Age: every 10-yr decrement |
11 030 patients (22 studies), median follow-up 12 mo | No serious risk of bias† | No serious inconsistency | No serious indirectness | No serious imprecision | Undetected; symmetric funnel plot; Begg test p = 0.8; Egger test p = 0.8 | High | OR 1.36 (1.24–1.48) | 30% for age 70 yr‡ | 7% more (5% to 9% more) patients with per 10-yr decrement of age having persistent pain |
Radiotherapy: yes v. no |
9468 patients (16 studies), median follow-up 23.5 mo | No serious risk of bias† | No serious inconsistency | No serious indirectness | No serious imprecision | Undetected; symmetric funnel plot; Begg test p = 0.6; Egger test p = 0.2 | High | OR 1.35 (1.16–1.57) | 30% | 7% more (3% to 10% more) patients with radiotherapy having persistent pain |
Axillary lymph node dissection (ALND): yes v. no or ALND v. sentinel lymph node biopsy |
7699 patients (13 studies), median follow-up 12 mo | No serious risk of bias† | No serious inconsistency | No serious indirectness | No serious imprecision | Undetected; symmetric funnel plot; Begg test p > 0.9; Egger test p = 0.5 | High | OR 2.41 (1.73–3.35) | 30% | 21% more (13% to 29% more) patients with ALND having persistent pain |
Acute postoperative pain, measured with 10-cm pain scale: better indicated by lower values |
1387 patients (5 studies), median follow-up 17.5 mo | No serious risk of bias† | No serious inconsistency | No serious indirectness | No serious imprecision | Uncertain: only 5 studies | High | OR 1.16 (1.03–1.30) | 30% for 1 cm on a 10-cm scale‡ | 3% more (1% to 6% more) patients with per 1-cm increment of acute pain on 10-cm pain scale having persistent pain |
Preoperative pain: yes v. no |
2504 patients (8 studies) median follow-up 7.5 mo | No serious risk of bias† | No serious inconsistency | No serious indirectness | Serious imprecision§ | Uncertain: only 8 studies | Moderate | OR 1.29 (1.01–1.64) | 30% | 6% more (0% to 11% more) patients with preoperative pain having persistent pain |
BMI: every 5-point increment |
3178 patients (8 studies) median follow-up 12 mo | No serious risk of bias† | No serious inconsistency | No serious indirectness | No serious imprecision¶ | Uncertain: only 8 studies | High | OR 1.11 (0.99–1.24) | 30% for BMI 25 kg/m2‡ | 2% more (0% to 5% more) patients with per 5-point increment of BMI having persistent pain |
Breast surgery: BCS v. mastectomy/modified radical mastectomy |
8566 patients (17 studies), median follow-up 17.5 mo | No serious risk of bias† | No serious inconsistency | No serious indirectness | No serious imprecision¶ | Undetected; symmetric funnel plot; Begg test p = 0.2; Egger test p = 0.8 | High | OR 1.08 (0.90–1.30) | 30% | 2% more (2% less to 6% more) patients with BCS having persistent pain |
Chemotherapy: yes v. no |
8481 patients (17 studies), median follow-up 12 mo | No serious risk of bias† | No serious inconsistency | No serious indirectness | No serious imprecision¶ | Undetected; symmetric funnel plot; Begg test p = 0.6; Egger test p > 0.9 | High | OR 1.12 (0.98–1.29) | 30% | 2% more (0% less to 6% more) patients with chemotherapy having persistent pain |
Endocrine therapy: yes v. no |
8312 (11 studies), median follow-up 27 mo | No serious risk of bias† | No serious inconsistency | No serious indirectness | No serious imprecision¶ | Undetected; symmetric funnel plot; Begg test p = 0.3; Egger test p = 0.2 | High | OR 1.07 (0.94–1.22) | 30% | 1% more (1% less to 4% more) patients with endocrine therapy having persistent pain |