Post-mastectomy Pain Syndrome

After having breast cancer surgery, some women have nerve (neuropathic) pain in the chest wall, armpit, and/or arm that doesn’t go away. This is called post-mastectomy pain syndrome (PMPS) because it was first noticed in women who had mastectomies. It can also happen after breast-conserving surgery (such as a lumpectomy).

What are the symptoms of post-mastectomy pain syndrome (PMPS)?

Post-mastectomy pain syndrome (PMPS) feels like:

• Pain and tingling in the chest wall, armpit, and/or arm
• Pain in the shoulder or surgical scar.
• Numbness, shooting or pricking pain, or unbearable itching.

How common is post-mastectomy pain syndrome (PMPS)?

PMPS is most common after operations that remove tissue in the upper outside portion of the breast or the underarm area.

PMPS is thought to be caused by damage to the nerves in the armpit and chest during surgery. Women who are more likely to have problems with PMPS are:

• Younger women who have had a full axillary lymph node dissection (ALND) and not just a sentinel lymph node biopsy
• Women who were treated with radiation after surgery
• Women with excess weight
• Women with anxiety or depression

PMPS is less common than it once was because ALND is done less often.

Managing post-mastectomy pain syndrome (PMPS)

PMPS can keep you from being able to use your arm like you used to, but there are options to manage it.

Treatments

• Gabapentin – Medicine used to treat nerve pain
• Venlafaxine – Medicine used to treat symptoms that you might have with nerve pain, such as hot flashes
• Surgical- Used to treat scars
• Complementary care and self- care - such as guided imagery and music therapy
• Physical therapy – often used to relieve symptoms, such as making movement in arms better

Talk to your cancer care team about these options to see what may work best for you.