Association of First-Postoperative-Day C-Reactive Protein Levels with Early Postoperative Inflammatory Response After Mastectomy

Introduction: Chronic post-mastectomy pain is a common and disabling survivorship problem, and growing evidence suggests that early postoperative inflammation may contribute to its development. C-reactive protein is an accessible biomarker of surgical inflammatory response. This study aimed to evaluate whether first-postoperative-day C-reactive protein levels are associated with subsequent chronic post-mastectomy pain.Material and methods: This descriptive cross-sectional study was conducted at Tabriz University of Medical Sciences in ۲۰۲۲ on ۵۰ women undergoing mastectomy, selected by convenience sampling. Sample size was estimated using the Cochran single-group formula. The main variables included first-postoperative-day serum C-reactive protein level and chronic post-mastectomy pain at follow-up, alongside demographic, clinical, surgical, oncologic, and postoperative variables potentially related to pain development.Results: Among ۵۰ women undergoing mastectomy, ۱۹ (۳۸.۰%) developed chronic post-mastectomy pain. Mean first-postoperative-day CRP was significantly higher in patients with chronic pain than in those without pain (۳۶.۲ ± ۱۱.۶ vs ۲۳.۹ ± ۸.۷ mg/L, P < ۰.۰۰۱). Axillary lymph node dissection (۸۴.۲% vs ۵۴.۸%, P = ۰.۰۳۴), longer operative time (۱۲۷.۹ ± ۲۵.۱ vs ۱۰۹.۸ ± ۲۱.۶ minutes, P = ۰.۰۱۱), and early postoperative complications (۳۶.۸% vs ۱۲.۹%, P = ۰.۰۴۶) were also associated with pain development.Conclusion: Elevated first-postoperative-day CRP was independently associated with chronic post-mastectomy pain, suggesting that an intensified early postoperative inflammatory response may play an important role in pain chronification after breast cancer surgery.

کلیدواژه ها:

C-reactive protein ، chronic post-mastectomy pain ، postoperative inflammation ، mastectomy