Post-Mastectomy Pain Syndrome

Breast cancer is a journey. From diagnosis and treatment, to breast reconstruction and long term side effects, a breast cancer patient faces a number of physical and psychological challenges. Our surgeons are dedicated to improving the lives of patients who have been affected by breast cancer by offering advanced surgical treatments for a number of cancer treatment related side effects, including post-mastectomy pain syndrome.

Following breast cancer surgery, some women may experience persistent pain in the chest wall, armpit, arm and/or shoulder. During surgery, the nerves in the breast and underarm area may become damaged, causing persistent nerve pain known as Post-Mastectomy Pain Syndrome (PMPS). It is estimated that anywhere between 20-60% of women experience symptoms of PMPS after breast cancer surgery. PMPS may occur in both patients who have undergone a mastectomy, as well as those who have had breast-conserving surgery.

What are the symptoms of PMPS?

PMPS is defined as neuropathic (nerve) pain affecting the area of a previous breast surgery. While pain after surgery is common, if the pain persists for longer than three months this may be indicative of PMPS. Most commonly, patients with PMPS experience nerve pain in the chest wall and/or nerve pain in the armpit. Nerve pain after surgery may also be experienced in the arm and/or shoulder. Patients with PMPS often describe the following symptoms:

  • Stinging, Burning or Tingling in chest, armpit, arm and/or shoulder
  • Numbness in chest, armpit, arm and/or shoulder
  • Dull or Aching Pain in chest, armpit, arm and/or shoulder
  • Stabbing Pain or Shooting Pain in armpit, chest, arm and/or shoulder

These symptoms may be exacerbated by movement, making it difficult to complete everyday tasks. The physical limitations and chronic pain associated with PMPS can significantly impact a patient’s quality of life.

What treatments are available for PMPS?

Like many other neuropathic pain conditions, the treatment of PMPS often focuses on temporary solutions to alleviate pain. Treatment often begins with oral medication and physical therapy. There are a number of medications available that may provide temporary symptom relief for nerve pain, but these do not address the underlying source of the pain, requiring medications to be taken daily. Physical therapy can be very effective in decreasing and in some cases, eliminating the pain associated with PMPS for some patients. Even when pain relief is not achieved, physical therapy is essential to maintain a patient’s range of motion and strength.

A nerve block may also be performed to temporarily alleviate pain. During this procedure, a small amount of numbing medication is injected into the nerve that is believed to be injured. Pain relief from a nerve block confirms that the injected nerve is causing the pain. Patients who experience pain relief following a nerve block may be candidates for surgical intervention.

What surgical treatment is available for PMPS?

At The Institute for Advanced Reconstruction, we perform nerve surgery to treat PMPS. Prior to surgery, we perform a diagnostic nerve block to identify the affected nerve. This nerve is then surgically cut above the injury site, removing the damaged nerve tissue. The end of the nerve is then placed into a nearby muscle, decreasing and potentially preventing misdirected nerve growth, which can contribute to pain. We can also move soft tissue from a nearby area into the affected area to help pain and sensitivity, as well as minimize tissue deformities that may be present due to breast cancer surgery.

What are the potential benefits of PMPS surgery?

Our surgeons specialize in treating nerve injuries and have successfully treated patients from around the world. Surgical treatment for PMPS has been found to be effective in alleviating pain, providing a long term treatment solution. Patients that are also interested in breast reconstruction may be able to undergo a procedure to restore their breast shape and volume at the same time as PMPS surgery.

In addition to PMPS, we offer advanced surgical treatment options for a number of cancer treatment side effects including: lymphedema, chemotherapy-induced neuropathy and radiation induced brachial plexopathy.

 

Contact our office today to learn about your treatment options for Post-Mastectomy Pain Syndrome.

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