Advances in the management and prevention of chronic pain following breast cancer surgery

Abstract

Post-mastectomy pain syndrome (PMPS) is a prevalent long-term complication after breast cancer surgery, affecting about 25-40% of survivors. Its causes are diverse, including surgical injury, adjuvant treatment, and individual vulnerability, yet these insights have not translated into consistent management. Conventional pharmacological therapies provide only modest benefit, while nerve blocks, cryoneurolysis, radiofrequency techniques, and surgical innovations such as autologous fat grafting or nerve reconstruction show encouraging but still limited evidence. Neuromodulation strategies and complementary approaches, including rehabilitation and psychosocial support, further illustrate the diversity of available options. Despite these advances, fewer than half of affected patients receive targeted interventions, and clinical practice varies widely across regions. This narrative review aims to raise clinical awareness of PMPS and to provide an evidence-based reference for practicing clinicians, it summarizes the latest findings on risk factors, preventive measures, and therapeutic options. We contend that PMPS should be recognized as a significant oncological and surgical challenge, warranting systematic management in routine follow-up.