Post-Breast Surgery Pain Syndrome: Shifting a Surgical Paradigm

Abstract

Summary: Post-mastectomy pain syndrome and the less well-described post-breast surgery pain syndrome are long-term neuropathic pain conditions that may affect more than 50% of patients after mastectomy and breast surgery. While the etiology, risk factors, and management have been reviewed in our literature, we offer here a focused outline that will gear the plastic surgeon with tools to lead a multidisciplinary, algorithmic approach to the care of patients with post-mastectomy pain syndrome/post-breast surgery pain syndrome. After reading this article, we hope the reader will have improved awareness of post-mastectomy pain syndrome/post-breast surgery pain syndrome, and thus be able to incorporate appropriate treatments and preventative steps into their primary surgical routine.

Postmastectomy Functional Impairments

“…This is largely due to the regenerative properties of adipose tissue which contains adipose-derived stem cells involved in secreting pro-survival cytokines and growth factors [ 16 ]. In addition, both amitriptyline and venlafaxine, two commonly used antidepressants, have demonstrated significant effectiveness in reducing PMPS-associated pain [ 17 ]. For those who choose not to take medication or do not benefit from it, peripheral blocks offer an effective alternative [ 18 ] (Table 1 ).…”

Changes in lymph node surgery in breast cancer and preoperative drug prescription analysis for postoperative pain management: A retrospective, cross-sectional study

“…For patients with stage 1 and 2 breast cancer, postoperative pain management plays an essential role in minimizing the risk of chronic pain, collectively referred to as “persistent postmastectomy pain” [ 32 , 33 ]. To examine the status of pain management after lymph node surgery in patients with breast cancer, this study analyzed the percentage of prescriptions of pain medication according to surgery type for the preoperative period, index date, and postoperative period.…”

Postmastectomy Pain Syndrome: A Narrative Review

“…According to reports in the literature, 20-68% of breast cancer survivors suffer from some degree of PMPS [7,8]. In a Danish study by Vilholm et al, the prevalence of PMPS was reported to be 24% in 258 surgically treated breast cancer patients [9].…”