Persistent Breast Cancer Pain

Abstract

Fortunately, with advances in screening and management, the prognosis of breast cancer has substantially improved. However, as patients with breast cancer are living much longer, consequences of management are becoming increasingly apparent, particularly persistent pain after breast cancer surgery. This pain disorder, referred to as Post-Mastectomy Pain Syndrome (PMPS) is common and typically presents as pain with neuropathic features around the surgical incision. This pain disorder is associated with negative effects on the patient’s social and psychological well-being as well as increased healthcare expenditures. Despite the common occurrence of this disorder, it is vastly under-recognized with a lack of preventative and treatment options. This chapter aims to outline the management of persistent breast surgery pain. The pathophysiology and etiology will be reviewed, followed by tools that clinicians can implement in order to appropriately diagnose neuropathic pain. Pertinent risk factors that are commonly seen in practice will be outlined, followed by non-pharmacological, pharmacological, and interventional therapeutic options that can be offered.