It’s not unusual to feel pain and discomfort following surgery, particularly a mastectomy. And whilst most of us have some pain in the days and weeks that follow having a breast surgery, some of us continue to have strange sensations for months, or even years following the surgery.
When pain lingers and begins to impact quality of life, this is called post-mastectomy pain syndrome, and is classified as a chronic pain. Post-mastectomy pain syndrome can occur following a mastectomy, or even after breast-conserving surgery, also known as a lumpectomy.
What are the symptoms of post-mastectomy pain syndrome?
If you suffer postmastectomy pain syndrome, you may experience persistent or intermittent pain that comes in waves that affects your chest, armpit, arm or shoulder area. In addition to the pain, you may also experience one or many other symptoms including:
- Itching that can’t be relieved by rubbing or scratching
- A burning sensation
- Increased sensitivity to apin or hyperalgesia
- Shooting pains
- Phantom breast pain
Suffering chronic pain can lead to other health problems, so it’s important to manage your pain and condition with the support of a healthcare team.
Persistent pain can also lead to insomnia which not only leaves you exhausted and more vulnerable to illness, but can impact your mental wellbeing.
Why does it happen?
It’s unclear why some women are more affected by others, however during surgery, some of the nerves in the chest must be severed and it’s possible that the pain is a result of nerve damage caused during this process.
Who is most likely to get this?
It’s reported that up to 30 per cent of women who undergo breast surgery develop symptoms of post-mastectomy pain syndrome, however it’s more common in women who:
- had a full axillary lymph node dissection as opposed to a sentinel lymph node biopsy
- received radiation treatment
- had chemotherapy
- had hormone therapy
Should I see my doctor?
Ongoing pain and discomfort following a mastectomy does not indicate the cancer has returned, or something went wrong as a result of the surgery, however you should not leave yourself to wonder. If the pain or other symptoms are not improving, it is best to discuss with your doctor so together you can make a plan to help you heal correctly, and support any pain you may be experiencing.
If the pain is occurring in the arm or shoulder region, your doctor can check to make sure you are not developing any limitations which may result in you compensating by using your body in other ways and consequently injuring yourself or developing other conditions such as a frozen shoulder.
Your doctor may also consider evaluating you for lymphedema, which is a potential side effect of a mastectomy and lymph node removal, where a blocked lymph system prevents drainage and subsequently causes fluids to build up and cause swelling, and further discomfort.
How is postmastectomy syndrome treated?
Working together with your doctor and healthcare team such as a physiotherapist, the most important first step is to determine where the pain is coming from. For shoulder problems for instance, a series of daily range-of-motion exercises can improve your flexibility and reduce the pain.
No cure for lymphedema is available, but special exercises and massage can help the flow of lymph fluid and help treat it.
Another treatment for lymphedema is compression, which helps to move lymph fluid. There are two ways to have compression therapy, the first one is with a pneumatic compression sleeve that’s connected to a pump to create intermittent pressure, whilst the other is to wear a specially fitted compression sleeve.
It’s important to set expectations early, that chronic pain can take time and a multipronged approach to manage. Exploring acupressure, acupuncture, massage, relaxation exercises and transcutaneous nerve stimulation are all avenues to explore in the treatment and management of postmastectomy pain syndrome.
Maintaining your overall health is also incredibly important to manage the symptoms of pain, including a nutritious diet and regular exercise. These steps will also help you to sleep better at night, allowing you to stay focused and positive about the road ahead.
What’s my long-term outlook?
Every single one of us has a different situation. Your age, health, lifestyle choices etc. are all factors which will influence your chronic pain scale and management, however it’s important to remember that regardless of your situation, in partnership with your doctor, postmastectomy pain syndrome can be managed; it’s simply a matter of developing a personalised plan to determine what control therapies work best for you.