Some patients develop chronic pain in the chest, breast, and/or underarm areas after mastectomy.
Summary
A significant percentage (over a third) of people who undergo mastectomy will go on to develop Post-Mastectomy Pain Syndrome (PMPS), a chronic pain in the breast, chest, and/or underarm areas that can persist for years after mastectomy.
Nerve pain diagnosis, treatment, and prevention may be under-addressed and difficult to manage in the breast. Despite this under-diagnosis, there are options to prevent and mitigate this chronic pain condition. Some groups of doctors and physical therapists have developed interdisciplinary approaches to address the issue in patients who have already had surgery.
Current research suggests that breast surgery can damage or affect sensory nerves in the breast, which may cause PMPS. These nerves are often disturbed as part of standard mastectomy techniques.
Patients who have yet to have breast surgery should know that careful nerve handling during mastectomy may prevent PMPS. Some breast surgeons and plastic surgeons are working to establish mastectomy practices that preserve, protect, and otherwise manage nerves during mastectomy and lymph node dissection.
Treatment Options
PMPS is best addressed through an interdisciplinary approach that is tailored to the individual patient’s needs. Treatment modalities include physical therapy, pharmaceutical pain management, local anesthesia, and reparative surgery. These options are typically introduced sequentially. Surgery, including nerve reconstruction procedures, is considered after non-surgical options have been exhausted.