Dale J. Langford, PhD, Brian Schmidt, DDS, MD, PhD, Jon D

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Preoperative Breast Pain Predicts Persistent Breast Pain and Disability After Breast Cancer Surgery Dale J. Langford, PhD, Brian Schmidt, DDS, MD, PhD, Jon D. Levine, MD, PhD, Gary Abrams, MD, Charles Elboim, MD, Laura Esserman, MD, Deborah Hamolsky, RN, MS, Judy Mastick, RN, MS, Steven M. Paul, PhD, Bruce Cooper, PhD, Kord Kober, PhD, Marylin Dodd, RN, PhD, Laura Dunn, MD, Bradley Aouizerat, PhD, MAS, Christine Miaskowski, RN, PhD Journal of Pain and Symptom Management Volume 49, Issue 6, Pages 981-994 (June 2015) DOI: 10.1016/j.jpainsymman.2014.11.292 Copyright © 2015 American Academy of Hospice and Palliative Medicine Terms and Conditions

Fig. 1 Plots of the estimated marginal means over time among the pain groups for the mixed effects models for a) state anxiety, b) depressive symptoms, c) sleep disturbance, d) fatigue, and e) energy. Statistically significant findings: State anxiety—group effect: P<0.001 and time effect: P<0.001; Depressive symptoms—group effect: P<0.001 and time effect: P<0.001; Sleep disturbance—group effect: P<0.001 and time effect: P=0.004; Fatigue—group effect: P=0.002; Energy—group effect: P=0.003. CES-D=Center for Epidemiological Studies–Depression Scale; GSDS=General Sleep Disturbance Scale. Journal of Pain and Symptom Management 2015 49, 981-994DOI: (10.1016/j.jpainsymman.2014.11.292) Copyright © 2015 American Academy of Hospice and Palliative Medicine Terms and Conditions

Fig. 2 Plots of the estimated marginal means over time among the pain groups for the mixed effects model for a) grip strength, b) flexion, c) abduction, d) internal rotation, and e) external rotation. Statistically significant findings: Flexion—group effect: P=0.03, time effect: P<0.001, Group×Time interaction: P=0.02; Abduction—group effect: P=0.007, time effect: P<0.001, Group×Time interaction: P<0.001; External rotation—time effect: P<0.001, Group×Time effect: P=0.03. kg=kilograms. Journal of Pain and Symptom Management 2015 49, 981-994DOI: (10.1016/j.jpainsymman.2014.11.292) Copyright © 2015 American Academy of Hospice and Palliative Medicine Terms and Conditions

Fig. 3 Plots of the estimated marginal means over time among the pain groups for the mixed effects model for the percentage of breast scar sites reported as less sensitive (green), the same (blue), and more sensitive (red) than the unaffected breast. Statistically significant findings: Percentage less sensitive—group effect: P=0.04, time effect: P<0.001; Percentage the same—group effect: P=0.004, time effect: P=0.001 (For interpretation of references to color in this figure legend, the reader is referred to the web version of this article.). Journal of Pain and Symptom Management 2015 49, 981-994DOI: (10.1016/j.jpainsymman.2014.11.292) Copyright © 2015 American Academy of Hospice and Palliative Medicine Terms and Conditions

Fig. 4 Plots of the estimated marginal means over time among the pain groups for the mixed effects models for a) total quality of life (QOL), b) physical well-being, c) psychological well-being, d) social well-being, and e) spiritual well-being. Statistically significant findings: Total QOL—group effect: P<0.001 and time effect: P=0.005; Physical well-being—group effect: P<0.001 and time effect: P<0.001; Psychological well-being—group effect: P<0.001 and time effect: P<0.001; Social well-being—group effect: P<0.001 and time effect: P<0.001. Journal of Pain and Symptom Management 2015 49, 981-994DOI: (10.1016/j.jpainsymman.2014.11.292) Copyright © 2015 American Academy of Hospice and Palliative Medicine Terms and Conditions