (40.5)	−7.25 (−13.53, −0.96)	0.024	−0.73 (−2.79, 1.32)	0.483	−1.35 (−2.83, 0.13)	0.075	−0.61 (−1.2, −0.01)	0.047	−0.15 (−0.66, 0.36)	0.554	−1.04 (−6.45, 4.37)	0.706
5–10		48 (18.5)	−4.59 (−12.39, 3.2)	0.248	−1.36 (−3.82, 1.1)	0.277	−1.39 (−3.14, 0.36)	0.118	−0.68 (−1.45, 0.09)	0.082	−0.08 (−0.72, 0.56)	0.808	−1.6 (−8.34, 5.14)	0.642
10–20		9 (3.5)	−6.46 (−17.11, 4.2)	0.235	−2.16 (−7.12, 2.8)	0.393	−1.47 (−4.84, 1.89)	0.389	−0.73 (−2.17, 0.7)	0.316	0.73 (−0.56, 2.02)	0.266	8.31 (−5.54, 22.16)	0.239
Weekly exercise amount, median (Q1, Q3); Self-reported, each instance >15 min, 1 point mild, 2 points moderate, 3 points heavy exercise	259	12.0 (6.0, 19.5)	0.1 (−0.16, 0.37)	0.44	−0.1 (−0.18, −0.01)	0.031	−0.01 (−0.07, 0.06)	0.83	−0.01 (−0.03, 0.02)	0.499	0 (−0.02, 0.02)	0.817	−0.17 (−0.43, 0.09)	0.207
Surgical Variables
Previous breast surgery, n (%)	259	66 (25.5)	2.21 (−4.58, 8.99)	0.524	0.5 (−1.56, 2.56)	0.632	0.35 (−1.09, 1.79)	0.634	−0.3 (−0.89, 0.29)	0.317	0.18 (−0.39, 0.75)	0.531	−0.34 (−5.9, 5.23)	0.906
Bilateral surgery, n (%)	257	53 (20.6)	−1.78 (−8.18, 4.63)	0.586	0.47 (−1.75, 2.69)	0.676	0.14 (−1.39, 1.66)	0.861	0.23 (−0.42, 0.88)	0.492	0.12 (−0.42, 0.66)	0.657	1.64 (−4.38, 7.67)	0.592
Surgery/reconstruction type, n (%)	259
Breast conserving surgery (Lumpectomy)		136 (52.5)	Reference	---	Reference	---	Reference	---	Reference	---	Reference	---	Reference	---
Mastectomy		34 (13.1)	4.43 (−4.09, 12.94)	0.308	2.06 (−0.68, 4.81)	0.14	2.41 (0.27, 4.56)	0.028	1.12 (0.24, 2)	0.013	0.9 (0.18, 1.62)	0.015	5.32 (−2.47, 13.12)	0.181
Mastectomy with reconstruction - tissue expander		68 (26.3)	0.73 (−5.34, 6.8)	0.814	0.48 (−1.61, 2.57)	0.656	0.91 (−0.48, 2.3)	0.198	0.37 (−0.25, 0.98)	0.24	0.21 (−0.33, 0.75)	0.447	2.17 (−3.51, 7.84)	0.454
Mastectomy with reconstruction - autologous		21 (8.1)	−0.72 (−10.49, 9.05)	0.885	3.54 (0.19, 6.9)	0.039	2.22 (−0.65, 5.09)	0.13	1.17 (0.18, 2.17)	0.021	0.23 (−0.62, 1.08)	0.594	3.19 (−5.86, 12.24)	0.489
Node surgery type, n (%)	259
No auxillary surgery		52 (20.1)	Reference	---	Reference	---	Reference	---	Reference	---	Reference	---	Reference	---
Sentinel lymph node procedure		165 (63.7)	1.28 (−4.48, 7.05)	0.663	0.29 (−1.75, 2.34)	0.78	0.79 (−0.59, 2.17)	0.261	0.37 (−0.24, 0.99)	0.235	0.29 (−0.27, 0.84)	0.311	5.25 (0.46, 10.05)	0.032
Axillary lymph node dissection		42 (16.2)	15.17 (5.2, 25.13)	0.003	6.33 (2.96, 9.71)	< 0.001	4.03 (1.78, 6.29)	< 0.001	1.78 (0.95, 2.61)	< 0.001	0.7 (−0.05, 1.44)	0.066	8.45 (1.04, 15.85)	0.025
Medical Treatment within first year after surgery
Radiation therapy, n(%)	256	146 (57.3)	3.28 (−2, 8.55)	0.223	1.57 (−0.2, 3.34)	0.082	0.74 (−0.49, 1.98)	0.236	0.25 (−0.27, 0.78)	0.344	−0.09 (−0.55, 0.37)	0.711	−0.22 (−5.03, 4.59)	0.928
Chemotherapy, n (%)	256	92 (35.9)	5.45 (0.1, 10.8)	0.046	3.89 (2, 5.78)	< 0.001	2.61 (1.21, 4.01)	< 0.001	1.11 (0.59, 1.63)	< 0.001	0.38 (−0.07, 0.83)	0.1	4.82 (−0.61, 10.25)	0.082
Hormone therapy, n (%)	255	126 (49.6)	4.01 (−1.16, 9.18)	0.129	−0.08 (−1.93, 1.77)	0.931	−0.21 (−1.46, 1.04)	0.738	0.44 (−0.09, 0.97)	0.102	−0.05 (−0.49, 0.39)	0.821	1.18 (−3.71, 6.06)	0.637
Baseline pain (Breast Cancer Pain questionnaire, BCPQ)
Pain Severity Index (PSI) (severity × frequency in 4 surgical areas, median) (Q1, Q3)	258	0.0 (0.0, 4.0)	0.95 (0.44, 1.45)	< 0.001	0.34 (0.21, 0.47)	< 0.001	0.18 (0.08, 0.28)	< 0.001	0.07 (0.04, 0.1)	< 0.001	0.62 (0.48, 0.75)	<0.001	5.67 (3.64, 7.7)	<0.001
Highest Severity in surgical area median (Q1, Q3)	259	0.0 (0.0, 2.0)	3.77 (1.57, 5.97)	0.001	1.35 (0.71, 1.99)	< 0.001	0.81 (0.41, 1.22)	< 0.001	0.35 (0.21, 0.49)	< 0.001
Physical Impact, median (Q1, Q3)	226	0.0 (0.0, 0.0)	3.06 (1.38, 4.74)	< 0.001	0.68 (0.2, 1.17)	0.006	0.74 (0.41, 1.07)	< 0.001	0.21 (0.09, 0.32)	< 0.001	0.05 (0.03, 0.06)	<0.001	0.51 (0.33, 0.7)	<0.001
Severity of chronic pain in other area(s), median (Q1, Q3)	228	0.0 (0.0, 3.0)	1.37 (0.06, 2.67)	0.04	0.6 (0.15, 1.05)	0.009	0.44 (0.13, 0.76)	0.006	0.09 (−0.01, 0.19)	0.087	0.33 (0.23, 0.43)	<0.001	3.39 (2.13, 4.65)	<0.001
Opioid use, n (%)	255	13 (5.1)	8.22 (−5.15, 21.59)	0.227	3.7 (−0.53, 7.93)	0.087	3.74 (0.74, 6.73)	0.015	0.1 (−1.19, 1.38)	0.884	1.87 (0.74, 3)	0.001	10.48 (−2.61, 23.57)	0.116
Psychosocial Variables
Pain Catastrophizing Scale (PCS total), median (Q1, Q3)	246	4.0 (1.0, 9.0)	0.29 (−0.2, 0.78)	0.24	0.31 (0.14, 0.48)	< 0.001	0.12 (0, 0.24)	0.059	0.05 (0.01, 0.09)	0.008	0.06 (0.02, 0.09)	0.002	0.76 (0.34, 1.18)	<0.001
Anxiety (PROMIS SF), median (Q1, Q3)	256	17.0 (13.0, 20.0)	0.35 (−0.25, 0.94)	0.254	0.45 (0.26, 0.64)	< 0.001	0.09 (−0.02, 0.2)	0.126	0.06 (0, 0.11)	0.034	0.02 (−0.02, 0.06)	0.324	0.42 (−0.13, 0.98)	0.133
Depression (PROMIS SF), median (Q1, Q3)	259	11.0 (9.0, 14.0)	0.47 (−0.19, 1.13)	0.163	0.61 (0.4, 0.81)	< 0.001	0.14 (0, 0.28)	0.057	0.08 (0.02, 0.14)	0.006	0.04 (−0.02, 0.09)	0.18	0.52 (−0.11, 1.15)	0.103
Sleep Disturbance (PROMIS SF), median (Q1, Q3)	250	21.0 (16.0, 26.0)	0.85 (0.4, 1.31)	< 0.001	0.33 (0.19, 0.47)	< 0.001	0.18 (0.09, 0.28)	< 0.001	0.06 (0.03, 0.1)	0.001	0.06 (0.03, 0.09)	<0.001	0.61 (0.24, 0.99)	0.001
Negative Affect (PANAS), median (Q1, Q3)	246	17.0 (13.0, 20.0)	0.33 (−0.12, 0.79)	0.15	0.46 (0.28, 0.64)	< 0.001	0.13 (0.01, 0.26)	0.035	0.07 (0.02, 0.11)	0.009	0.04 (0, 0.07)	0.065	0.61 (0.11, 1.12)	0.018
Positive Affect (PANAS), median (Q1, Q3)	246	35.0 (30.0, 39.0)	−0.14 (−0.49, 0.2)	0.409	−0.28 (−0.4, −0.16)	< 0.001	−0.1 (−0.19, −0.01)	0.025	−0.05 (−0.09, −0.02)	0.004	−0.02 (−0.05, 0.01)	0.209	−0.21 (−0.55, 0.12)	0.207
Somatization (BSI), median (Q1, Q3)	248	7.0 (6.0, 8.0)	2.84 (1.07, 4.61)	0.002	1.11 (0.62, 1.6)	< 0.001	0.73 (0.39, 1.07)	< 0.001	0.23 (0.1, 0.35)	< 0.001	0.33 (0.23, 0.44)	<0.001	2.73 (1.22, 4.23)	<0.001
Coping Strategies Questionnaire subscales, median (Q1, Q3)
Behavioral	250	5.0 (3.0, 7.0)	−0.07 (−0.88, 0.75)	0.871	−0.09 (−0.36, 0.18)	0.496	0.03 (−0.16, 0.22)	0.776	−0.03 (−0.11, 0.05)	0.472	−0.03 (−0.1, 0.04)	0.433	−0.31 (−1.1, 0.47)	0.434
Catastrophizing	249	0.0 (0.0, 2.0)	1.25 (−0.33, 2.83)	0.12	0.43 (−0.05, 0.91)	0.077	0.33 (−0.02, 0.068)	0.063	0.06 (−0.08, 0.21)	0.401	0.15 (0.02, 0.28)	0.027	2.11 (0.57, 3.64)	0.007
Diverting	251	4.0 (1.0, 6.0)	0.17 (−0.71, 1.05)	0.703	−0.08 (−0.37, 022)	0.612	0.02 (−0.19, 0.24)	0.819	−0.02 (−0.1, 0.07)	0.734	−0.02 (−0.1, 0.06)	0.601	−0.08 (−0.91,0.74)	0.843
Ignoring	249	5.0 (2.0, 6.0)	0.68 (−0.25, 1.6)	0.151	−0.22 (−0.52, 0.08)	0.158	0.01 (−0.21, 0.23)	0.917	−0.02 (−0.11, 0.07)	0.664	0.02 (−0.06, 0.1)	0.63	0.08 (−0.79, 0.94)	0.864
Praying	249	3.0 (0.0, 5.0)	0.11 (−0.85, 1.06)	0.826	0 (−0.33, 0.34)	0.978	0.09 (−0.13, 0.32)	0.427	0.03 (−0.07, 0.12)	0.612	−0.05 (−0.13, 0.03)	0.258	−0.16 (−1.01, 0.69)	0.711
Reinterpreting	251	1.0 (0.0, 3.0)	−0.31 (−1.29, 0.66)	0.526	−0.09 (−0.43, 0.24)	0.595	0.02 (−0.21, 0.26)	0.838	−0.02 (−0.12, 0.08)	0.705	−0.08 (−0.16, 0.01)	0.083	−0.17 (−1.08, 0.75)	0.719
Self Statements	251	5.0 (3.0, 8.0)	0.39 (−0.48, 1.27)	0.38	−0.08 (−0.36, 0.2)	0.569	0 (−0.2, 0.2)	0.975	−0.03 (−0.11, 0.06)	0.549	0 (−0.07, 0.07)	0.992	−0.1 (−0.89, 0.68)	0.798
Psychophysical Variables (Quantitative Sensor Testing, QST)
Territorial Summation of Pain, median (Q1, Q3)	257	1.9 (1.0, 3.8)	0.13 (−1.34, 1.6)	0.861	0.27 (−0.2, 0.73)	0.256	0.08 (−0.26, 0.41)	0.643	0.13 (−0.01, 0.27)	0.065	0.06 (−0.06, 0.18)	0.343	0.36 (−1.01, 1.74)	0.607
Painful After-Sensations, median (Q1, Q3)	256	0.0 (0.0, 0.2)	0.81 (−6.28, 7.89)	0.823	−0.77 (−2.87, 1.34)	0.475	0.03 (−1.5, 1.56)	0.971	0.35 (−0.3, 1)	0.288	−0.28 (−0.83, 0.27)	0.318	−1.39 (−7.45, 4.67)	0.653
Pressure pain threshold-forearm, median (Q1, Q3)	257	4.8 (3.7, 6.2)	−0.03 (−0.18, 0.12)	0.714	−0.02 (−0.07, 0.03)	0.385	−0.01 (−0.04, 0.03)	0.678	−0.01 (−0.02, 0.01)	0266	0 (−0.01,0.01)	0.768	−0.03 (−0.17, 0.11)	0.695
Pressure pain threshold-trapezius, median (Q1, Q3)	254	7.2 (5.0, 9.6)	0.09 (−0.81, 1)	0.837	−0.12 (−0.4, 0.16)	0.392	0.03 (−0.16, 0.22)	0.759	0 (−0.08, 0.09)	0.983	0.02 (−0.05, 0.09)	0.573	0.04 (−0.72, 0.8)	0.915
Pressure pain tolerance-forearm median (Q1, Q3)	257	7.4 (5.4, 9.4)	−0.01 (−0.98, 0.97)	0.991	−0.04 (−0.34, 0.25)	0.774	0.04 (−0.17, 0.25)	0.736	0.03 (−0.06, 0.12)	0.539	0 (−0.08, 0.08)	0.955	0.14 (−0.68, 0.97)	0.738
Pressure pain tolerance-trapezius, median (Q1, Q3)	254	10.4 (7.3, 13.7)	−0.32 (−1.03, 0.4)	0.383	−0.13 (−0.37, 0.1)	0.268	−0.06 (−0.23, 0.1)	0.449	−0.02 (−0.09, 0.05)	0.513	0 (−0.06, 0.06)	0.999	−0.03 (−0.69, 0.62)	0.924

Beta coefficients, 95% confidence intervals, and p values were estimated using simple linear regression models of pain outcomes 12 months after surgery with multiple imputation to account for missing data

Darker colored cells indicate significance of univariate association at the 0.05 level, and lighter cells the 0.1 level; each outcome has an associated color which corresponds to colors in Fig. 4

PROMIS SF Patient-Reported Outcomes Measurement Information System Short Form, PANAS Positive And Negative Affect Schedule, BSI Brief Symptom Inventory

^*Considered in univariate but not included in LASSO