Introduction

Post-mastectomy pain syndrome (PMPS) is a chronic pain condition, neuropathic in nature, which can occur following surgery of the breast.

Mastectomy is the surgical removal of the breast, usually to remove a malignant tumor. Mastectomy might also be carried out in conditions like cystic breast disease or if a lump is too big to be removed by lumpectomy.

The pain arising out of PMPS is typically characterized as a dull, burning and aching sensation in the anterior chest, arm and axilla and is exacerbated by movement of the shoulder girdle.

Recent studies report that chronic pain has also been reported after other breast procedures including lumpectomy, breast reconstruction, augmentation and reduction.

Research indicates that an estimated 30% to 60% of women develop this chronic neuropathic pain syndrome after lumpectomy or mastectomy. In addition, younger women are reportedly at a greater risk of developing symptoms of the post mastectomy pain syndrome.

Causes of PMPS

Pain in the post mastectomy pain syndrome usually results from irritation of one or more of the nerves in the chest wall, which may be entrapped by scar tissue or cut during the surgery.

In a few cases, a neuroma or a painful bundle of nerves grows at the stump of a nerve that has been cut. Meanwhile, for some patients with post mastectomy pain, the muscles of the chest, shoulder or arm can also contribute to the pain.

The pain syndrome may also develop as a result of surgical trauma to nerves or if acute pain is not treated properly in the first 24 hours after surgery.

Lastly, some researchers believe that certain psychological factors also play a role in the development of symptoms, apart from actual physical injury or stress.